Wisdom Tooth Removal: Oral Surgeon On-Site

Wisdom Teeth: Why They Cause Problems So Often

Wisdom teeth are the last teeth to emerge in the human mouth — typically between the ages of 17 and 25, sometimes considerably later. The challenge is straightforward: over the course of evolution, the human jaw has become shorter. In many cases, there simply is not enough space for the third molars.

According to the German Association for Oral and Maxillofacial Surgery (DGMKG), approximately 80 percent of young adults in Europe have at least one impacted or partially impacted wisdom tooth — meaning the tooth either fails to erupt through the gum or does so only partially. In Germany alone, an estimated one million surgical wisdom tooth removals are performed each year (source: DGZMK guideline on operative removal of wisdom teeth, 2019).

At Pul's Zahnmedizin in the WiloHealthCube at Wilopark 15 in Dortmund Phoenix-West, wisdom tooth extraction is performed by a specialist oral surgeon who practises regularly at our clinic. Diagnosis, surgery and aftercare all take place under one roof — no referral letter, no changing practices.

When Do Wisdom Teeth Need to Come Out?

Not every wisdom tooth requires extraction. The decision depends on the individual clinical situation. Following the S2k guideline of the German Society for Dental, Oral and Maxillofacial Medicine (DGZMK), the main indications include:

Acute Symptoms

• Pericoronitis: Inflammation of the gum tissue around a partially erupted wisdom tooth. This frequently affects the lower jaw and can lead to abscess formation if left untreated.
• Decay on the wisdom tooth or adjacent tooth: The difficult-to-reach position makes oral hygiene challenging. The second molar is often damaged as a result.
• Pain and pressure: Particularly when the wisdom tooth pushes against the neighbouring tooth or the jawbone.

Preventive Reasons

• Lack of space with foreseeable impaction: When imaging shows a wisdom tooth lying at an angle or horizontally in the jaw, threatening the adjacent tooth.
• Cyst formation: Impacted wisdom teeth can develop follicular cysts that damage the surrounding bone.
• Orthodontic planning: Extraction may be necessary as part of ongoing or planned orthodontic treatment.

When Can the Wisdom Tooth Stay?

If a wisdom tooth has fully erupted, stands in the correct position, has a functioning opposing tooth and shows no signs of inflammation or decay, there is no reason to remove it. At our practice, healthy and functional wisdom teeth are not extracted.

Diagnosis: CBCT Instead of Guesswork

Precise diagnosis is the first step in every wisdom tooth case at Pul's Zahnmedizin. Dr. Pul carries out the initial examination and imaging — including a three-dimensional scan using Cone Beam Computed Tomography (CBCT).

What CBCT Reveals That a Standard X-Ray Cannot

A conventional panoramic X-ray (OPG) shows the jaw in two dimensions. That is sufficient for straightforward cases. For the safe planning of a surgical wisdom tooth removal, however, three-dimensional information is essential:

• Exact position: How deep is the wisdom tooth? At what angle is it impacted?
• Proximity to the inferior alveolar nerve: This nerve runs through the jawbone directly beneath the wisdom tooth roots. Damage can cause numbness in the lower lip. CBCT shows the distance down to the millimetre.
• Root morphology: How many roots does the tooth have? Are they curved, fused or hook-shaped? This information determines the surgical approach.
• Bone quality and thickness: How much bone surrounds the tooth? Are there cysts or signs of resorption?

Dr. Pul evaluates the CBCT scans and discusses the findings with the specialist oral surgeon. Together, they develop the treatment plan — digitally documented, transparent and based on three-dimensional data.

The Procedure: Specialist Oral Surgeon Directly In-House

The extraction itself is performed by the specialist oral surgeon who practises regularly at our clinic at Wilopark 15 in Dortmund. The advantage of this model is clear: you stay in the practice you already know. The infrastructure, the digital records, the team — everything is on site.

How the Surgical Removal Works

1. Anaesthesia: The procedure is usually carried out under local anaesthesia. Sedation or general anaesthesia can be discussed if required.
2. Access: Depending on the position of the tooth, the gum is opened and bone may be removed to expose the tooth.
3. Extraction: In straightforward cases, the tooth is removed in one piece. For complex impactions, the surgeon divides the tooth into fragments and removes them individually — this preserves the surrounding bone.
4. Wound closure: The wound is sutured. In certain cases, a collagen insert can support healing.

Treatment duration varies: an uncomplicated removal often takes only 15 to 30 minutes per tooth. Complex impactions may take longer.

Aftercare: Follow-Up by Dr. Pul

After the procedure, Dr. Pul takes over the aftercare. This is a key benefit of the specialist centre model: you do not need to return to the surgeon for suture removal or follow-up examinations.

What to Expect After the Extraction

• Cooling: External cooling during the first 48 hours helps reduce swelling. Short intervals of 15 to 20 minutes with breaks in between are effective.
• Physical rest: Avoid sport and heavy physical activity for two to three days. Blood pressure should not rise significantly.
• Diet: Soft foods for the first few days. Avoid hot drinks, dairy products immediately after the procedure, and alcohol for the first 24 hours.
• Oral hygiene: Teeth may be brushed carefully from the second day, avoiding the wound area. No aggressive rinsing during the first few days.
• No smoking: Smoking significantly increases the risk of wound healing complications. At least one week of abstinence is strongly recommended.

When Should You Contact Us?

Please contact the practice if heavy bleeding occurs, if pain increases noticeably after three days rather than improving, if fever develops, or if swelling continues to grow after the third day. In such cases, a prompt check-up is important.

Impacted and Displaced Wisdom Teeth: A Common Scenario

The term impacted means the tooth remains fully enclosed in bone and does not erupt. Partially impacted describes a tooth that is only partly visible. Displaced means the tooth lies in an abnormal position — horizontal, angled or inverted.

A German study found the prevalence of impacted third molars in young adults to be approximately 73 percent (source: DGZMK guideline, literature review). The most common displacement patterns in the lower jaw are mesioangular (tilted towards the adjacent tooth) and horizontal impaction.

It is precisely with displaced wisdom teeth that the value of CBCT diagnostics becomes clear: the three-dimensional view allows the oral surgeon to plan the least invasive approach and to assess the proximity to critical structures with precision. The result is a shorter procedure with fewer post-operative complications.

Frequently Asked Questions

Is wisdom tooth extraction painful?

During the procedure, you will feel no pain thanks to local anaesthesia. In the days that follow, you can expect swelling and a feeling of pressure. Standard pain medication manages this effectively. Most patients report that discomfort subsides noticeably after three to five days.

Are all four wisdom teeth removed at once?

That depends on the individual situation. In many cases, removing all four teeth in one session is advisable, as you only go through one healing phase. For complex impactions or existing health conditions, removing teeth one side at a time may be preferable. The oral surgeon will discuss the best approach with you.

How long will I be off work after the procedure?

Typically, you should expect two to four days. Physically demanding occupations may require longer recovery. A medical certificate will be issued accordingly.

Why a specialist oral surgeon rather than a general dentist?

A specialist oral surgeon (Fachzahnarzt fuer Oralchirurgie) has completed a four-year postgraduate training programme in surgical dentistry after their degree. For deeply impacted, displaced or nerve-adjacent wisdom teeth, this experience makes a measurable difference in terms of safety and healing outcomes.

What does wisdom tooth removal cost?

When medically indicated, surgical wisdom tooth removal is covered by statutory health insurance in Germany. The CBCT scan may be billed as a private service for patients with statutory insurance if it goes beyond standard diagnostics. We will inform you transparently about any potential costs beforehand.

Wisdom Teeth in Dortmund: Everything Under One Roof

The combination of precise CBCT diagnostics by Dr. Pul and the surgical expertise of a specialist oral surgeon makes the difference. At the WiloHealthCube at Wilopark 15 in Dortmund Phoenix-West, the usual journey between dentist and surgeon is eliminated. Diagnosis, surgery and aftercare come from a single source.

If you have questions about your wisdom teeth or would like to arrange an initial consultation, you can reach us through our practice website. From 2027, our team welcomes you at the specialist centre for modern dentistry in Dortmund.