Wisdom Tooth Extraction

Wisdom teeth are removed here in Petersburg when they are impacted, repeatedly infected, decayed, or damaging the tooth in front. A simple extraction takes 20 to 40 minutes under local anaesthetic; a surgical one 45 to 90, with sedation available, and most patients have all four out in one visit. Recovery is two to three days for a simple removal and about a week for a surgical one.

Do yours need to come out?

Not all wisdom teeth do. A wisdom tooth that has come through fully, sits where a brush reaches, and causes no trouble is just a tooth. Removal is for the ones that are:

• Impacted — stuck against the tooth in front or under bone, never going to come through properly
• Repeatedly infected — a partly erupted tooth leaves a gum flap that traps food; one episode may settle, a second usually means removal
• Decayed where a brush cannot reach and a filling will not last
• Damaging the second molar, a tooth you actually need
• Associated with a cyst on the X-ray
• Likely to flare up at a bad time — before orthodontics, a deployment, or a move abroad

Our article on when wisdom teeth need to come out goes through each situation, and the decision is made from an X-ray and an exam, not by default.

Simple or surgical?

The appointment

1. Assessment and X-ray. A panoramic image shows the roots, the nerve that runs below the lower wisdom teeth, and how the tooth sits. That decides simple versus surgical, and whether sedation is worth having.
2. Numbing. Topical gel, then local anaesthetic. We do not start until the area is fully numb. Sedation, if chosen, is given first — see sedation dentistry.
3. Removal. You feel pressure and pushing, not pain. If anything feels sharp, tell us and we add more anaesthetic.
4. Closing. Surgical sites usually get a few dissolving stitches. You bite on gauze for 20 minutes while a clot forms.
5. Going home with written aftercare and a number to call. After anything beyond local anaesthetic you need a driver.

The facts, at a glance

• Best age: late teens to early twenties, before roots fully form — easier removal, faster healing
• Numb for: 2–4 hours; do not eat until it wears off
• Swelling: peaks at 48–72 hours; cold packs on day one, warm from day three
• Pain relief: ibuprofen if safe for you, started before the numbness fades
• No straws, smoking or spitting: 72 hours minimum — suction pulls out the clot
• Stitches: dissolve in about a week

Recovery, honestly

Day one is about protecting the clot: cool soft food, no straws, no rinsing. Day two the swelling is at its worst and cold packs help. By day three or four most people are on soft solids on the other side, and by the end of the week eating is close to normal. Our day-by-day guide to what to eat after wisdom tooth removal and our home care instructions cover it in detail.

What to call about: pain that gets worse after day three rather than better, often radiating to the ear, is usually dry socket — the clot has been lost. It is treated in minutes with a dressing. Swelling that grows after day three, fever, or a bad taste that returns after rinsing also need a call.

Risks worth knowing

Dry socket affects a small minority, mostly smokers and those who use straws early. Temporary numbness of the lip, chin or tongue can follow removal of a lower wisdom tooth whose root sits close to the nerve; the X-ray tells us in advance if that is the case, and we discuss it with you before deciding. Persistent numbness is rare. Infection is uncommon and treatable.

Frequently Asked Questions

Q: Does wisdom tooth removal hurt?
A: Not during the procedure — the area is fully numbed, and sedation is available if you would rather not be aware of it. Afterwards, expect soreness and swelling for a few days, peaking around day two or three and manageable with the pain relief we advise.

Q: How much does it cost to have wisdom teeth removed?
A: Typically $150 to $350 per tooth for a simple extraction and $250 to $650 for a surgical one, with sedation extra. Insurance usually covers extractions as a basic or major service. We quote in writing after the X-ray, and check your benefits first.

Q: Should I have all four out at once?
A: Most patients prefer it — one appointment, one recovery, and sedation makes a longer visit comfortable. If your health or the complexity of one tooth makes it wiser to split the treatment, we will say so.

Q: How long does recovery take?
A: Two to three days for a simple extraction and five to seven for a surgical one. Swelling peaks around day two or three. Soft food, no straws or smoking, and gentle salt-water rinses from day two protect the socket and prevent dry socket.

Q: Can I drive home?
A: After local anaesthetic alone, yes. After nitrous oxide, once it has cleared, which takes a few minutes. After oral or IV sedation you must have someone drive you and stay with you for a few hours.

Q: What is dry socket?
A: The blood clot protecting the socket is lost, exposing the bone. It causes pain that worsens around day three or four, often spreading to the ear, and does not settle on its own — but a medicated dressing relieves it quickly. Avoiding straws, smoking and spitting for 72 hours is the main prevention.

Book an assessment

If your wisdom teeth have started to ache, or have never been X-rayed, an assessment settles whether they can stay. Call (804) 732-8557 or request an appointment at our Petersburg office — and mention if you would like sedation so we allow for it.