Who removes wisdom teeth, a dentist or an oral surgeon?

Both can, depending on the tooth. A general dentist assesses wisdom teeth with an examination and X-rays, and straightforward ones can be removed under local anaesthetic. Complicated ones are referred to a maxillofacial and oral surgeon. Dr Davies, a general dental practitioner at BRS Dental in Cape Town, assesses each wisdom tooth first and refers the complicated ones.

In short

• A general dentist examines your mouth and takes X-rays to see where each wisdom tooth sits and what its roots look like.
• A wisdom tooth that has fully come through the gum and has simple roots can be removed by a general dentist under local anaesthetic.
• A tooth that is impacted, only partly through the gum, close to a nerve or needing bone removed can be more complicated, and complicated extractions are referred to a maxillofacial and oral surgeon.
• At BRS Dental, Dr Davies assesses wisdom teeth first, normally between the ages of 18 and 21. Simple ones are removed at the practice under local anaesthetic, and complicated ones are referred.

This article is part of the extractions and wisdom teeth information on this site for patients in Cape Town.

What does a general dentist check before a wisdom tooth comes out?

The dentist looks at the tooth and the gum around it, and takes an X-ray. The X-ray shows what cannot be seen by looking, such as a tooth that is still under the gum, and where its roots lie. A wisdom tooth that causes no problems is usually left alone and checked at routine appointments. Wisdom teeth are normally assessed between the ages of 18 and 21, and X-rays are taken at a general check-up every 12 to 18 months. When should wisdom teeth be checked? covers the timing, and wisdom tooth pain covers a tooth that hurts.

Which wisdom teeth are straightforward, and which are complicated?

A straightforward wisdom tooth has come fully through the gum and has simple roots. It can be numbed with local anaesthetic and taken out with forceps, much like any other tooth.

A complicated one may be impacted, which means it is stuck under the gum or against the next tooth or the jawbone. It may be only partly through the gum, or have long or curved roots, or roots close to a nerve in the lower jaw. Removing it may mean opening the gum, taking away a little bone, or dividing the tooth into pieces. The X-ray and the examination help to tell the two apart.

What is a maxillofacial and oral surgeon?

In South Africa, a maxillofacial and oral surgeon is a dentist who has completed further specialist training in surgery of the mouth, jaws and face, and is registered with the Health Professions Council of South Africa (HPCSA) as a specialist. These surgeons treat the structures in and around the mouth, which includes removing impacted teeth. The surgeon’s practice makes its own appointments and sets its own fees.

How does Dr Davies handle wisdom teeth?

Dr Davies is a general dental practitioner. She assesses each wisdom tooth before any treatment is decided. Simple tooth extractions, including wisdom teeth, can be done at the practice under local anaesthetic. When an extraction is more complicated, she refers it to a maxillofacial and oral surgeon after she has assessed it. Only an examination can say which route your own tooth needs.

What happens after a referral to a surgeon?

In general terms, the surgeon examines you and looks at your X-rays. They may take more X-rays, and may suggest a 3D scan if the roots lie close to a nerve. The surgeon then explains your options for anaesthetic. Local anaesthetic is common, and a general anaesthetic is usually offered only for more complex cases. Any sedation or general anaesthetic is arranged through the surgeon’s practice and the hospital. When a hospital and an anaesthetist are involved, they send their own accounts as well as the surgeon’s, and How much does wisdom teeth removal cost in Cape Town? explains what to expect.

Afterwards, follow the surgeon’s own instructions. What should I do after a tooth extraction? and recovery after wisdom teeth removal cover the general steps.

When should I see a dentist about a wisdom tooth?

See a dentist if a wisdom tooth is painful, the gum around it is swollen or sore, there is a bad taste, or opening your mouth is hard. These can be signs of infection. If you are in pain now, see the dental emergency guidance on this site. If swelling spreads towards your eye or neck, or you struggle to breathe or swallow, go to a hospital emergency unit instead.

How do I reach Dr Davies?

To have a wisdom tooth assessed, call Dr Davies directly on her own mobile, which is shown on this page. Dr Davies treats adults and children at BRS Dental on Strand Street, in Cape Town City Centre. This page gives general information and does not replace an examination.