Wisdom teeth
Lower wisdom teeth are the most common reason people are referred to us. These are the questions we are asked most often, with what the research shows and what we have found in our own patients.
Looking for an overview, fees and locations? See our Wisdom Teeth Removal page.
Deciding on treatment
Do my wisdom teeth need to come out?
Not always. Removal is usually recommended when a wisdom tooth is causing problems, such as:
- Repeated gum infections around the tooth (pericoronitis), or one severe infection
- Decay in the wisdom tooth that cannot be repaired
- Decay or gum damage on the back of the tooth in front
- A cyst or other change around the tooth on the X-ray
- The tooth being in the way of other planned treatment
For wisdom teeth that are causing no problems, the research does not clearly support or rule out removing them. We weigh the chance of future problems against the risks of surgery, which increase with age.
My wisdom tooth does not hurt. Why has my dentist referred me?
A lower wisdom tooth that leans forward against the tooth in front can trap food at the gum line and cause decay on the back of that tooth. This decay is hard to see and often painless until it is advanced, so your dentist may recommend removal before symptoms start.
Why might I need a 3D scan (CBCT)?
The nerve that gives feeling to your lower lip, chin and tongue runs below the lower wisdom teeth. Certain signs on a standard X-ray (OPG) suggest the roots are close to this nerve. When we see them, we take a CBCT scan to show exactly where the nerve runs. About 4 in 10 of our lower wisdom tooth patients now have a CBCT before surgery.
A scan does not lower the risk by itself. Its value is in helping us choose the safest technique and give you an accurate estimate of your own risk.
Dr Tom co-authored a study of how the degree of nerve canal compression seen on CBCT relates to nerve injury after lower wisdom tooth surgery (reference 7).
What is the risk of numbness after surgery?
Published studies report altered feeling in the lower lip, chin or tongue after 0.4% to 8.4% of lower wisdom tooth removals. Most cases recover. Permanent changes are uncommon, but have been reported in up to 3.6% of people in higher-risk groups. We will explain your individual risk at the consultation.
What is a coronectomy?
If the roots are wrapped around or pressing on the nerve, we may recommend a coronectomy. We remove the crown of the tooth and deliberately leave the healthy roots in place, below the bone, so the nerve is not disturbed. A large review of almost 8,000 coronectomies found:
| Outcome | How often | What it means |
|---|---|---|
| Nerve injury | 0.76% | Lower than for full removal of high-risk teeth (0.4–8.4%) |
| Roots moving | 12.5% | Usually 2–4 mm, mostly in the first 1–2 years, and generally away from the nerve |
| A second procedure | 4.5% | Usually simpler, about 10 months later, mainly if a root works its way to the surface |
Recovery is similar to an extraction, and we take a review X-ray in the first year. Coronectomy is not suitable if the tooth is infected or loose, or for some people with weakened immunity or planned radiotherapy to the head and neck.
What have your coronectomy results been?
Since 2024 we have planned a coronectomy for about 1 in 10 lower wisdom teeth we treat (125 of 1,246). So far, no coronectomy patient has had altered feeling lasting more than two weeks.
With 125 cases, this result is consistent with a true rate of up to about 2.4%, so it is reassuring rather than a guarantee. In two cases the roots came loose during surgery and were removed, which is why your consent will always cover full removal if needed. We will report how often roots move once follow-up is complete.
Infection around a wisdom tooth
What is pericoronitis, and how is it treated?
Pericoronitis is an infection of the gum flap over a partly erupted wisdom tooth. Your dentist will usually clean under the gum, and advise warm salty water or chlorhexidine rinses and pain relief. Antibiotics are only needed if the infection is spreading or you feel unwell. If it comes back, or one episode is severe, removing the tooth is usually recommended once the infection has settled.
When is it an emergency?
If you have swelling spreading under the jaw or tongue, increasing difficulty opening your mouth, difficulty swallowing or a fever, go to your nearest public hospital emergency department. If you have any difficulty breathing or a change in your voice, call 000. For a flare-up without these signs, see your dentist promptly.
Infections that spread from teeth can become serious quickly. Dr Tom co-authored a paper on severe dental infections (reference 8).
Your surgery and recovery
Will I be awake or asleep?
| Option | Typically suits |
|---|---|
| Local anaesthetic, in our rooms | Upper wisdom teeth, lower teeth that are erupted or partly erupted, single teeth |
| General anaesthetic, day surgery in a private hospital | Deeply impacted teeth, several teeth at once, significant anxiety, or medical reasons |
What happens from referral to recovery?
- Referral: we aim to see you within 2 weeks, and urgent cases the same or next day.
- Consultation: we review your X-rays or scan, explain your options, and give you a written estimate with item numbers.
- Surgery day: you go home with written instructions and an after-hours number.
- Follow-up: a post-operative review at our rooms, with phone advice in between.
- Back to your dentist: we send your dentist a report on your treatment and outcome.
What is normal after surgery?
Pain and swelling usually peak on day 2 or 3, then settle. If things are getting worse rather than better after day 3, call us. See our post-operative instructions for detailed care.
What is a dry socket?
A dry socket is a painful socket where the healing blood clot has been lost, usually a few days after surgery. Chlorhexidine rinse or gel lowers the risk. If it happens, we clean and dress the socket at our rooms, at no charge.
Will I need antibiotics?
We usually give a single dose of antibiotic during surgery. A course of tablets afterwards is only needed if the area was infected at the time of surgery.
Our approach to antibiotics draws on Dr Tom’s research on antibiotic prescribing in general dental practice (reference 9).
What if my lip or tongue still feels numb?
Let us know. We record it at your review and follow you until it resolves, and arrange earlier assessment if it persists.
Fees
How much will it cost?
| Fee | Typical amount |
|---|---|
| Single tooth, in our rooms (local anaesthetic) | $605–$1,010 |
| Four wisdom teeth, in hospital (general anaesthetic) | $3,400–$4,200 |
| Anaesthetist (general anaesthetic only) | $500–$900 |
| Hospital (general anaesthetic only) | $1,350–$2,650 |
Fees are before health fund rebates. Private hospital cover usually pays most of the hospital fee, less any excess, and extras cover may rebate part of the surgical fee depending on your policy. You will receive a written estimate with item numbers after your consultation, so you can check with your fund before booking.
- Zip Money: 6 months interest free on surgeon’s and anaesthetist’s fees where total estimated costs exceed $2,000 (Zip approval, fees and terms apply). See About our Fees (PDF) and Paying for your surgery with Zip Money (PDF).
- No charge for aftercare and post-operative reviews
Getting started
Do I need a referral?
Yes. Ask your dentist (or your GP) for a referral to Dr Tom Jaunay. If you already have a referral, call us and we will book you in.
What should I bring to my consultation?
- Your referral, and a recent OPG X-ray (within 12 months) or CBCT scan if you have one
- How many times you have had infections around the tooth
- A list of your medicines, especially blood thinners, bone-strengthening medicines (such as Prolia or bisphosphonates), and any history of head and neck radiotherapy, and if you are or may be pregnant
- Any orthodontic or other dental treatment you have planned
How do I contact you?
Call 02 8513 9810 (8:30am to 4:30pm, Monday to Friday) or email reception@oromaxnsw.com.au. Sydney CBD Level 2, 225 Macquarie St · Hurstville Suite 9.06, Level 9, 288 Forest Rd · Miranda Suite 2, Level 5, 86 Kiora Rd. See our locations.
References
- NICE. Guidance on the extraction of wisdom teeth (TA1). nice.org.uk
- Ghaeminia H, et al. Surgical removal versus retention for asymptomatic disease-free impacted wisdom teeth. Cochrane Database Syst Rev. 2020. doi:10.1002/14651858.CD003879.pub5
- Rood JP, Shehab BA. The radiological prediction of inferior alveolar nerve injury during third molar surgery. Br J Oral Maxillofac Surg. 1990. doi:10.1016/0266-4356(90)90005-6
- Di Spirito F, et al. Re-intervention rate, timing, and indications following coronectomy of the mandibular third molar. J Clin Med. 2025. doi:10.3390/jcm14113877
- SDCEP. Management of Acute Dental Problems: acute pericoronitis. sdcep.org.uk
- Daly BJ, et al. Local interventions for the management of alveolar osteitis (dry socket). Cochrane Database Syst Rev. 2022. doi:10.1002/14651858.CD006968.pub3
- Sklavos A, Delpachitra S, Jaunay T, Kumar R, Chandu A. Degree of compression of the inferior alveolar canal on cone-beam computed tomography and outcomes of postoperative nerve injury in mandibular third molar surgery. J Oral Maxillofac Surg. 2021. doi:10.1016/j.joms.2020.12.049
- Uluibau IC, Jaunay T, Goss AN. Severe odontogenic infections. Aust Dent J. 2005. doi:10.1111/j.1834-7819.2005.tb00390.x · full text (PDF)
- Jaunay T, Sambrook P, Goss A. Antibiotic prescribing practices by South Australian general dental practitioners. Aust Dent J. 2000. doi:10.1111/j.1834-7819.2000.tb00554.x · full text (PDF)
Our results come from an audit of lower wisdom tooth surgery by Dr Jaunay at all Oromax sites, September 2022 to October 2026 (1,518 teeth).
This page is general information to help you prepare for your consultation. It does not replace an assessment and advice about your own situation.