Wisdom Tooth Removal

Wisdom teeth — the third molars — usually appear between the late teens and mid-twenties, and for many people they cause no trouble at all. Wisdom teeth that erupt cleanly and can be kept clean need no treatment. Problems tend to arise when there is not enough room, leaving the tooth partly through the gum or angled against its neighbour (impacted). Wisdom tooth removal in London at our Wimpole Street practice covers the whole pathway: assessment, monitoring and, where clinically justified, in-house surgical removal.

Signs that a wisdom tooth may need attention include recurrent soreness or swelling of the gum over the tooth (pericoronitis), difficulty cleaning the area, food trapping, decay in the wisdom tooth or the tooth in front, and occasionally cyst formation seen on X-ray. These signs have several possible causes, so a proper examination — rather than self-diagnosis — is the sensible first step.

Our approach follows NICE guidance: wisdom teeth are removed only when there is a clear clinical justification, such as repeated infection, unrestorable decay or damage to adjacent teeth — not simply because they are present or impacted. Many wisdom teeth are best monitored, and we will tell you honestly when that is the right course. Suitability for removal is always confirmed at an in-person consultation with a GDC-registered dentist.

Assessment begins with an examination and a panoramic X-ray to show the position of the tooth, the shape of its roots and its relationship to important structures. Where the roots sit close to the inferior dental nerve — which supplies feeling to the lip and chin — we take a CBCT 3D scan to map the anatomy precisely before planning any surgery. This imaging stage is central to keeping treatment predictable and risks well understood.

If removal is recommended, we explain the specific findings for your tooth: how it will be removed, whether the gum will need lifting or the tooth sectioning, expected recovery, and the individual risks that apply. Straightforward upper wisdom teeth are often quick, simple extractions; lower impacted teeth are more involved. For anxious patients, intravenous sedation is available so you can be deeply relaxed throughout.

On the day, the area is fully numbed with local anaesthetic — with sedation on top if chosen — and the tooth is removed carefully, sectioning it where that means less pressure and a smaller procedure. Dissolving stitches are placed if the gum has been lifted. Most surgical removals take between thirty and sixty minutes, and you leave with written aftercare instructions and a direct line to the practice if anything concerns you while healing.

Costs at our Marylebone practice are set out clearly in advance: simple extraction from £250, complicated extraction from £450 and surgical extraction from £650, always with a written, itemised quote after your assessment. Cost drivers include the depth and angle of impaction, whether CBCT imaging is required, whether sedation is chosen, and the surgical time involved.

Alternatives are always part of the conversation. Monitoring with periodic X-rays suits many symptom-free impacted teeth. For pericoronitis, treating the infection and improving cleaning sometimes settles the problem without surgery. In selected lower teeth very close to the nerve, coronectomy — removing the crown and leaving the roots — can reduce nerve risk, and complex cases can be referred to oral surgery specialists where that serves you better.

Honest discussion of risks matters. Common, temporary effects include swelling, bruising, jaw stiffness and discomfort for a few days. Dry socket can occur, particularly in smokers. Lower wisdom teeth close to the nerve carry a small risk of temporary — rarely persistent — altered sensation in the lip, chin or tongue; your scan lets us quantify and discuss that risk for your specific anatomy. Individual healing varies.

Aftercare is straightforward: rest for the remainder of the day, avoid rinsing for the first twenty-four hours, then gentle warm salt-water rinses, soft foods and keeping the area clean as it heals. Most patients are comfortable within three to five days after routine extractions, a little longer for surgical cases. A review is included, and we are always available if you have concerns while healing.

Nervous patients often ask what the removal actually feels like, and it is worth answering plainly. With effective local anaesthetic you should feel pressure and movement but not pain — and if you feel anything sharp, you raise a hand and we stop and top up the anaesthetic before continuing. The sounds and sensations are usually the strangest part, which is one reason sedation is popular for lower impacted teeth: most sedated patients report the appointment passing quickly and remember little of it. Telling us about anxiety at booking means we can plan the appointment, and the anaesthetic approach, around it.

Preparing for the appointment helps recovery go smoothly. Eat a normal meal beforehand unless you are having sedation, in which case we give specific fasting and escort instructions in advance. Arrange a quiet rest of the day — most people can work the next day after a simple extraction, while surgical cases often warrant a day or two of lighter activity. Stock soft foods at home, avoid alcohol and strenuous exercise for the first couple of days, and if you smoke, abstaining for as long as possible around the procedure meaningfully reduces the risk of dry socket.

Where monitoring rather than removal is the plan, it has structure too. We record the tooth’s position at baseline, advise you on cleaning around a partially erupted tooth — a single-tufted brush can reach where a normal head cannot — and review at agreed intervals with periodic X-rays where justified. If circumstances change, such as a second episode of pericoronitis or new decay, the balance of the NICE criteria may shift towards removal, and we revisit the decision together rather than leaving it to drift.

The practice is on Wimpole Street in Marylebone, a short walk from Bond Street, Oxford Circus and Regent’s Park underground stations, which matters practically: after sedation you must travel home with an escort, and easy central London transport links make that straightforward for patients coming from across the city. Reviews after surgery are quick visits, easily combined with a trip into town.

Patients choose our central London practice, near Harley Street, for wisdom tooth care because assessment, 3D imaging, surgery and sedation are all available under one roof, without long referral waits. If a wisdom tooth is troubling you — or you simply want to know where you stand — an assessment at our Wimpole Street practice will give you a clear answer and a plan, whether that is removal or simply watchful monitoring.