What happens during a wisdom tooth extraction?

Wisdom tooth eruption is a notorious cause of dental pain and the majority of people will notice discomfort as these molars push through the gums. Unfortunately, for many, the complications don’t stop there. Our dental anatomy means that oftentimes there is not enough space in the mouth for wisdom teeth to emerge fully and the overhanging gums can easily trap bacteria leading to infections and tooth decay. Wisdom teeth can also be impacted meaning they grow sideways instead of upwards. In this instance, wisdom tooth extraction may be recommended as a means of pain management or to prevent further issues from arising. 

If you are experiencing ongoing pain caused by wisdom teeth or have been recommended wisdom tooth extraction then you are likely to feel nervous about what is to come. This is completely normal. Tooth extraction is a major decision and for those with dental phobias, it can be particularly frightening. However, at West Grove Dental, we have seen that having a clear understanding of what to expect before, during, and after the extraction can make a significant difference to your peace of mind, which is why we have explained exactly what is involved in a wisdom tooth extraction so you feel prepared.

What are wisdom teeth? 

Wisdom teeth are the final set of molars that typically emerge at the back of the mouth, usually between the ages of 17 and 25. While some people experience no issues with their wisdom teeth, others may find that there isn’t enough space for them to come through properly.

When should you see a dentist about your wisdom teeth? 

You don’t need to wait until symptoms become severe to seek advice. Early assessment can often prevent discomfort from developing into something more complex.

It may be helpful to book an appointment if you notice:

• Tenderness or swelling at the back of the mouth
• Difficulty cleaning around the area
• Food becoming trapped near the tooth
• Intermittent discomfort when biting or chewing
• Pain that doesn’t ease with basic hygiene practices 
• Any of the above combined with an unpleasant taste even after brushing 

How will a dentist decide whether wisdom tooth extraction is necessary? 

The decision to remove a wisdom tooth is always made carefully and collaboratively, with your comfort and long term oral health in mind. Rather than being a single moment of decision, this is usually a step by step process that allows your dentist to fully understand your situation and guide you appropriately:

1. Listening to your experience: Your dentist will begin by taking time to understand what you’ve been feeling. This may include pain, pressure, swelling, or repeated infections, but also how these symptoms are affecting you day to day. If you feel anxious, this is also a space to share any concerns about treatment.
2. Gentle clinical examination: A careful examination of your mouth allows your dentist to assess the area around the wisdom tooth. This is always carried out at a pace that feels comfortable, with clear explanations so you know what is happening and why.
3. X-rays and imaging: Dental X-rays provide a more complete picture of how the wisdom tooth is positioned beneath the surface. This helps identify whether the tooth is impacted, close to nerves, or likely to cause problems in the future.
4. Understanding the cause of symptoms: Your dentist will combine what they can see clinically with your symptoms and imaging results to understand exactly what is happening. 
5. Exploring all appropriate options: Where possible, conservative approaches may be discussed first, such as improved cleaning techniques or medication. If these are unlikely to resolve the issue, your dentist will explain why.
6. Clear, honest explanation of recommendations: If extraction is advised, your dentist will talk you through the reasoning in a calm and straightforward way. This includes what the procedure involves and how your comfort will be prioritised throughout.
7. Time to ask questions and reflect: You will never be expected to make a decision immediately. You will have time to ask questions, consider your options, and feel confident in your understanding before moving forward. 

Repeated infections or persistent pain are among the most common reasons for extraction. However, your dentist will never rush this decision unless it is deemed an emergency. Instead, they will work alongside you to ensure you feel informed and reassured with the next steps.

Types of wisdom tooth extraction 

There are two types of wisdom tooth extraction and the one you receive will depend only on whether the tooth has fully erupted (can be seen above the gum line) or whether it is still fully or partially below the gum line.

• Simple extraction: A tooth that is fully erupted will require a simple extraction. Because the tooth is easily accessible, it will be loosened and gently removed followed by a thorough clean of the area.
• Surgical extraction: A tooth that has only partially erupted or is still wholly below the gum will require surgical extraction. This involves making a small incision in the gum that allows us access to the tooth which will then be divided into smaller sections so it can be removed with minimal chance of causing trauma to the surrounding teeth and gums. 

We understand that the thought of surgical extraction can cause distress, but rest assured that experienced dental teams will discuss the option of sedation prior to the procedure. We will always put your comfort first. 

Will a wisdom tooth extraction hurt?

This is one of the most common concerns we hear from our patients, and an entirely understandable one.

During the procedure itself, the area will be fully numbed using local anaesthetic, meaning you should not feel pain. You may feel some pressure or movement, but your dentist will check in with you throughout to ensure you remain comfortable.

After the procedure, some discomfort is normal as the area heals. This is manageable with the aftercare guidance and medication your dentist provides. Any persistent pain should be investigated. 

Importantly, you are always in control. If at any point you feel uncomfortable, you can pause treatment and check in with the surgeon. 

Preparing for your wisdom tooth extraction

Feeling prepared ahead of your appointment can make a significant difference, not only to the practical side of your treatment, but also to how you feel in the days leading up to it. 

Your dentist will guide you

Before your extraction, your dentist will provide clear, personalised instructions so you know exactly how to prepare. 

Depending on your treatment, this may include:

• Advice on eating and drinking before your appointment
• Guidance on medications you should take or avoid
• Arranging for someone to accompany you or take you home if needed

You will also have the opportunity to ask questions and talk through any concerns. 

Practical steps to take before your extraction

In addition to your dentist’s guidance, there are small steps you can take at home to make the experience feel more manageable. Taking these steps ahead of time can help you feel more in control, which is particularly important if you are feeling anxious.

You could:

• Plan a quiet, comfortable space to rest after your appointment
• Prepare soft foods such as yoghurt, soup, or mashed potatoes
• Have any recommended pain relief ready in advance
• Arrange time away from work or commitments if needed
• Make sure you have a clean, soft bristled toothbrush for the coming days
• Invest in a neck pillow to reduce pressure on your jaw overnight
• Create a stash of soothing teas
  
  

Preparing for aftercare

Knowing what happens after your extraction can be just as reassuring as understanding the procedure itself.

Your dentist will explain how to care for the area as it heals, including how to keep it clean, what to eat, and how to manage any discomfort. You will leave your appointment with clear instructions, so you are never left unsure about what to do next.

Questions to ask your dentist

If you feel unsure, asking questions can help you feel more confident and informed. A supportive dental team will always welcome these conversations, and there is no limit to what you can ask. Your dentist will want you to be as informed as possible so they will encourage even the most basic queries. Do not be afraid to make a list if you need to. 

You might ask:

• How many teeth will be extracted?
• Will anaesthesia or sedation be used?
• How long will the procedure take?
• Are there any potential complications?
• Do I need to bring anything to my appointment? 
• How should I prepare for my appointment? 
• Should I book time off work? 
• Will I be conscious during the procedure? 
• Can I eat and drink before the appointment? 
• What do I do if I want the procedure to stop? 

What happens on the day of your extraction? 

Before the extraction

On the day of the treatment, you will need to arrange for someone to take you to and from the surgery. Follow any advice your dentist has given you about diet and arrive at the scheduled time. 

You may be required to fill in some forms that ensure you consent to the surgery and that you have disclosed medications and medical conditions that could impact the procedure. 

Before surgery begins, your dentist will ensure you feel calm, informed, and ready to proceed.

This includes talking through the process, agreeing on signals to pause, and giving you time to ask questions. 

During the extraction

While each procedure varies slightly depending on the position of the tooth, the process is carefully structured to prioritise your comfort at every stage. A typical simple extraction will involve: 

1. Numbing the area thoroughly: The procedure begins with local anaesthetic to ensure the area is completely numb. Your dentist will take time to make sure this has fully taken effect before continuing, so you should not feel pain during the extraction.

2. Gaining gentle access to the tooth: If the tooth is impacted or partially beneath the gum, your dentist may need to carefully access the area. 

3. Loosening the tooth: The tooth is then gently loosened from its position. You may feel some pressure at this stage, but it should not be painful. Your dentist will continue to check in with you throughout.

4. Removing the tooth: Once loosened, the tooth is carefully removed. In some cases, it may be divided into smaller sections to make the process smoother and more comfortable.

5. Cleaning and protecting the area: After the tooth is removed, the area is thoroughly cleaned.

6. Placing stitches if needed: If required, small stitches may be placed to help the area heal. These are often dissolvable and will not need to be removed.

After the extraction 

After the procedure, you may be advised to:

• Rest for the remainder of the day
• Bite gently on gauze to control the bleeding 
• Drink plenty of water 
• Avoid strenuous activity
• Eat soft foods
• Keep the area clean without disturbing it
• Take painkillers as required 
• Replace the gauze every 30 minutes until bleeding stops 
• Gently rinse your mouth with salt water after eating 

When to Contact Your Dentist

While most recoveries are straightforward, you should contact your dentist if you experience:

• Persistent or worsening pain
• Excessive bleeding
• Unusual swelling
• Signs of infection

How long will it take to recover from a wisdom tooth extraction? 

Most patients begin to feel more comfortable within a few days, with initial healing taking around one to two weeks. Your dentist will give you personalised guidance so you know what to expect and feel reassured throughout your recovery.

If you are living with persistent wisdom tooth pain and are nervous about needing wisdom tooth extraction, you are not alone. Having a tooth removed is understandably daunting and for anyone with a dental phobia it can feel like the worst case scenario. However, the right dental team will help you identify what you need throughout the process to make it as easy as possible. 

At West Grove Dental, we have extensive experience in helping patients with dental phobia feel safe, understood, and in control as they navigate wisdom tooth pain and extraction. If you live in the Cardiff area and are seeking dental support that gently helps you overcome your fears, or you have a child who is in need of support from a team of highly trained dentists who really listen, please reach out and book an appointment today. You are in safe hands.