Wisdom Tooth Extraction

Gentle and fear-free removal of wisdom teeth

With us, you will be cared for by a professional team of dentists who specialize in careful and painless removal of wisdom teeth. The modern equipment of the practice is designed to meet the needs of gentle wisdom tooth extraction.

Wisdom teeth are a relic from the Stone Age. In the past, people's jaws were longer and larger, which is why wisdom teeth also found space without difficulty. In the course of evolution, the jaws became shorter and smaller, but the number of teeth remained unchanged. Since wisdom teeth are the last teeth to form and grow, they often do not find enough space in the oral cavity. This can lead to problems, such as displacement of the teeth.

Today, orthodontic therapy is in the foreground because it is known that teeth that are straight in the jaw are optimally loaded and thus have the longest lifespan. After all, today's generation has a life expectancy of almost 100 years. In addition, with straight teeth you look much better on the selfies.

When and why do wisdom teeth need to be removed?

Urgent wisdom tooth extraction is recommended if:

• The jaw no longer has room for the wisdom teeth
• Wisdom teeth can only partially appear due to lack of space and the remaining part is thus covered by a gingival hood. In this case, food residues can regularly settle there and trigger a painful inflammation (also known as a "novice infection") and/or caries on the tooth itself, because it is not possible to clean well or not at all with a toothbrush. Both sooner or later cause severe pain and require urgent treatment!
• Press the lower wisdom teeth on the last molars in the lower jaw. This can cause the mandibular incisors to shift.
• Wisdom teeth have tooth decay. This does not cause any pain at first, but the caries can also spread to the last molar tooth unnoticed. Such a course is particularly annoying because a previously healthy, permanent tooth is damaged and can thus be lost.
• The wisdom teeth threaten to dissolve the neighboring teeth due to the growth pressure. This sometimes even makes it necessary to remove the adjacent tooth.
• The "tooth bag" turns into a so-called cyst. All teeth, before they pass through the gums, are packed in the so-called "tooth bag", which normally transforms into surrounding gums when the tooth enters the oral cavity. However, if there is no space for the wisdom tooth, the tooth bag remains in the jaw and does not cause any pain at first, but gradually dissolves the surrounding bone and can thus endanger the surrounding teeth.

Prophylactic (precautionary) wisdom tooth extraction is recommended when:

• the antagonist is missing, because chewing only works if one tooth has its opposite tooth. If this is missing, the tooth loses its function. As a result, it carries the risk of developing tooth decay, becoming inflamed or endangering other teeth.
• Teeth are in the bone. Then, as they get older, they can come into contact with the oral cavity, for example through gingival pockets on the neighboring teeth. The risk of severe inflammation is extremely high due to the difficult accessibility.

When is the best time to have wisdom tooth extraction?

"Not too early and not too late". The ideal time window is between the ages of 14 and 20. Why? Before the age of 14, wisdom teeth are usually not yet properly formed and all other teeth are not yet fully visible in the oral cavity. After the age of 20, the roots of the teeth are fully formed and often very close to surrounding anatomical structures, such as the mandibular nerve. In addition, the teeth «cake» with the surrounding bone as they age.

This is comparable to the roots of a plant: «If the plant is still small, it is much easier to uproot it than with a tall tree with a strong root system.»

How does wisdom tooth extraction work?

The procedure for the removal of wisdom teeth can vary depending on the individual situation and the extent of the treatment. Here we explain the general procedure of wisdom tooth surgery.

1. Preliminary consultation: It is recommended to arrange a preliminary consultation with the treating dentist / oral surgeon in which you can clarify your questions and discuss your fears and concerns. The dentist will use X-rays to assess the position of the wisdom teeth, the shape of the roots, and the proximity to certain anatomical structures such as nerves and maxillary sinuses. In some cases, a CBCT (3D) X-ray may also be required.
2. Anesthesia: Most wisdom tooth surgeries are performed under local anesthesia to prevent pain during the procedure. Alternatively, nitrous oxide or general anesthesia are also possible, especially for patients with dental anxiety.
3. Cut open the gums: After anesthesia, the gums above the wisdom tooth are cut open and detached from the bone. This gives the dentist access to the wisdom tooth.
4. Expose the tooth: If the wisdom tooth is still in the jaw, the dentist carefully removes the covering bone with a surgical mini-milling machine to expose the wisdom tooth.
5. Tooth extraction: If the wisdom tooth is accessible, it is removed either as a whole or piecemeal, depending on the location and shape of the tooth. In the case of wisdom teeth that have already erupted, they can often only be extracted with pliers like normal teeth.
6. Close the wound: Once the extraction is complete, the wounds are carefully sutured. The stitches are painlessly removed about seven to ten days after the operation.
7. Check-up: After the procedure, a wound check is carried out to monitor the healing process and detect possible complications at an early stage.

Wisdom teeth can usually be removed either individually or sideways at intervals of a few weeks. Depending on the difficulty, the procedure takes 20-60 minutes.

As a general rule, we mainly use absorbable (i.e. self-dissolving) sutures for wound closure, so that suture removal can be completely omitted after 7-10 days. As a result, our patients should only come to us for a further check-up appointment within three days and all further check-ups only have to be carried out if necessary. This saves time and unnecessary driving for the accompanying person.

Pain and anesthesia during wisdom tooth surgery

Those who have already gained experience with conventional dental syringes and therefore know the feeling of local anesthesia are best placed to decide which type of anesthesia they prefer. For wisdom tooth extraction, we offer two different types of anesthesia.

On the one hand, this procedure can be performed under local anesthesia, i.e. by injections with a very, very fine cannula. Of course, it goes without saying that there will be no pain during the actual procedure. During the procedure, you will only feel a slight feeling of pressure. This slight feeling of pressure is completely normal and very easy to tolerate.

On the other hand, we offer wisdom tooth extraction under general anesthesia, for which we have been working closely with an experienced team of anesthesiologists for many years, who are present during the entire operation and monitor the patients. It is important to know that you are not allowed to eat anything 6 hours before general anesthesia. Since you are asleep, you do not notice anything about the actual procedure, but only feel the small access that is placed in the crook of your arm at first. As soon as the general anesthesia is stopped, the wisdom teeth are already removed and only the slightly numb feeling in the lips, tongue and cheek remains for a few hours, which favors immediate freedom from pain immediately after the operation, until the first painkiller you take at home takes effect.

What are the alternatives to surgical wisdom tooth extraction?

If the wisdom teeth have already erupted completely and the X-ray shows that there is no damage to adjacent teeth, the wisdom teeth can be extracted in the conventional way. The affected tooth is gripped with special pliers and carefully pulled out.

If you are afraid of wisdom teeth removal and want to have them removed in stages, sequential or side-by-side removal is also possible. First, the two teeth are removed on one side and then, a few weeks later, the one on the other side to minimize the strain on the patient and the restrictions on chewing.

Anxiety patients

What is the aftercare and healing process after wisdom tooth extraction?

Aftercare and healing after wisdom tooth extraction is an important process to avoid complications and promote a speedy recovery. Usually, the wound heals within about seven days, depending on the severity of the operation and the patient's behavior after the procedure.

To keep the chances of complications low, your dentist should give you sick leave for up to seven days – longer if necessary. It is important that you go for a follow-up check after wisdom tooth extraction, ideally in conjunction with the review of the wound sutures. After about a week, the wound in the jaw has usually healed well enough for the dentist to remove the stitches.

Your preparation for wisdom tooth extraction should include providing cold packs, arranging a companion or taxi, and scheduling recovery time. In the first few days after the procedure, it is important to avoid heavy physical work or sports.

The best tips for the time after wisdom tooth surgery are:

• Cooling: Use ice packs to reduce swelling and pain.
• Sports: Avoid heavy physical exertion and sports for at least 3-7 days after surgery.
• Food: Eat soft, easy-to-chew food for the first few days to reduce the strain on the wound.
• Drinking: Avoid alcohol, caffeinated beverages and hot liquids to prevent irritation of the wound.
• Dental care: About 24 hours after the wisdom teeth are removed, start cleaning the remaining teeth again. However, avoid cleaning the wound and its immediate surroundings. Gently rinsing your mouth with cool water or a mixture of water and chlorhexidine may also be helpful.

Dr. Frank Willebrand – Our specialist for surgical tooth extraction

Dr. Frank Willebrand is an experienced oral surgeon who specializes in the surgical removal of teeth. In the practice of Dr. Nina van Sprundel, he brings his extensive expertise to the best possible care for patients during the removal of teeth.

Dr. Willebrand has in-depth knowledge of modern techniques and takes a minimally invasive approach to minimize swelling, pain, and healing time for patients. With his know-how and conscientious way of working, he ensures that tooth extractions are safe and comfortable for patients.

Dr. Frank Willebrand

Only the frog thinks thick cheeks are cool!

Our experienced team consists of oral surgeons and dentists who specialize in performing wisdom tooth extraction as gently and carefully as possible. The daily routine allows us to offer these treatments not only quickly, but also in a relaxed atmosphere. Dr. Frank Willebrand removes between 500 and 1000 wisdom teeth per year. Thanks to our many years of experience, we have also constantly developed and perfected the procedures of removal in order to make this procedure as comfortable as possible for the patient.

Thanks to our intraoperatively gentle approach and our postoperative aftercare, we are able to keep the swelling to a minimum.

Anxiety patients are very welcome. Our staff is specially trained in the field of anxiety therapy and will make your stay with us very pleasant.

Team