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Impacted tooth extraction

Impacted tooth extraction — surgical removal of teeth retained within bone or gum tissue.

A procedure that surgically removes teeth (especially wisdom teeth) that have not fully erupted and remain covered by bone and soft tissue.

Indication

  • Recurrent pericoronitis (infection around a wisdom tooth)
  • Pressure-related decay or root resorption in the adjacent second molar
  • Cyst or tumor formation associated with the impacted tooth
  • Suspected unexplained jaw-facial pain or neuralgia
  • Need to gain space before or during orthodontic treatment
  • A wisdom tooth that cannot erupt properly due to insufficient jaw space

Preparation

  • Panoramic and, when needed, cone-beam computed tomography (CBCT) to evaluate tooth position and its relation to the mandibular canal and maxillary sinus
  • Review of medical history, medications (blood thinners, bisphosphonates), and allergies
  • Necessary consultations for patients with systemic diseases
  • Light meal before the procedure; reduction of smoking
  • Arrange a companion to take the patient home (mandatory if sedation is planned)

How it's performed

  1. Local anesthesia is applied; sedation or, rarely, general anesthesia may be selected when needed
  2. A small flap is raised over the gum
  3. If necessary, the bone covering the tooth is carefully removed
  4. The tooth is often divided into sections to facilitate removal
  5. All fragments of the tooth are removed, the socket is cleaned, and sutures are placed if needed
  6. A pad is placed to control bleeding

Post-procedure

  • Cold compresses for the first 24 hours, then warm compresses if needed, to manage swelling and pain
  • Use of recommended pain relievers and antibiotics if needed
  • Avoid rinsing, spitting, smoking, and alcohol for the first 24 hours
  • Soft, lukewarm diet; protect the chewing area in the first week
  • Suture removal or follow-up within 7-10 days; consult your dentist if swelling persists, fever develops, or numbness occurs

Risks

  • Swelling, pain, and temporary limitation in jaw opening (trismus)
  • Dry socket (alveolar osteitis) — more common in smokers
  • Temporary or, rarely, permanent numbness in the lip, chin, or tongue due to proximity to the mandibular nerve in lower wisdom teeth
  • Possible communication with the maxillary sinus in upper wisdom teeth
  • Surgical site infection, hematoma

FAQ

Do I have to extract my wisdom tooth?

Wisdom teeth that cause no symptoms and have erupted properly with full function generally do not require routine extraction. Extraction is recommended in cases of recurrent infection, decay, pressure on the adjacent tooth, or cyst formation.

How long does the procedure take, and is it painful?

Most surgical extractions take 30-60 minutes. You will feel no pain during the procedure thanks to local anesthesia; you may feel pressure. Afterward, pain is controlled with the recommended medications.

How many days will I be off work?

Most patients return to daily life within 2-3 days. The rest period may be slightly longer for those with heavy physical work or when two teeth are extracted in the same session.

Will I have numbness in my lip?

When lower wisdom teeth are close to the inferior alveolar nerve, temporary and, much more rarely, permanent numbness may develop. This risk is evaluated with a CT scan before the procedure.