Wisdom Tooth

Wisdom teeth are the last teeth to emerge in the mouth, usually between the ages of 18 and 25. They are also known as third molars and are located at the very back of the dental arch. Many people first discover them when they are visible on X-rays during a routine dental examination, or when they begin to feel pain and discomfort.

Wisdom teeth and lack of space

Wisdom teeth are the very last teeth to erupt, and in many cases there is simply not enough room in the jaw for them to grow in normally. When a wisdom tooth does not have enough space, it can grow at an angle, tilt towards the neighbouring tooth, or remain fully or partially embedded in the jawbone (impacted).

Lack of space can lead to a number of problems:

• Pain and increasing pressure at the back of the jaw
• Inflammation in the gums around a partially erupted tooth (pericoronitis)
• Damage to neighbouring teeth
• Cyst formation around the tooth
• Build-up of bacteria and cavities in an area that is difficult to clean

If the wisdom tooth has only partially broken through the gums, a pocket can form where bacteria collect. This can cause recurring infections with swelling, pain and difficulty opening the mouth.

Should I have my wisdom tooth removed?

Not all wisdom teeth need to be removed. The Norwegian Dental Association (NTF) recommends that wisdom teeth that do not cause symptoms and are in a normal position can be left alone. Regular X-ray check-ups are still important to monitor any changes.

Removal is recommended when the wisdom tooth causes recurring problems such as:

• Recurring infections (pericoronitis)
• Cavities in the wisdom tooth or neighbouring tooth
• Pain and swelling
• Cyst formation
• The tooth is positioned in a way that damages the neighbouring tooth

If you have symptoms and are between the ages of 18 and 30, it is generally recommended to remove the wisdom tooth early. Younger patients typically heal better and faster than older ones, and the risk of complications increases with age.

Does it hurt?

Wisdom tooth removal is always performed with local anaesthesia, so you should not feel pain during the procedure itself. You may feel pressure when the dentist loosens the tooth, but it should not be painful.

If you are particularly anxious, we can offer sedation to make the experience more comfortable. We also have a specialist at our Sandaker clinic who performs the most demanding surgical removals.

How much does it cost?

The price for removing a wisdom tooth varies depending on the position of the tooth and how complex the procedure is.

Simple extraction (the tooth has erupted and can be extracted without surgery):

• Price: NOK 1,200 to NOK 1,900
• Not covered by Helfo

Surgical removal (the tooth is fully or partially embedded in the jawbone and must be surgically removed):

• Helfo covers 30-40% of the cost for surgical removal
• Out-of-pocket cost: NOK 2,200 to NOK 4,500

Wisdom teeth in the upper jaw are generally easier to remove than those in the lower jaw, as the bone tissue in the upper jaw is softer and the teeth are often in a more accessible position. Wisdom teeth in the lower jaw more frequently require surgical removal.

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How long does it take?

Surgical removal of a wisdom tooth normally takes between 45 minutes and 1 hour. Simple extraction of an erupted wisdom tooth usually takes less time. You will always be informed about the expected duration before the procedure begins.

Tips while you wait

Are you experiencing wisdom tooth pain and waiting for your dental appointment? Here are some tips that can help relieve the discomfort:

• Painkillers: Take ibuprofen 400 mg up to 3 times daily, ideally in combination with paracetamol 1 g. Follow the instructions on the packaging.
• Ice pack: Place an ice pack (wrapped in a towel) against your cheek in the affected area. 15-20 minutes at a time can reduce swelling and pain.
• Saltwater rinse: Dissolve half a teaspoon of salt in a glass of lukewarm water and rinse gently around your mouth. This can reduce inflammation and keep the area clean.

After wisdom tooth removal

It is normal to experience some discomfort after a wisdom tooth has been removed. Here is what you need to know about aftercare and what to expect.

Pain and swelling

It is completely normal to experience pain and swelling during the first 48 hours after the procedure. Swelling is usually at its peak 2-3 days after removal and gradually subsides. Use painkillers as recommended and an ice pack against the cheek to reduce swelling.

The combination of ibuprofen 400 mg and paracetamol 1 g provides good pain relief for most people. Take painkillers before the pain sets in, preferably before the anaesthesia has worn off.

The socket after extraction

After the tooth is removed, there will be a socket (alveolus) in the jaw where the tooth was. This socket initially fills with a blood clot that protects the bone and is important for healing. The socket gradually heals over several weeks to 3 months. The outer gum tissue usually closes within 1-2 weeks.

Bleeding

Some bleeding during the first hours after the procedure is normal. If the bleeding is heavy, you can bite on a moist compress (e.g. a clean cotton cloth) for 20-30 minutes with steady pressure. Avoid spitting frequently or rinsing vigorously in the first hours, as this can disturb the blood clot.

Signs of infection

In most cases, healing goes well, but you should be aware of signs that may indicate infection:

• Persistent or increasing pain and swelling after 2-3 days
• Fever
• Bad taste in the mouth or foul-smelling pus
• Difficulty swallowing or opening the mouth

If you experience any of these symptoms, you should contact the dentist for a check-up. Infections are usually treated with antibiotics.

Eating

Avoid hot food and drinks for the first 24 hours after the procedure, as heat can increase bleeding. Preferably eat soft foods for the first 2-3 days — for example yoghurt, soup (not hot), mashed foods and smoothies. Avoid hard, crispy or crunchy food that can irritate the wound area.

Exercise

Avoid strenuous physical exercise during the first few days after the procedure. Physical activity raises blood pressure and can lead to increased bleeding and swelling. Light activity such as gentle walks is usually fine after the first day.

Painkillers

We recommend the following combination for optimal pain relief:

• Ibuprofen 400 mg — up to 4 times daily
• Paracetamol 1 g — up to 4 times daily

These can be taken at the same time and are very effective when used in combination. Start with painkillers before the anaesthesia wears off, and take them regularly for the first 2-3 days.

Corsodyl mouthwash

The dentist will often recommend Corsodyl mouthwash (chlorhexidine) after surgical removal. Start using the mouthwash from the day after the procedure. Rinse gently twice daily for 1-2 weeks. Corsodyl prevents infection and aids healing.

Brushing

You can brush your teeth as normal, but avoid brushing directly on the wound area for the first few days. Be careful around the surgical site. Use a soft toothbrush and consider switching to a smaller brush head for better control.

Wick and stitches

If the dentist has placed stitches (sutures), these are usually removed after 1 week. Some dentists use dissolvable stitches that disappear on their own. If a wick (gauze packing) has been inserted, it should usually be removed or changed after a few days. Follow the dentist's instructions on this.

View infographic — After wisdom tooth extraction