Removal of other impacted teeth or complex extractions

Information about removing other impacted (retained) teeth that your dentist will normally not perform in their practice due to the complexity and associated risks. If you have any questions, you should ask your GP or your Dentist.

What are impacted teeth and complex extractions?

Some teeth remain inside your bone and never erupt causing symptoms that include infections. Sometime teeth erupt in a position that is close to important anatomical structures such as your sinus cavity, nose cavity or near nerve that run along our jaws.

Your Dentist will refer you to an oral surgery specialist if this is your case before attempting to extract your tooth without success or placing you at risk.

Some Dentist who limit their practice to orthodontics, (brace treatment) will refer you to an oral surgery specialist for multiple teeth extractions that are required for your brace treatment or are in a difficult position for them to perform a simple extraction.

What are the benefits of seeing an oral surgeon for a complex extraction?

Your oral surgeon will analyse your case individually and possibly indicate special x-rays that can determine more details about the risks. Risk will be discussed with you and a treatment plan (surgical extraction) will be tailored to your case.

Oral Surgeons are used to complex and difficult extraction, have surgical  experience, training, use specialised instruments and equipment that  can minimise risks.

Are there any alternatives to surgery?

Some cases a buried tooth that is completely asymptomatic can be monitored with x-rays and avoid surgical treatment. However, is symptoms appear, antibiotics and rinsing with hot, salty water or chlorhexidine mouthwash, can help if the area around the impacted tooth becomes infected. These measures give only temporary relief of symptoms and do not treat the underlying cause.

Most likely surgical treatment will be necessary if conservative management fails.

What does the operation involve?

Complex extractions can be done by your oral surgeon under a local anaesthetic. Sometimes a sedation or a short general anaesthetic is needed depending on the complexity of the extraction and the patient’s tolerance. Complex extractions involve cutting the gum to uncover the tooth, removing bone around the tooth and dividing the tooth with a  drill. 

What complications can happen?

  • Pain
  • Bleeding
  • Swelling and bruising
  • Infection
  • Dry socket
  • Retained roots
  • Damage to nearby teeth
  • Sinus problems - (Oro-antral communication)
  • Broken jaw
  • Not being able to open the mouth fully (trismus) and jaw stiffness
  • Damage to nerves
  • Bisphosphonate-associated osteonecrosis of the jaw

How soon will I recover?

You should be able to go home the same day.

Depending on the difficulty of the operation and the likelihood of infection, you may be prescribed antibiotics.

You should not do any strenuous activities for the first 48 hours to reduce the risk of bleeding, swelling and bruising. You may need to take up to a week off work.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice. Most people make a full recovery.

  • Communication to maxillary sinus (Oro-antral communication)


Impacted teeth can sometimes cause serious problems. Removing a impacted teeth is usually a safe and effective way to prevent symptoms coming back.


Author: Mr Luis M Bruzual BDS, Cert(OMFS) 

This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.



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