Wisdom tooth removal is one of the most common dental procedures carried out in London, but for many patients, the anticipation is far more uncomfortable than the procedure itself. Whether you have already booked your appointment or you are still weighing up your options, knowing what to expect during and after wisdom teeth extraction takes much of the anxiety out of the process. At Fitzroy Dental Practice in Fitzrovia, we walk every patient through each stage before we begin. Here is what you can expect.
What happens at the appointment before wisdom teeth extraction?
Before any extraction, your dentist at Fitzroy carries out a thorough clinical assessment. This involves examining the tooth and surrounding gum tissue, reviewing your dental and medical history, and taking X-rays to understand the root anatomy and the tooth’s relationship to adjacent structures, particularly the inferior alveolar nerve in the lower jaw.
At this stage, your dentist discusses the planned approach with you, confirms your consent, and explains what anaesthetic or sedation options suit your situation. You leave knowing exactly what the procedure involves and what recovery typically looks like.
Will the dentist always take an X-ray before removing a wisdom tooth?
Yes, in almost all cases. A panoramic X-ray (OPG) gives the dentist a full picture of root depth, angulation, and proximity to the nerve canal. For lower wisdom teeth where roots sit close to the inferior alveolar nerve, a cone beam CT scan may also be requested to give a three-dimensional view before the dentist proceeds.
What should I do and avoid in the hours before my extraction appointment?
Eat a light meal beforehand. You will likely be numb for a couple of hours after the procedure and will want food to be straightforward when sensation returns. Avoid alcohol for 24 hours before the appointment. If your dentist has prescribed antibiotics beforehand, complete the course as directed. Arrange someone to accompany you if you are having sedation, as you will not be able to drive afterwards.
What happens during the wisdom tooth extraction itself?
Your dentist administers a local anaesthetic injection to numb the tooth, surrounding gum, and jawbone. Within five to ten minutes, the area becomes fully numb. You remain awake and aware throughout, but you should not feel pain. Most patients find the injection the least comfortable part of the entire appointment.
For a straightforward erupted wisdom tooth, the dentist loosens the tooth within its socket using specialist instruments and then removes it with forceps. For a partially or fully impacted tooth, a surgical wisdom teeth extraction in London, the dentist makes a small incision in the gum, removes a small amount of bone if needed, and often sections the tooth into pieces before removing each part. This sounds significant but typically adds only ten to twenty minutes to the procedure.
Will I feel pain during wisdom tooth removal, or just pressure?
Under effective local anaesthetic, you feel pressure, movement, and vibration but not pain. If you do feel sharp discomfort at any point, tell your dentist immediately. There is always the option to administer more anaesthetic before continuing. Most patients report that the procedure felt far less unpleasant than they had expected.
How long does the extraction procedure typically take?
A straightforward erupted wisdom tooth takes roughly ten to twenty minutes to remove. A surgical extraction involving incision, bone removal, and tooth sectioning typically takes between thirty and sixty minutes per tooth, depending on complexity. Your dentist gives you a time estimate at your assessment appointment.
Can I have sedation if I am anxious about wisdom tooth removal?
Yes. We offer intravenous (IV) sedation for anxious patients or those undergoing multiple surgical extractions. Sedation produces a deeply relaxed, semi-conscious state you remain able to respond to the dentist but retain very little memory of the procedure. If sedation interests you, mention it when you book so we can plan your appointment accordingly.
What should I do immediately after wisdom tooth removal?
The first hour after extraction is the most important window for setting up a good recovery. Your dentist places a folded gauze pad over the socket and asks you to bite firmly on it for thirty to forty-five minutes. This pressure helps the blood clot form, and that clot is the foundation for all subsequent healing.
During this first hour, avoid touching the socket with your tongue or fingers, do not spit, and do not rinse your mouth. Disturbing the socket too early is the most common cause of dry socket, a painful but treatable complication that affects a small number of patients.
How long should I bite on the gauze after extraction, and what if bleeding continues?
Bite firmly on the gauze for thirty to forty-five minutes without lifting it to check. Slow oozing from the socket for several hours after extraction is entirely normal; the saliva makes it look more dramatic than it is. If you are still experiencing significant fresh bleeding beyond two hours, fold a clean piece of gauze or a damp teabag (the tannic acid aids clotting) over the socket, bite firmly for another thirty minutes, and call us if bleeding does not reduce.
Why must I avoid rinsing my mouth in the first 24 hours?
Rinsing creates suction and turbulence in the mouth that can dislodge the forming blood clot before it has had time to stabilise. A dislodged clot leaves the bone exposed, the mechanism behind dry socket. From the morning after the extraction, you can begin gentle warm salt water rinses (half a teaspoon of salt in a glass of warm water) after meals to keep the area clean.
What is recovery like in the first few days after wisdom teeth removal?
For most patients, the first 48 hours are the most uncomfortable, and even then, discomfort is typically manageable with standard over-the-counter pain relief. Take ibuprofen and paracetamol alternately as directed, starting before the anaesthetic wears off rather than waiting until you feel pain.
Swelling around the jaw and cheek is normal and typically peaks at around 48 hours before gradually reducing. Applying an ice pack to the outside of the face in twenty-minute intervals during the first 24 hours helps limit swelling. Facial bruising sometimes appears two to three days after the extraction and fades over the following week.
How much swelling and bruising should I expect, and how long does it last?
Swelling varies depending on the complexity of the extraction and the individual patient. Surgical extractions involving bone removal tend to produce more swelling than straightforward removals. Most swelling resolves within five to seven days. Bruising, when it appears, typically fades within ten days. If swelling worsens after the third or fourth day rather than improving, contact your dental practice, as increasing swelling can indicate infection.
What can I eat and drink safely after wisdom tooth removal?
Soft foods at room temperature suit the first two to three days best: think scrambled eggs, yoghurt, soup (not too hot), mashed potato, and soft pasta. Avoid anything hard, crunchy, or chewy that might dislodge the clot or pack into the socket. Avoid hot drinks for the first 24 hours. Do not use a straw the suction is one of the most common causes of dry socket.
When can I return to work or exercise after having a wisdom tooth out?
Most patients with desk-based roles return to work the day after a straightforward extraction. Surgical extractions may warrant two to three days off, depending on individual recovery. Avoid strenuous physical exercise for at least 48 hours raised heart rate and blood pressure increase the risk of bleeding and can delay clot formation.
What are the warning signs that something has gone wrong after extraction?
Most wisdom tooth extractions heal smoothly. However, certain symptoms warrant a prompt call to your dental practice rather than waiting:
- Pain that intensifies from day two or three onwards, particularly if it radiates to the ear or jaw, suggests dry socket
- Swelling that worsens after day three, rather than improving, may indicate a possible infection
- Fever, difficulty swallowing, or swelling spreading to the neck, seek urgent care
- Persistent altered sensation in the lower lip, chin, or tongue beyond a few days warrants flagging to your dentist
How do I know if I have dry socket rather than normal post-extraction soreness?
Normal post-extraction soreness follows a clear trajectory: worst in the first 24–48 hours, then improving day by day. Dry socket reverses this pattern: pain returns or escalates two to four days after the procedure, often described as a deep, throbbing ache radiating toward the ear. Looking at the socket (in good light, with a mirror), you may see exposed bone where you would expect to see a dark clot. Contact your practice promptly a medicated dressing placed in the socket provides significant relief within hours.
What does a healing socket look like, and when should I be concerned about how mine looks?
A healthy healing socket will initially show a dark red or maroon clot. Over the first week, this gradually fills with whitish or cream-coloured granulation tissue as the body begins to repair the area. A pale or white appearance at this stage is normal healing, not infection. Yellow or green discharge, increasing pain, and worsening swelling are signs of genuine infection and need clinical review.
How long does full healing take after wisdom tooth removal?
Gum tissue closes over the socket within two to three weeks for most patients. By this point, you can eat normally, and the site needs no special attention beyond your usual oral hygiene routine. Bone remodelling of the socket continues beneath the surface for three to six months, but patients do not feel this process, and it does not affect daily life.
When will the hole where my wisdom tooth was finally close over?
The gum closes over the socket within two to three weeks in the majority of cases. Larger surgical extractions may take slightly longer. Patients often notice food catching in the socket during the first week or two. Gentle saltwater rinsing after meals keeps it clean until the gum closes fully.
Do I need a follow-up appointment after wisdom tooth removal at Fitzroy?
For straightforward extractions, a follow-up is not always necessary if healing proceeds as expected. For surgical extractions, we typically arrange a review appointment one to two weeks after the procedure to check healing and remove any sutures. If you have any concerns at any point during recovery, we encourage you to contact us. We would rather reassure you promptly than have you worry unnecessarily.
If you are considering wisdom tooth removal in London, or you have questions about an extraction that has already been recommended, the team at Fitzroy Dental Practice would be glad to talk it through. You will find us at 14 Fitzroy Square, Fitzrovia, London W1T 6AH. Call us on 020 7387 3317 or book online.
Frequently Asked Questions
How painful is wisdom tooth removal?
Under local anaesthetic, the procedure itself causes no pain, only pressure and movement. Post-operative discomfort, managed with ibuprofen and paracetamol, typically peaks within the first 48 hours and improves steadily thereafter. Most patients find recovery more straightforward than they anticipated.
How long does wisdom tooth removal take?
A simple extraction takes ten to twenty minutes. A surgical extraction for impacted or partially erupted teeth typically takes thirty to sixty minutes per tooth. Your dentist gives you an accurate estimate after assessing your X-rays.
What is dry socket, and how common is it?
Dry socket occurs when the blood clot in the extraction socket dislodges before healing is complete, leaving bone exposed. It affects roughly 2–5% of all extractions and is more common after lower wisdom tooth removal. The main risk factors are smoking, using a straw, and rinsing too forcefully in the first 24 hours. Treatment involves placing a medicated dressing in the socket, which provides relief within hours.
When can I eat normally after wisdom tooth removal?
Soft foods suit the first two to three days. Most patients return to normal eating within one to two weeks, once the gum begins to close over the socket and discomfort reduces. Avoid hard, crunchy, and sticky foods until the area has settled.
Do I need to take time off work after wisdom tooth removal?
For a straightforward extraction, most patients with office-based roles return to work the following day. Surgical extractions may warrant two to three days off. Strenuous physical exercise should be avoided for at least 48 hours to reduce the risk of bleeding and delayed healing.
