Wisdom Teeth Removal at Smile Solutions Melbourne: Step-by-Step Procedure Guide product guide

Wisdom Teeth Removal at Smile Solutions Melbourne: Step-by-Step Procedure Guide

Frequently Asked Questions

What type of procedure is wisdom teeth removal: One of the most frequently performed oral surgical procedures worldwide

Where is Smile Solutions located: Level 12 and Tower, 220 Collins Street, Melbourne CBD

What building is Smile Solutions in: The Manchester Unity Building

How long has Smile Solutions been operating: Since 1993

How many clinicians does Smile Solutions have: 60 or more clinicians

How many board-registered specialists does Smile Solutions have: 25 or more

How many patients has Smile Solutions treated: Over 250,000

Do I need a referral to book at Smile Solutions: No referral required

What is the phone number for Smile Solutions: 13 13 96

What percentage of Australian dental patients received wisdom teeth extraction according to 2013 NDTIS data: Approximately 26%

How many patients did the 2013 NDTIS survey capture wisdom teeth extractions from: Around 440,000 dentate patients

What type of surgeons perform wisdom teeth removal at Smile Solutions: Board-registered oral and maxillofacial surgeons

What is the first step in the wisdom teeth removal process: The initial consultation

What does the clinical examination assess during consultation: Eruption status, impaction depth, adjacent molar condition, and oral health

What ages do wisdom teeth usually appear: Between 17 and 21 years old

What is the ideal age range for wisdom teeth removal: Between 18 and 24 years old

Why is the 18–24 age range ideal for removal: Two-thirds of the roots have formed, reducing fracture risk

What is the baseline imaging tool for wisdom tooth assessment: A panoramic radiograph (OPG)

What is CBCT: Cone Beam Computed Tomography, a 3D imaging scan

When is CBCT ordered instead of OPG: When lower wisdom teeth appear close to the inferior alveolar nerve

What nerve is most at risk during lower wisdom tooth removal: The inferior alveolar nerve (IAN)

What does CBCT allow assessment of that OPG cannot: Three-dimensional position relative to nerves and bony structures

Can CBCT detect root resorption of the adjacent second molar: Yes

Is informed consent discussed before surgery: Yes

What risks are discussed during informed consent: Nerve injury, sinus proximity, dry socket, and infection

Is anaesthesia type confirmed at the consultation: Yes

What are the three anaesthesia options at Smile Solutions: Local anaesthetic, IV conscious sedation, and general anaesthetic

Is local anaesthetic used during IV sedation or general anaesthetic: Yes, in all cases regardless of sedation type

Why is local anaesthetic used even under general anaesthetic: To reduce post-operative discomfort and lower systemic agent doses

Is fasting required before general anaesthesia: Yes, after midnight the night before

Is fasting required before IV sedation: Yes, as directed by the surgeon

How long should patients stop smoking before surgery: 48 to 72 hours prior to the operation

How long should patients stop smoking after surgery: 48 to 72 hours after the operation

Can you drive yourself home after IV sedation: No

Who must drive you home after IV sedation: Someone over 18 years old

What should you wear on surgery day: Loose, comfortable clothing

Should you wear jewellery to a hospital procedure: No

How long does the surgical extraction typically last: Approximately 45 to 60 minutes

How long will patients typically be at the clinic total: Approximately 90 to 120 minutes

What is the first intraoperative step for an impacted tooth: Soft tissue incision and flap elevation to expose the tooth

Why is saline irrigation used during bone removal: To prevent thermal damage to the bone

What is tooth sectioning: Dividing the tooth into sections before removal

Why is tooth sectioning performed: To reduce extraction force and minimise trauma to adjacent structures

What type of sutures are typically used at Smile Solutions: Resorbable (dissolvable) sutures

Do resorbable sutures require a removal appointment: No

What is the biological foundation of socket healing: Formation of a stable blood clot

How long should you bite on gauze after surgery: 30 to 45 minutes post-surgery

How should ice packs be applied post-surgery: 10 to 20 minutes on, every 1 to 2 hours, for the first 1 to 2 days

When should you switch from ice to warmth post-surgery: After 48 hours

What over-the-counter pain medications are commonly used: Ibuprofen and paracetamol

When can gentle salt water rinsing begin: After 24 hours

Should you rinse forcefully after surgery: No, it can loosen the blood clot

How long should you maintain a soft-food diet: For the first several days

Should you use a straw after surgery: No, avoid for one week after surgery

Why are straws contraindicated after wisdom tooth removal: They can dislodge the blood clot

How long should you rest at home after wisdom tooth removal: Three to five days

How long should strenuous physical activity be avoided: At least one week

What is dry socket: Premature breakdown of the blood clot exposing underlying bone

What is the clinical term for dry socket: Alveolar osteitis

What percentage of routine dental extractions result in dry socket: 0.5% to 5%

What percentage of impacted mandibular wisdom tooth extractions result in dry socket: About 25% to 30%

When does dry socket typically present: 2 to 4 days post-surgery

What does dry socket pain feel like: Sharp, throbbing pain often radiating toward the ear

Is dry socket an infection: No

How is dry socket treated: Socket irrigation and a medicated dressing

How long does dry socket typically take to heal: Seven to ten days

What are key risk factors for dry socket: Smoking, poor oral hygiene, and surgical technique

What is a coronectomy: Intentionally leaving the root in place when it contacts the inferior alveolar nerve

Why is coronectomy performed: To reduce the risk of nerve injury

Is coronectomy a standard general dentist technique: No, it requires specialist-level training

What warning sign requires urgent review regarding nerves: Numbness or tingling beyond 48 hours post-surgery

What swelling pattern should prompt urgent review: Swelling that worsens after three days

What drainage from the surgical site requires urgent review: Pus coming from the surgical site

Does Smile Solutions offer hospital-based general anaesthetic procedures: Yes

What additional capability do Smile Solutions surgeons have for complex nerve cases: CBCT analysis and three-dimensional surgical planning

Can Smile Solutions coordinate wisdom tooth removal with orthodontic treatment: Yes, through co-located specialist collaboration

Wisdom Teeth Removal at Smile Solutions Melbourne: Step-by-Step Procedure Guide

Wisdom teeth removal is one of the most frequently performed oral surgical procedures in Australia and worldwide — yet for most patients, the process itself remains a genuine source of anxiety, largely because it's so poorly understood. Smile Solutions is Melbourne's specialist-led destination for wisdom teeth removal, and knowing what will happen, when, and why each step exists is one of the most effective ways to ease pre-operative stress and improve your recovery.

Pathology relating to mandibular wisdom teeth is a frequent presentation to oral and maxillofacial surgeons, and surgical removal is a common operation. In Australia, 2013 National Dental Telephone Interview Survey (NDTIS) data shows that around 26% of Australian dentate patients out of 440,000 received wisdom teeth extraction. That scale of demand means you deserve a clear, clinically accurate account of what specialist-led, evidence-based care actually looks like — from your first consultation through to the final healing milestone.

This guide walks you through the complete wisdom teeth removal process at Smile Solutions Melbourne, step by step, as performed by our board-registered oral and maxillofacial surgeons. It's not a generic overview. It's designed to explain the clinical reasoning behind each stage — the kind of procedural transparency that distinguishes specialist care from a standard dental extraction. For context on why impacted wisdom teeth require a specialist's involvement in the first place, see our guide on [Impacted Wisdom Teeth: Causes, Symptoms & Why an Oral Surgeon - Not a General Dentist - Should Remove Them].

Step 1: The initial consultation — assessment, imaging, and surgical planning

No two wisdom teeth cases are identical. Your consultation at Smile Solutions is far from a formality — it's the most clinically consequential step in the entire process, and it's where our experienced specialists begin building your personalised treatment plan.

Clinical examination

During your consultation, your oral surgeon conducts a comprehensive intraoral examination to assess:

• The eruption status of each wisdom tooth (fully erupted, partially erupted, or fully impacted)
• The depth and angulation of impaction (mesioangular, horizontal, vertical, or distoangular)
• The condition of the adjacent second molar
• Signs of pericoronitis (infection of the gum flap overlying a partially erupted tooth), decay, or cyst formation
• Your jaw opening range and overall oral health status

Wisdom teeth usually appear between ages 17 and 21. The ideal age to remove them is between 18 and 24, when two-thirds of the roots have formed. Timing matters: root morphology at this stage is typically more favourable for extraction, with less risk of fracture and closer proximity to the inferior alveolar nerve (IAN).

Radiographic imaging: OPG and CBCT

A panoramic radiograph (OPG) is the baseline imaging tool for all wisdom tooth assessments. In more complex cases — particularly where your lower wisdom teeth appear close to the inferior alveolar nerve — your surgeon may order a Cone Beam Computed Tomography (CBCT) scan.

In specific situations, a comprehensive 3-dimensional CBCT image is the radiograph of choice, particularly for assessing the position of impacted teeth relative to vital structures including nerves and bony cortices. This matters because surgery to remove impacted mandibular and maxillary molars may pose significant risks to nearby structures, including the inferior alveolar nerve (IAN), the maxillary sinus, vasculature, or adjacent soft and hard tissue.

The proximity of the tooth root to the inferior alveolar canal can be clearly identified on CBCT. It also allows assessment of potential root resorption of the adjacent second molar and bone loss at its distal aspect as a consequence of the third molar.

A real-world example of CBCT's clinical value: a patient initially visited their dentist in pain, and the dentist attempted removal based only on an OPG. Only after referring to a specialist — where CBCT revealed the inferior alveolar canal running between the roots — was the risk of nerve injury avoided.

Informed consent and surgical planning

Decisions are made based on your detailed medical history, physical and radiographic examination, and your level of anxiety. The discussion covers the standard risks, benefits, and alternatives — including the small chance of injury to the nerve of the lower jaw and the upper jaw sinus that sit in close proximity to the wisdom teeth. Short- and long-term consequences, along with post-surgical instructions and possible complications like dry socket and infection, are discussed in detail with you.

Your anaesthesia option is also confirmed at this stage. For a detailed breakdown of the clinical criteria that determine whether local anaesthetic, IV sedation, or general anaesthetic is appropriate for your situation, see our guide on [Anaesthesia Options for Oral Surgery: Local, IV Sedation & General Anaesthetic Compared].

Step 2: Pre-operative preparation

What to do before surgery day

Once your surgical plan is confirmed, you'll receive specific pre-operative instructions. These aren't optional — they directly affect your safety and outcomes.

Key pre-operative requirements include:

• Fasting: After midnight the night before if you're having general anaesthesia. For IV sedation, similar fasting windows apply as directed by your surgeon.
• Smoking cessation: No smoking or vaping for 48 to 72 hours before, and after, the operation. Smoking is a significant risk factor for post-operative complications, particularly dry socket.
• Medication review: Certain medications — including blood thinners, some supplements, and anti-inflammatory drugs — may need to be paused or adjusted. Bring a full medication list to your consultation so your surgeon can advise you.
• Transportation: After IV sedation, you cannot drive yourself and will need someone over 18 to take you home. You'll be groggy and in no state to drive, so arrange this well in advance.
• Clothing: Wear loose, comfortable clothing. Avoid jewellery, contact lenses, or nail polish if a hospital procedure is planned.

Step 3: Anaesthesia administration

Anaesthesia selection is one of the most important decisions in your procedure — and, understandably, one of the most anxiety-provoking for patients. At Smile Solutions, our experienced specialists offer three primary options, tailored to your clinical needs and personal comfort:

General anaesthesia — given through an IV, gas, or both — puts you to sleep during the procedure. This is typically used for more complex situations.

Your surgeon will also administer local anaesthetic to numb the surgical field in all cases, even under IV sedation or general anaesthetic. This reduces post-operative discomfort and allows for lower doses of systemic agents.

Step 4: The surgical extraction — a step-by-step breakdown

Depending on how many wisdom teeth are being extracted, surgery typically lasts approximately 45 to 60 minutes, though more complex extractions can take longer. Combined with check-in and recovery room time, you'll likely be with us for about 90 to 120 minutes in total.

Here is what happens intraoperatively, in sequence:

4a. Soft tissue incision (flap elevation)

Your surgeon makes incisions in the gums, if necessary, to expose teeth trapped in the gums or jawbone. For a fully impacted tooth, a mucoperiosteal flap is carefully elevated to expose the underlying bone and tooth crown.

4b. Bone removal

After the anaesthesia takes effect, your surgeon carefully checks all surgical sites for numbing and makes an incision in the gum tissue to expose the tooth and bone. Any bone blocking access to the tooth root is then removed using a surgical handpiece with copious saline irrigation to prevent thermal damage to the bone — a step that is critical for healing.

4c. Tooth sectioning

For deeply impacted or curved-root teeth, the tooth is divided into sections before removal. Your surgeon carefully loosens the wisdom tooth and lifts it from its socket, dividing it into sections for easier removal where needed. Sectioning reduces the force required for extraction and minimises trauma to adjacent structures.

4d. Tooth delivery and socket debridement

Once the tooth is out, the site is cleaned of debris from the tooth and bone. The socket is irrigated with sterile saline, and your surgeon inspects the site to confirm all tooth fragments and any pathological tissue (such as a dentigerous cyst lining) have been removed.

4e. Wound closure and haemostasis

The wound is stitched — usually with dissolvable sutures — to promote healing, with gauze placed over the site to control bleeding and help a blood clot form. In most cases at Smile Solutions, resorbable sutures are used, so no suture removal appointment is required.

The formation of a stable blood clot in the socket is the biological foundation of healing. This clot will organise into granulation tissue and, over several weeks, be replaced by new bone — a process detailed in our guide on [Wisdom Teeth Removal Recovery: A Day-by-Day Timeline, Diet Plan & Warning Signs to Watch].

Step 5: Immediate post-operative recovery

Following your procedure, you'll be monitored in our recovery area until the anaesthetic has sufficiently worn off. Our clinical team will:

• Assess bleeding, vital signs, and your level of alertness
• Apply fresh gauze packs and guide you on bite pressure technique
• Administer or prescribe analgesics and, where clinically indicated, antibiotics
• Provide clear written post-operative instructions before discharge

After wisdom teeth removal, you can expect mild discomfort, slight bleeding, and swelling. Your oral surgeon will give you personalised instructions to ease these side effects and support your recovery.

Step 6: Post-operative care instructions

Your adherence to post-operative instructions is the primary patient-controlled variable in your healing outcomes. Following your surgeon's guidance carefully gives you the best possible chance of a smooth recovery.

Bleeding management

Some oozing is normal, but excessive bleeding is not. Bite firmly on gauze for 30 to 45 minutes post-surgery and replace packs as needed. Persistent bleeding beyond 24 hours warrants urgent contact with our practice.

Swelling and pain control

Apply an ice or cold pack to your cheek for 10 to 20 minutes at a time, every 1 to 2 hours for the first 1 to 2 days (when awake) or until the swelling subsides. After 48 hours, switching to gentle warmth can help reduce any residual swelling.

For pain, most people manage well with over-the-counter ibuprofen and paracetamol. Your surgeon will prescribe stronger analgesics if the complexity of your case warrants it.

Oral hygiene

After 24 hours, gently rinse with warm salt water several times a day to reduce swelling and relieve pain. Don't rinse hard — this can loosen the blood clot and delay healing.

Diet

Maintain a soft-food diet for the first several days. Yoghurt, mashed vegetables, scrambled eggs, and smooth soups are all good options. Hard, crunchy, and spicy foods should be avoided. Straws are also off the table: avoid them for a week after surgery, as the suction can dislodge the blood clot.

Return to normal activity

Plan to rest at home for three to five days after wisdom tooth removal. Most people can resume work, school, and other routines at that point. Strenuous physical activity should wait at least a week, as anything that raises your heart rate can increase post-operative pain, bleeding, and swelling.

Recognising complications: what requires urgent review

Most wisdom tooth removals proceed without serious complications. Knowing what to watch for gives you confidence during recovery — and means you'll act quickly if something does go wrong.

Dry socket (alveolar osteitis)

Dry socket is the most common post-operative complication. It occurs in 0.5% to 5% of routine dental extractions, and in about 25% to 30% of extractions of impacted mandibular wisdom teeth. Some studies have reported rates as high as 68%. The condition is characterised by prolonged moderate to severe pain at the extraction site.

It results from premature breakdown of the early platelet clot, exposing the underlying bone in the socket. Key risk factors include smoking, poor oral hygiene, and surgical technique.

Dry socket typically presents as sharp, throbbing pain beginning 2 to 4 days post-surgery, often radiating toward the ear. It is not an infection, but it does require clinical management — usually socket irrigation and a medicated dressing. With proper care, dry socket heals within seven to ten days as new tissue forms to cover the exposed area.

Other red-flag symptoms

Contact Smile Solutions urgently if you experience:

• Excessive bleeding; severe pain that doesn't improve with medication; difficulty breathing or swallowing; swelling that worsens after three days; or pus coming from the surgical site.
• Prolonged numbness, tingling, or altered sensation in the lip, chin, cheek, or tongue beyond 48 hours post-surgery.

Our team is here to support you — don't hesitate to reach out if something doesn't feel right.

How Smile Solutions' specialist-led approach differs from a general dental extraction

The procedural steps described above are technically possible in a general dental setting for simple, fully erupted wisdom teeth. The clinical difference becomes significant for complex or impacted cases — which represent the majority of wisdom tooth presentations in young adults.

A board-registered oral and maxillofacial surgeon at Smile Solutions brings several capabilities that are not standard in general dental practice:

• Advanced imaging interpretation: CBCT analysis and three-dimensional surgical planning for nerve-proximate cases, enabling a safer and more informed surgical approach.
• Coronectomy technique: Retaining a small part of the root or root apex to reduce the risk of nerve injury has been common practice for many decades. Intentionally leaving the root in place when it is in direct contact with the inferior alveolar nerve requires specialist-level training and clinical judgement.
• Hospital and IV sedation access: Complex cases, highly anxious patients, or patients requiring all four teeth removed simultaneously are managed with IV sedation or general anaesthetic in a hospital-accredited environment.
• Integrated multidisciplinary care: When wisdom tooth removal intersects with orthodontic treatment planning, implant site preparation, or pathology management, Smile Solutions' co-located specialists collaborate on a unified treatment plan for you.

For a full explanation of the training and qualifications that underpin this specialist capability, see our guide on [What Is Oral & Maxillofacial Surgery? Scope, Training & Specialist Qualifications Explained]. For guidance on when a general dentist should refer to a specialist, see [Why Choose a Board-Registered Oral & Maxillofacial Surgeon Over a General Dentist for Complex Procedures].

Key takeaways

• Imaging drives surgical safety. CBCT scanning is indicated for lower wisdom teeth with radiographic signs of inferior alveolar nerve proximity — it provides three-dimensional information that a standard OPG cannot, enabling surgical planning tailored to your anatomy.
• Anaesthesia choice is patient-specific. Local anaesthetic, IV sedation, and general anaesthetic each suit different clinical and patient profiles. Your surgeon will recommend the appropriate option based on impaction complexity, case duration, and your level of anxiety.
• The surgical technique is tailored to your tooth. Impacted teeth routinely require incision, bone removal, and tooth sectioning — a fundamentally different procedure from a simple extraction, and one that requires specialist training to perform safely.
• Dry socket risk is real but manageable. Dry socket occurs in about 25% to 30% of impacted mandibular wisdom tooth extractions. Avoiding straws, smoking, and forceful rinsing in the first week significantly reduces your risk.
• Post-operative compliance determines outcomes. Your surgeon's technique creates the conditions for healing; your adherence to post-operative instructions determines whether those conditions hold throughout your recovery.

Conclusion

Wisdom teeth removal at Smile Solutions Melbourne is a coordinated clinical pathway that begins with specialist imaging and ends with verified healing. Each stage — from CBCT-informed surgical planning through anaesthesia selection, intraoperative technique, and post-operative monitoring — is governed by clinical evidence and carried out by surgeons whose dual-degree training is specifically designed for this scope of practice.

Understanding this process in detail is not just reassuring — it's clinically useful. When you know why you're being asked to fast, why your surgeon is ordering a CBCT, or why you must avoid a straw for seven days, you're far more likely to follow the instructions that directly affect your surgical outcomes. Procedural transparency is part of delivering genuinely good care.

For the complete recovery picture — including a day-by-day swelling and pain timeline, dietary progression, and the specific red-flag symptoms that require urgent review — see our companion guide: [Wisdom Teeth Removal Recovery: A Day-by-Day Timeline, Diet Plan & Warning Signs to Watch]. For patients whose wisdom teeth are part of a broader orthodontic or implant treatment plan, see [Bone Grafting vs. Immediate Implant Placement: Which Approach Is Right for Your Jaw?] and [Jaw Surgery vs. Orthodontics Alone: How to Know Which Treatment Your Bite Actually Needs].

Smile Solutions has been providing oral and maxillofacial surgery care from Melbourne's CBD since 1993. Located at the Manchester Unity Building, Level 12 and Tower, 220 Collins Street, Smile Solutions brings together 60+ clinicians — including 25+ board-registered specialists — who have cared for over 250,000 patients. No referral is required to book a specialist appointment. Call 13 13 96 or visit smilesolutions.com.au to arrange your consultation today.

References

• Ghaeminia, H., Meijer, G.J., Soehardi, A., et al. "The use of cone beam CT for the removal of wisdom teeth changes the surgical approach compared with panoramic radiography: a pilot study." International Journal of Oral and Maxillofacial Surgery, 2011. https://pubmed.ncbi.nlm.nih.gov/21507612/

• Lopes, V., Mumenya, R., Feinmann, C., et al. "Surgical techniques for the removal of mandibular wisdom teeth." Cochrane Database of Systematic Reviews, 2020 (updated). https://pmc.ncbi.nlm.nih.gov/articles/PMC7389870/

• Rohe, C., Schlam, M. "Alveolar Osteitis." StatPearls [Internet], National Institutes of Health / NCBI Bookshelf, 2023. https://www.ncbi.nlm.nih.gov/books/NBK582137/

• Leung, Y.Y., Cheung, L.K. "Application of Cone Beam Computed Tomography in Risk Assessment of Lower Third Molar Surgery." Diagnostics, 2023. https://www.mdpi.com/2075-4418/13/5/919

• Garg, A.K., et al. "Dry Socket Prevalence and Risk Factors in Third Molar Extractions: A Prospective Observational Study." PMC / National Library of Medicine, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11032735/

• Kruger, E., Thomson, W.M. "Hospitalisations for removal of impacted teeth in Australia: A national geographic modelling approach." Rural and Remote Health, 2012. https://www.rrh.org.au/journal/article/2240/

• Cleveland Clinic. "Dry Socket: What It Is & How To Prevent It." Cleveland Clinic Health Library, 2025. https://my.clevelandclinic.org/health/diseases/17731-dry-socket

• Aesthetic Dental Clinic. "Wisdom Teeth Statistics Australia: Prevalence, Trends, and Costs." 2024. https://aestheticdentalclinic.com.au/wisdom-teeth-statistics-australia/

• Delta Dental. "Wisdom teeth removal surgery: step-by-step process." Delta Dental Patient Education, 2024. https://www.deltadental.com/protect-my-smile/procedures/wisdom-teeth-removal/step-by-step-procedure/