Should Wisdom Teeth Go?
How we judge whether a wisdom tooth is better out or left in, what makes one flare up and hurt, what happens on the day of removal, and how to help it heal.
Do My Wisdom Teeth Need to Come Out, and How Much Does Removal Cost in Lanark?
Not unless they're causing problems or are clearly heading that way. The usual reasons for removal are gum infections that keep coming back around a part-erupted tooth, decay that can't be repaired, harm to the molar next door, or a cyst seen on an X-ray. Healthy wisdom teeth, including ones that are still buried, are normally best left where they are. At Lanark Smile Studios, a surgical or wisdom tooth extraction costs £450. If a lower tooth lies close to the nerve, we can take a 3D CT scan here in the practice, and IV sedation is available if you'd prefer not to be aware of the procedure.
Why They Can Often Stay
Your wisdom teeth are the third molars. They're the last teeth to come in, generally at some point between the ages of 17 and 25. For some people they arrive straight and do the same job as any other back tooth. For others the jaw runs out of room, and the tooth stays below the gum or comes through tilted. Dentists describe that as impacted.
A tooth doesn't have to come out simply because it's impacted. UK guidance advises against removing wisdom teeth that are healthy and trouble-free, whether or not they've come through. Many people keep impacted wisdom teeth for life without a single problem. Every operation carries some risk, and when a tooth is doing no harm, that risk isn't worth running.
Instead, we monitor them. During your dental examinations we check their position and take an occasional X-ray, so if one begins to decay or damage the tooth beside it, we find out before it starts to hurt.
When Removal Makes Sense
| The problem | Why it matters |
|---|---|
| Repeated pericoronitis | The gum covering a part-erupted tooth becomes infected over and over. Having two or more bouts is a frequent reason to take the tooth out |
| A decayed wisdom tooth | So far back, it's often impossible to fill properly or to keep clean |
| Harm to the tooth in front | Food packs in between the two teeth and causes decay on the back of the second molar, the tooth that really matters for chewing |
| Gum disease and bone loss | Deep pockets round the wisdom tooth put the support of the neighbouring molar at risk |
| A cyst or other change seen on an X-ray | Sacs of fluid sometimes develop around buried teeth and gradually destroy bone |
| Injury to the cheek or gum | An upper wisdom tooth biting into the gum over a lower one, or catching the inside of the cheek |
We'll tell you which of these is happening, and talk about leaving the tooth alone and watching it as an option too. The decision is yours, and the fee will be in writing before anything is booked. 1
Trouble with a Wisdom Tooth?
Book in for an X-ray, and we'll explain what can be done.
What Makes a Wisdom Tooth Hurt
Most painful wisdom teeth are down to pericoronitis. Part of the tooth is hidden under a flap of gum, food and bacteria collect beneath it, and the gum becomes inflamed. Signs include an unpleasant taste, pain on swallowing, a stiff jaw that won't open all the way, or a swollen face on that side. It tends to flare up when you're tired, run down or fighting a cold.
The first time, it usually calms down with careful cleaning, using a soft brush right at the back of the mouth, along with warm salt-water rinses several times a day. We can clean beneath the flap for you, and if the upper wisdom tooth is biting into the swollen gum, smoothing it or taking that upper tooth out often stops the problem coming back. Antibiotics are only worth prescribing if the infection is spreading or you have a fever. For repeated bouts, taking out the lower tooth is the long-term answer.
Decay in the wisdom tooth, or in the molar in front of it, can also be the source of the pain, and an X-ray will show it. Go to A&E if swelling makes swallowing or breathing difficult, or spreads up towards your eye or down into your neck.
Scanning Before an Extraction
Before we take out a wisdom tooth, we take an X-ray that shows all of it, including the roots and the surrounding bone. In the lower jaw there's a nerve running through the bone just below the roots of the wisdom tooth. It supplies feeling to the lower lip and chin, and a branch close by supplies part of the tongue. For many teeth, an ordinary X-ray shows plenty of space between the roots and the nerve, and that's all we need.
If the roots appear to be close to the nerve, we take a 3D CT scan, £160, using the scanner we have here, so there's no need to travel anywhere else. 1 It shows precisely how the roots and nerve are positioned, so we can plan the safest way to take the tooth out and give you an honest idea of the risk in your case. Sometimes the scan points to a different approach as the safer choice, such as removing just the crown of the tooth and leaving the roots behind. Our CT scan guide explains more about the scan.
The Day of Your Extraction
We numb the area thoroughly with local anaesthetic, so you'll be aware of pressure and pushing but not sharp pain. If the wisdom tooth has fully come through, it can often be removed in much the same way as any other tooth. A buried or partly erupted tooth needs a surgical extraction. We lift back a small flap of gum, sometimes remove a little bone around the tooth, and often split the tooth into sections so each one comes out with less force. A few stitches, which dissolve on their own, close the gum afterwards. Most extractions take anywhere from 20 minutes to an hour.
If the X-ray or scan suggests a tooth will be especially difficult, we'll tell you before booking anything. If it would be safer in the hands of a hospital oral surgery team, we'll refer you to them.
Sedation for Nervous Patients
Plenty of people would prefer not to be fully alert while a wisdom tooth is taken out, and that's an entirely sensible request. IV sedation is given through a thin tube in a vein, alongside the usual local anaesthetic. You can still hear us and respond, but you'll feel relaxed and sleepy, and afterwards you'll probably remember very little.
Sedation is £500 per session, with £250 for each additional 30 minutes. 1 You'll need a responsible adult to take you home and stay with you until bedtime. For 24 hours you mustn't drive, operate machinery or sign anything important. Our IV sedation guide covers how to get ready.
Helping the Socket Heal
Three to five days is how long most people take to feel themselves again. The first 48 hours are the most uncomfortable, and swelling tends to be at its worst on the second or third day.
- Bite firmly on the gauze for 20 minutes. If it starts to ooze again later, do the same with a fresh piece
- Have your first painkillers while you're still numb, then keep taking them regularly, at the dose on the packet, for a couple of days
- For the first 24 hours, avoid hot drinks, alcohol, smoking, vaping, using a straw and rinsing vigorously, as any of these can dislodge the clot
- Eat soft food that's lukewarm, and chew on the opposite side
- From the following day, rinse gently with warm salty water after you eat, and brush the rest of your teeth as normal
- A cold pack held on the cheek during the first 24 hours helps keep swelling down
- Give the gym a miss for a few days, and keep your head a little raised at night
If the pain starts getting worse around day three or four instead of easing, perhaps with a nasty taste, the clot may have come away. This is called a dry socket. Give us a ring, and we can place a soothing dressing in the socket, which eases it quickly.
Fees for Wisdom Tooth Treatment
| Treatment | Fee |
|---|---|
| Surgical or wisdom tooth extraction | £450 |
| Extraction of a tooth that's fully through | £125 |
| Examination for new patients, including X-rays | £70 |
| Emergency appointment on the day for a flare-up | £85 |
| 3D CT scan where the roots are near the nerve | £160 |
| IV sedation, each session | £500 |
The fee is set out in your written plan before treatment starts, and dental plan members get 10% off extractions and scans. 1 If it's hurting now, call 01555 662441. On the days we're open, we keep emergency appointments available for anyone, registered with us or not. You'll find every fee on our price list.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.