Wisdom teeth: when they really need removing

Wisdom teeth are the last to appear, often when space has run out. But their presence is not an automatic sentence: extraction is a clinical decision, not a routine.

When we extract

Symptomatic impactions: pain, recurrent infections (pericoronitis), cysts.
Unrestorable decay or damage to the neighbouring molar.
Selected orthodontic reasons, assessed with the specialist.

When we monitor

A healthy, well-positioned, cleanable wisdom tooth can stay for life with periodic checks. International guidance (such as the UK's NICE) advises against prophylactic removal of asymptomatic, disease-free wisdom teeth.

How we assess

Clinical examination plus panoramic X-ray; in complex cases 3D CBCT defines the relationship with the alveolar nerve. When surgery is needed, it happens under local anaesthesia — with conscious sedation for anxious patients.

Sources

National Institute for Health and Care Excellence (NICE), guidance on wisdom teeth removal — against prophylactic extraction of healthy asymptomatic teeth.
European Commission, Radiation Protection No 172 (SEDENTEXCT) — CBCT justification in complex cases.

Frequently asked questions

Do wisdom teeth always need removing?

No: if healthy, properly erupted and cleanable, they are monitored. Extraction is considered for symptomatic impactions, unrestorable decay, recurrent pericoronitis or damage to neighbouring teeth.

Is extraction painful?

It is performed under local anaesthesia, with conscious sedation if you wish. Recovery is managed with ice, rest and common painkillers.

How long is recovery?

Usually a few days for simple extractions, up to a week for complex impactions: we provide written instructions and stay reachable.