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Not every wisdom tooth needs to be removed, and not every one can stay. The decision follows an examination and imaging, not a description of pain over the phone.
Wisdom teeth erupt last, usually between the ages of 17 and 25, when the jaw has already taken its adult shape. When there is not enough room, the tooth stays partly or fully covered by gum and bone, tilted against the neighbouring molar or against the ascending branch of the lower jaw.
That is where the familiar complaints begin: inflammation of the gum flap over a partly erupted tooth, repeated episodes of pain and swelling, plaque collecting in an area a brush cannot reach, decay on the back surface of the adjacent second molar, and sometimes a periodontal pocket behind it.
Removal is justified when inflammation around the crown keeps returning, when the wisdom tooth or its neighbour has decay that cannot be treated predictably, when there is a periodontal pocket behind the second molar, when imaging shows a cyst-like change around the crown, or when the tooth obstructs planned orthodontic or prosthetic treatment.
A fully erupted, cleanable and symptom-free wisdom tooth that has an opposing tooth and is not damaging its neighbour is usually left alone. In those cases we suggest monitoring with a follow-up radiograph. Preventive removal of a healthy tooth is not an automatic decision and we do not offer it as a default.
The cone beam scanner (CBCT) in the clinic shows the exact position of the roots in relation to the inferior alveolar nerve canal, the thickness of the surrounding bone, and for upper wisdom teeth the relationship to the maxillary sinus. A conventional two-dimensional radiograph cannot answer those questions reliably.
Based on the scan we plan the access, decide whether the tooth will be sectioned, and assess the individual risk for your specific case. When the roots sit directly against the nerve canal, we discuss more conservative options before proceeding to complete removal.
We reply within one working day.
All surgical procedures in the clinic are performed by Dr Nevena Karadjova, specialist in oral surgery (Medical University of Varna, 2019), former assistant in the Department of Oral and Maxillofacial Surgery at MU-Varna and resident at the Maxillofacial Surgery Clinic of UMHAT Sv. Marina until 2017.
We work Monday to Friday 09:00 to 18:00 and Sunday 08:00 to 14:00. The clinic is closed on Saturday. Appointments outside these hours are possible only by prior arrangement.
Stages of treatment
Five steps. There is normally time to think between the first and the second, since we do not schedule surgery on the day of the consultation unless you ask us to.
Clinical examination, assessment of the complaint and an honest conversation about whether removal is indicated at all. If a scan is needed, we explain why and what it costs before taking it.
We read the position of the roots, the nerve and the sinus and choose the surgical approach. You are told what will be done, how long recovery takes and what it costs: EUR 125 for an erupted wisdom tooth and EUR 200 to EUR 250 for an impacted tooth requiring surgical removal.
The procedure is carried out under local anaesthesia. For patients with marked anxiety, sedation is available and is planned in advance rather than arranged on the day.
Access through the gum, sectioning of the tooth where needed, removal, cleaning of the socket and sutures. In a typical case the procedure rarely takes longer than an hour.
The first 48 hours carry most of the swelling. You receive written instructions on cooling, eating, hygiene and medication. Sutures are removed at a review appointment about a week later.
What the evidence shows
1.4 mm
pocket depth reduction after non-surgical therapy
Systematic review commissioned for the European Federation of Periodontology S3-level clinical practice guideline: subgingival instrumentation produced a weighted pocket depth reduction of 1.4 mm (95% CI 1.0–1.7 mm) at 6–8 months, with an estimated 74% of pockets closing.
Suvan J, et al. Subgingival instrumentation for treatment of periodontitis: a systematic review. J Clin Periodontol 2020;47(S22):155–175. (opens in a new window) · Sanz M, et al. Treatment of stage I–III periodontitis — the EFP S3 level clinical practice guideline. J Clin Periodontol 2020;47(S22):4–60. (opens in a new window)
Who this is for
Good to know
Removing an impacted wisdom tooth is surgery and carries real risks. The most common are swelling, limited mouth opening for a few days and dry socket, a painful condition in which the blood clot breaks down early. Less commonly, lower wisdom tooth surgery can injure the inferior alveolar nerve and cause temporary altered sensation in the lip, chin or tongue; permanent injury is rare. Your individual risk is assessed on the CBCT and discussed before we operate.
With upper wisdom teeth there is a possibility of a communication between the mouth and the maxillary sinus, which is closed immediately if it is recognised. Bleeding, wound infection and slower healing in smokers and in patients with certain medical conditions are also possible.
We work with precise anaesthesia and a gentle touch, adapting to your individual comfort level. Under local anaesthesia you should feel pressure rather than pain, but discomfort afterwards is a normal part of healing. If you have difficulty breathing or swallowing, bleeding you cannot control, major facial swelling or significant trauma, seek urgent medical help or call 112.
Alternatives
For a symptom-free tooth with no sign of damage to its neighbour, a review appointment and radiograph at set intervals instead of surgery.
For inflammation of the gum flap and a pocket behind the second molar. Non-surgical periodontal therapy reduces pocket depth by an average of 1.4 mm at six to eight months, but it does not solve a problem that the position of the tooth keeps recreating.
When the roots lie directly against the nerve, it is sometimes more sensible to remove the crown and leave the roots under review. The approach has its own limitations and is not suitable in every case.
Price
We will get back to you within one working day to arrange the time that suits you best.
| Treatment | Price |
|---|---|
| Wisdom tooth extraction | from €125 |
| Surgical removal of an impacted wisdom tooth | €200–250 |
Meet the dentist
Dentist · Specialist in Oral Surgery
All implantology and All-on-X surgery of the clinic: implants, bone grafting and sinus lift, oral surgery, aesthetic medicine.
No. A wisdom tooth that has erupted fully, has an opposing tooth, can be cleaned and causes no symptoms is usually monitored. Removal is indicated for repeated inflammation, decay, a periodontal problem behind the neighbouring tooth or a change visible on imaging. The decision follows an examination and a radiograph, not a phone call or a list of symptoms.
An erupted wisdom tooth removed in the conventional way costs EUR 125. An impacted tooth requiring surgical access through bone costs between EUR 200 and EUR 250 depending on the complexity, which the scan defines. The price is confirmed after the examination.
Usually yes. Swelling is part of normal healing, peaks within the first 48 hours and then settles gradually. Cooling from outside on the first day, a quiet day or two and following the written instructions all help. If swelling increases after the third day or you develop a fever, contact the clinic.
Most patients return to their usual routine after two or three days, though soft tissue healing takes around two weeks and bone healing takes months. Plan the surgery so that you have at least one quiet day afterwards, and avoid heavy physical exertion during the first days.
Yes. Sedation is available and is discussed in advance so that preparation, an accompanying adult and the restrictions for that day are clear. It does not replace local anaesthesia; it reduces anxiety during the procedure. If dental treatment frightens you, tell us at the consultation so we can plan around it.
The clinic holds a contract with the National Health Insurance Fund. What is covered depends on the type of procedure, your age and your insurance status, and the scope changes over time. At the consultation we check what can be carried out under the fund in your case and what remains payable, before treatment begins.
After an extraction the most useful thing is knowing in advance what is expected and what is not. This article sets out the first 48 hours, how to care for the socket and the signs that need a call.
Read moreThere is no single universal waiting time. An implant can go in at the same appointment, after the gum has closed, or after the bone has rebuilt. Which applies is decided by the condition of that specific site.
Read moreInflammation around a partially erupted wisdom tooth usually settles within days and returns months later. This article explains why that happens, what is done for an acute episode and when the problem is solved for good.
Read morePain behind the last tooth, pressure in the jaw or a swollen flap of gum lead to the same question. This article sets out which symptoms are common, which need fast action and why a description is never a diagnosis.
Read moreRemoving a wisdom tooth that has not erupted is planned surgery rather than a simple extraction. This article sets out what the operation involves, how recovery usually goes, what the real risks are and what it costs.
Read moreRelated treatments
Discover the smile that suits you.
You leave with a clear answer on whether removal is indicated, what the risk is and what it costs, with no obligation to continue with us.
We reply within one working day.
