The extraction of wisdom teeth

Wisdom teeth are third molars. They normally grow between 15 and 25 years. They are most often has four (two top, two bottom), but it is not unusual that there are only three, two or none.

The wisdom teeth can be:
completely exits; they say when they are on arcade.
to half-way we tell them when they are isolated.
completely buried under the gum, then they say they are included.



Your maxillo-facial surgeon may offer the extraction of wisdom teeth for different reasons:

- Because they are causing pain and / or recurrent infections often (péricoronarites). This is often the case with wisdom teeth poorly positioned (too horizontal for example) or wisdom teeth that are not normally break up. They are often included or isolated. But it may also be the case of wisdom teeth completely exits (on arcade) but are decayed and why your dentist can offer more conservative treatment.

- After orthodontic treatment, because they will not have enough space to exit normally and that leaving them grow, they might press ahead on other teeth, eventually disrupt the proper alignment and dental would lose everything or part of the benefit of orthodontic treatment.




The extraction of wisdom teeth can be performed:

- Either under local anesthesia. The operation is performed while in the chair, cabinet, in two sessions spaced a reasonable time (3 weeks in general). You are not hospitalized (e). It starts with one side (wisdom tooth top and a wisdom tooth bottom) and then the other side is made during the second meeting.

- Either under general anesthesia. Hospitalization and anesthesia consultation are essential.



Whatever the mode of anesthesia, the surgical technique remains the same and is:

- Incisa the gum when necessary (or isolated teeth) to explain the procedure.

- Identify the tooth fresh bone around him to allow its extraction. This is often the case for the wisdom teeth at the bottom, more rarely on the top.

- Section sometimes the tooth before extracting it when the extraction is difficult (especially the wisdom teeth bottom).

- Extract the tooth.

- Clean and wash the tooth socket. The tooth socket is the hole that remains after the extraction of a tooth. This cavity is filled with blood in post-operative who s'ossifiera progressively to be fully consolidated 2 months after surgery.

- Suture gum with absorbable son who, by their nature, disappear spontaneously in 10 days to 3 weeks. Sometimes the surgeon suture does not the gums of the wisdom tooth of the top because this suture is often unnecessary.

The duration of the intervention varies according to technical difficulties. It is an average of 5 and 10 minutes per tooth to extract.

Principle of extracting a wisdom tooth below (click on the image below to turn against the animated GIF)


The post-operative care include:

- From mouth to begin only 24 to 48 hours after the operation. Of mouth started too early can have small hemorrhages in evacuating the blood clot which usually stops the bleeding.

- Drugs against pain (painkillers).

- Often anti-inflammatories.

- Sometimes antibiotics.

- The application of ice on the cheeks during the first 24 hours (ice has a good anti-inflammatory and anti-edematous).

- A food warm or cold during the first 24 hours. This reduces the risk of bleeding.

- A diet soft during the first days after the operation.

- Brushing teeth should remain careful and rigorous in the post-operative.

- It is better to stop smoking during the post-operative period. The continuation of tobacco favors developing complications from poor healing of the gums.

The operating suites include:

- Small bleeding that can occur in areas made during the first 24 hours.

- The pain in areas made the transfers with painkillers and anti-inflammatory prescribed and generally disappears within a few days.

- The swelling is common. It is unpredictable and varies from person to person. It is often more pronounced in adolescents.

- Restricting painful mouth is open and frequent fades in a few days.


Any medical procedure, even under conditions of competence and safety data conform to current science and regulations in force, carries risks of complications. Today, any surgeon must inform the patient about risks and possible complications of the intervention it will receive. This information must be clear, fair and understandable. It was pure but allow each patient to weigh the risks involved in relation to the benefits it will withdraw from the surgery so that it could take the decision in his soul and conscience, be operate or not.

This notion is particularly important for certain acts of maxillofacial surgery are surgical comfort (plastic surgery of the face, implants, etc.. ...). The listing "literature" of various complications aims to make you fully participate in decisions that affect the health or well-being and make you accountable.

The complications associated with the extraction of wisdom teeth can be:

Nerve damage:

Two nerves pass near the lower wisdom tooth and can therefore be adversely affected in its extraction.

1) The inferior alveolar nerve travels in a canal bone in the lower jaw passing near the roots of teeth. It provides nerves for each tooth then ends up breaking the bone at the chin to the sensitivity of half of upper lip (on the same side). When is too in touch with the roots of the lower wisdom tooth, it can be stretched and injured during the extraction.

This translates into a loss of sensitivity total (anesthesia) or partial (hypoesthesia) of half the lower lip. This loss of sensitivity is temporary and recovers in a few weeks. The permanent loss of the sensitivity of the lip remain exceptional.

The risk of nerve damage that is easily assessable panoramic radiography because you were prescribed shows the relationship between the bony canal in which circulates the nerve roots and the wisdom tooth from below. Your maxillo-facial surgeon so you can specify whether you are more likely than another to make this type of complication.

In very special cases (when the risk of nerve injury seems very important), the maxillo-facial surgeon may prescribe DENTASCANNER (scanner teeth and jaws) to assess the best anatomical relationship between the and the tooth nerve and clarify the risk involved.

2) The lingual nerve travels to the inner side of the mandible, between the bone and tongue, near the wisdom teeth from below. This proximity can be injured during the extraction of wisdom teeth from below.

This is manifested by a loss of sensitivity total (anesthesia) or partial (hypoesthesia) of half the language on the same side. This loss of sensitivity is temporary and recovers in a few days to several weeks. The permanent loss of the sensitivity of the language are exceptional.

The risk of nerve injury is difficult to measure lingual preoperatively.

Infectious complications:

- An infection of the cavity of a tooth extraction (suppurée alveolitis) or cheek (cellulite) may occur a few days to several weeks after extraction (typically the third week post-operative). This complication concerns almost exclusively the wisdom tooth from below. It seems favored by the stagnation of food in the cavity of a tooth extraction. It sells antibiotic treatment with or gesture to a revision of the cavity under local anesthesia. It rarely requires a second under general anesthesia.

- An infection without pus from the tooth socket (alveolitis dry) can occur a few days after the operation. It is mostly about wisdom teeth and the bottom is painful. It often requires local treatment. The establishment of a wick soaked clove (Alvogyl) quickly divest pain.

- The infection of the bone (osteitis) is exceptional.

Bone complications:

- A fracture of the lower jaw remains outstanding. This risk is more with this age. Indeed, over time, the ligament that surrounds the tooth normally ends up s'ossifier; tooth fusion with bone. It s'ankylose and makes extraction more difficult increasing the risk of fracture of the mandible.

- When this complication occurs, it requires at the same time procedure (under general anesthesia), the establishment of a plate and screws osteosynthesis and / or a lock jaw.

- A fracture of the bone surrounding the upper wisdom tooth may occur. It is immaterial and does not require specific treatment.

Dental complications:

- The loss of an amalgam (fillings), a fractured tooth or unsealing of a crown are possible. These complications mainly the second molar teeth that are located just forward of wisdom teeth.

- Some wisdom teeth, especially below, sometimes difficult to root extract, also very close lower alveolar nerve. The desire to extract all costs to root fractured fragment may be a danger to the nerve. The best is often the enemy of the good ", it is sometimes better to leave in place the small piece of root. There was no action in most cases.

- Necrosis (death) of the adjacent molar tooth wisdom can occur when the extraction was difficult in the weeks or months and require a decay of this molar. It is an infection of the latter or pain chewing and / or percussion of the tooth.

Sinusiennes complications:

This type of complication relates exclusively to the wisdom teeth that are high in close contact with cavities located above the upper jaw: the maxillary sinus.

- A communication between the maxillary sinus and mouth can occur during the extraction of the upper wisdom tooth when it is very close to the maxillary sinus. It closes automatically in 10 days to 3 weeks in most cases. But his persistence may require surgical treatment adapted.

- An abnormal migration (dislocation) of the wisdom tooth earlier in the maxillary sinus may occur. This complication is rare. It can justify when it occurs, we open the sinuses through an incision above the upper canine to recover this tooth and avoid the occurrence of sinusitis. The danger of this type of complication is easily assessable through panoramic radiography has been prescribed and that shows the relationship between the maxillary sinuses and wisdom tooth from the top. Your maxillo-facial surgeon so you can specify whether you are more likely than another to make this type of complication. More top tooth is located, the more this risk is important.

- Similarly, a dislocated tooth wisdom from the top rear of the maxillary sinus (in the pit-maxillary ptérygo) may rarely occur. This can cause pain or infection. However, the first surgery of this region are very complex and this region is very rich in blood vessels and nerves, the tooth, if it can not be captured by simple and atraumatic maneuvers, is generally retained.

Other complications:

- A burning the corner of the lips (angle of the mouth), a sore lips or the inner cheeks are benign complications, which will decline a few days.

- Complications hemorrhagic (bleeding endobuccaux too high) may occur and yield to a simple compression (by biting compresses).