Wisdom teeth removal: should local anesthesia or sedation be used?

Wisdom teeth are our third molars. Located completely at the back of the mouth—behind the second molars—wisdom teeth can grow incorrectly, cause pain or even lead to abscesses.

To avoid complications and maintain good oral and general health, wisdom teeth sometimes have to be removed. The wisdom teeth removal procedure always requires anesthesia and the choice between local anesthesia alone or sedation depends on the situation.

When do wisdom teeth need to be removed?

Wisdom teeth growth should be checked by means of a panoramic x-ray or 3D radiology around adolescence. This clinical and radiological examination determines the positioning of your wisdom teeth and if they are close to emerging from the gum.

The maxillofacial surgeon may recommend wisdom teeth extraction if they determine that the wisdom teeth are badly positioned or have no space to grow.

They may also recommend the procedure if the gum surrounding the partially emerged wisdom tooth is swollen or infected.

Local anesthesia or sedation?

Local anesthesia

Local anesthesia is enough to proceed with wisdom teeth removal in simple cases. This surgery is performed in a maxillofacial surgery clinic by a specialized dentist: the maxillofacial surgeon.

Local anesthesia involves injecting anesthetic near the nerve or group of nerves in the area to be operated on. Under local anesthesia, the patient is conscious but does not feel any pain.

Sedation

Surgeons may recommend sedation in more complex dental extractions, for example if your wisdom tooth is enclosed. Sedation is also often recommended if all four wisdom teeth must be removed in one procedure for the patient to feel more at ease.

Maxillofacial surgeons usually use intravenous sedation, but oral or inhalation sedation may occasionally be used. General anesthesia is essentially no longer used anymore.

Under sedation, the patient’s state of consciousness is altered during the entire extraction procedure and little to nothing will be remembered about the operation.

Sedation can also be used in anxious patients or those who have a phobia of surgery.

Local or general anesthesia: the maxillofacial surgeon decides

Choosing between local anesthesia or sedation depends on the patient and the maxillofacial surgeon’s professional opinion, so the choice can only be made after a consultation with your surgeon.

Several guidelines should be followed before and after wisdom teeth removal, from oral hygiene to what to eat after your wisdom teeth are removed. Fasting may also be required prior to sedation.