In the past, it was common for surgeons to remove most patients' wisdom teeth on the basis that they either had problems, or might develop them in the future. The removal of wisdom teeth (third molars) was one of first topics for the National Institute for Health and Clinical Excellence - and their guidance can be found here http://www.nice.org.uk/TA1
The NICE guidance gives a set of acceptable reasons for removing wisdom teeth - including caries (decay), repeated bouts of infection requiring antibiotics, cysts, decay in an adjacent tooth that cannot be managed without removing the wisdom tooth - and a number of rarer reasons including (for example) jaw fracture and treatment for cancer.
Insurance companies are increasingly keen to ensure that wisdom teeth removed privately meet the same conditions as those removed under the NHS - and some companies require that your surgery is 'pre authorised'. This requires your surgeon to write to your insurance company, describing your problem and enclosing (if possible) a copy of your x ray and referral letter from your dentist. This process can take up to two weeks, and may delay your surgery slightly.
This procedure can be done under local anaesthesia (an injection like you would get at the dentist) or general anaesthesia (with you asleep). If you choose a general anaesthetic, this is often a day case procedure and you will be discharged from hospital on the same day.
It is often necessary for your surgeon to make a small cut in the gum overlying your wisdom tooth, and it may be necessary for a small amount of bone to be removed in order to make your surgery easier. It is a common misconception that your jaw is 'broken' to remove your wisdom tooth - this is not the case!
If a wisdom tooth is impacted (lying in an unusual way), it may be necessary for the surgeon to divide the tooth into pieces in order to remove it.
It is very common for patients to require sutures (stitches) after surgery of this nature. They will dissolve after two or three weeks, and it is often better to leave them to disappear rather than remove them earlier.
Everyone is different, but you will get some swelling after having your wisdom teeth removed. This won't reach it's peak until forty eight hours after surgery, but will start to subside after four or five days.
Again, everyone is different but it is usually sensible to have a few days off - even if you end up working from home. A maximum of seven days is reasonable.
There is always a risk of infection with any oral surgical procedure, even if antibiotics are given. If you experience a sudden increase in your pain three or four days after surgery and get a nasty taste, seek advice or make a review appointment.
There are two nerves close to the wisdom tooth, one supplies the feeling to your lower lip/chin and lower teeth and the other supplies the sensation to your tongue and helps with taste. Sometimes these nerves are damaged or bruised when wisdom teeth are removed, and this can cause tingling or numbness in your lip, chin, tongue or teeth. Alteration to taste is unusual. About one in ten people will have some tingling or numbness which can last several weeks, but less than one in a hundred will have problems that last longer than a year. The risks can be higher if your tooth is particularly difficult, but your surgeon will discuss this with you.
There is some evidence to suggest that particularly difficult lower wisdom teeth can be treated with a procedure called 'decoronation' rather than tooth removal. This is where the crown of the wisdom tooth is removed only - rather than the whole tooth. This procedure may be suggested where the relationship between the wisdom tooth roots and the nerve that gives you the sensation to your lip/chin is particularly close. It does however carry a risk that the remaining root will become infected and require removal at a later date.
Not always. Patients lead busy lives, and it's not always convenient to come for a repeat appointment. Your surgeon will try and contact you a week or so after surgery to ensure that all is well however, and you're welcome to make an appointment for review if you're worried.