In 30 seconds: Wisdom teeth (third molars) are extracted when they cause pain, infection, decay or cyst formation, or when they have no room to erupt properly. Surgery takes 30 to 60 minutes under local anaesthesia or IV sedation. Most patients return to normal activities within 3 to 5 days. When performed by a maxillofacial surgeon for impacted cases, the complication rate is under 5%.
Do you actually need your wisdom teeth removed?
Not always. Wisdom teeth that erupt fully, are functional and easy to clean don’t need extraction. Indications for removal are:
- Recurrent pericoronitis — inflammation and infection of the gum overlying a partially erupted tooth.
- Decay (caries) that cannot be restored because the tooth is too far back for proper hygiene or restoration.
- Cyst formation around an unerupted tooth (dentigerous cyst), which can erode the jawbone if left untreated.
- Damage to the adjacent second molar — root resorption, decay on the distal surface.
- Pre-orthodontic clearance when crowding is anticipated as orthodontic treatment progresses.
- Recurrent pain or infection impacting daily life.
A cone-beam CT scan (CBCT) is the most reliable way to plan extraction safely, especially for lower wisdom teeth that lie close to the inferior alveolar nerve.
The procedure step by step
Surgery is performed in three phases:
- Anaesthesia — local injection (and sedation if planned).
- Surgical access — small intra-oral mucosal incision; minimal bone removal when the tooth is fully impacted; tooth sectioned if needed to limit bone resection.
- Closure — gentle irrigation, optional socket preservation graft if implant placement is planned, resorbable sutures.
Each tooth typically takes 15 to 30 minutes. All four teeth in a single session take 60 to 90 minutes under IV sedation or general anaesthesia.
Anaesthesia options
Local anaesthesia only
Suitable for fully erupted teeth or simple partial impactions. You’re awake and aware throughout. 30 to 45 minutes total. You can drive yourself home.
IV sedation
Recommended when:
- Multiple teeth are extracted in one session
- The patient is anxious or has a strong gag reflex
- The tooth is deeply impacted
You won’t remember the procedure. Need someone to drive you home.
General anaesthesia
For complex cases with full bony impaction or four teeth in a single session. Performed in an accredited hospital with an anaesthesia team.
Recovery timeline
| Day | What to expect |
|---|---|
| Day 0 | Local anaesthesia wears off after 2 to 4 hours. Pain controlled with NSAIDs. Ice 20 min on / 20 min off for the first 4 hours. |
| Day 1–2 | Peak swelling. Cold soft diet (yoghurt, smoothies, lukewarm soup). Saline rinse from hour 24. |
| Day 3–5 | Swelling subsides. Most patients return to work. Gradual reintroduction of softer cooked foods. |
| Day 7 | Suture removal or self-dissolution. 90% of the discomfort gone. |
| Day 14 | Solid food fine. Final bone healing in 6 to 8 weeks. |
Dry socket — the complication everyone hears about
Dry socket (alveolar osteitis) happens when the blood clot at the extraction site is lost or fails to form, exposing bone. Signs: severe throbbing pain at day 3 to 5 post-op, bad taste, no clot visible in the socket.
Risk factors:
- Smoking (the largest risk factor — stop 48 hours before and 7 days after).
- Oral contraceptives (slightly increased risk).
- Vigorous rinsing in the first 24 hours.
- Lower wisdom teeth (10x higher risk than upper teeth).
Treatment: the socket is cleaned, an analgesic dressing placed, full recovery in 5 to 7 days. It’s not dangerous — just painful.
Frequently asked questions
Q: How long does wisdom teeth extraction take?
A: 15 to 30 minutes per tooth. All four teeth in one session takes 60 to 90 minutes.
Q: Is wisdom teeth removal painful?
A: Not during the procedure (local anaesthesia or sedation). Some discomfort in the first 2 to 3 days, easily managed with standard pain medication.
Q: When can I exercise after wisdom teeth removal?
A: Light walking from day 2. No gym, running or contact sport for 7 days. Avoid heavy lifting in the first week (increases the risk of bleeding).
Q: Will my jaw be locked?
A: Mild trismus (limited mouth opening) is normal for the first week, especially after lower impactions. Gentle exercises help. Resolves in 2 to 3 weeks.
Q: Why use a CBCT for wisdom teeth?
A: For lower wisdom teeth close to the inferior alveolar nerve, a 3D scan reduces the risk of nerve injury and helps plan the safest extraction technique.
Q: Can I keep my wisdom teeth if they don’t hurt?
A: Yes, if they are fully erupted, in good position and easy to clean. Asymptomatic deeply impacted teeth are reviewed case by case; some can stay if they pose no risk.
Q: Should the dentist or the maxillofacial surgeon extract them?
A: Erupted or simple cases can be handled by a general dentist. Impacted, deep, or anatomically risky cases should go to a maxillofacial surgeon — outcomes are significantly better.
About the author
Dr Marc-Kevin Le Roux is a French board-certified Oral and Maxillofacial Surgeon practising in Dubai. Trained in France’s top university hospitals with international fellowships in Asia. 1,500+ facial procedures performed. Bilingual English and French.
Considering wisdom teeth extraction in Dubai?
A consultation with clinical exam and panoramic radiograph (CBCT if needed) tells you exactly what to expect and which anaesthesia is best for your case.
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