Four Wisdom Teeth, One Sleep: All Four Wisdom Teeth Removed at Once
It usually starts in one corner. The gum at the very back gets sore, food keeps getting stuck, and it flares up again every few months. Sometimes it’s all four wisdom teeth causing trouble at once — two stuck under the gum, two only half through. When that’s the picture, our Brisbane dentists often take all four out together in one go, while you’re fully asleep and through sleep dentistry in Brisbane under general anaesthesia. That’s what it means when all four wisdom teeth come out at once: one sleep, the whole lot done in a single visit — when it’s necessary and the right path.
What Makes Us Decide All Four Should Come Out
Taking out all four at once isn’t automatic — it depends on what your wisdom teeth are actually doing. A few things tip the decision for our team:
- More than one is playing up: When several wisdom teeth are sore, infected, or stuck at the same time, we’ll often deal with them together rather than dragging it out over separate visits.
- A tooth is stuck (impacted): Some wisdom teeth are buried under the gum or bone with no real path out. These rarely sort themselves out, so we usually recommend wisdom teeth removal Brisbane.
- The gum keeps getting infected: A tooth that’s only half through traps bacteria, and the gum over it flares up again and again. Once that becomes a pattern, taking the tooth out is usually the fix.
- Food keeps getting trapped: When a wisdom tooth is hard to reach, food and plaque build up there — and that can start to rot both that tooth and the healthy one next to it.
- It’s harming the tooth next door: If our dentists can see a wisdom tooth pushing on or damaging the molar beside it, removing it protects the good tooth.
- You’re already going to be asleep: Once you’re under for one or two, taking all four out in the same visit usually means one procedure and one recovery — instead of going through it all again later.
Why This One Went to Sleep, Not the Sedation Chair
Not every wisdom tooth needs a hospital and a general anaesthetic. Plenty come out in the chair with a local anaesthetic. So why did this person go all the way to sleep?
It came down to what we were dealing with. All four wisdom teeth were coming out in one visit — two of them up top sitting impacted, and two down the bottom, only partway through, with the gum around them flaring up and food getting caught. Teeth like that don’t just lift straight out. A couple of them needed proper surgical removal, which takes time and a still, settled patient.
That last part is the real reason. The deepest sleep-type sedation we can run in our own rooms is IV sedation — but sometimes it isn’t the right tool for wisdom tooth surgery. Under it, you’re drowsy but not fully under, and small unconscious movements may still occur. You don’t want movement when there’s work going on close to the nerve at the base of a lower wisdom tooth. So for a job like this — all four at once, surgical lowers, no room for fidgeting — sleep dentistry Brisbane, which means a full general anaesthetic in hospital is the safer, calmer option.
And it worked the way it should. Our dentist took all four out in a single visit; the patient was looked after by the anaesthetist the whole time, and they came through it well.
What We Check on the X-ray Before We Decide to Operate
Before we agree to take any wisdom teeth out, we take a picture. Usually, a full-mouth X-ray called an OPG — the same one we reviewed for the patient in this case, before planning all four. It tells us far more than looking in the mouth ever could, because most of a wisdom tooth’s story is hidden under the gum and bone.
Here’s what we’re actually looking at:
- Position: How the tooth is sitting — upright, tilted, or lying sideways. A tooth angled into the one in front is heading for trouble; one sitting straight and clear often isn’t.
- How deep it is: Whether it’s through the gum, half-through, or fully buried in bone. Sometimes, the deeper and more buried it is, the more likely it needs a surgical removal rather than a simple lift-out.
- The nerve underneath: On the lower teeth, we look at how close the roots sit to the nerve that runs through the lower jaw. If they look close, that changes our plan.
- Whether we need a 3D scan: If that nerve looks close on the OPG, we’ll often take a CBCT — a 3D scan — before anyone operates, so we can see exactly how the roots and the nerve line up.
- The tooth next door: Whether the wisdom tooth is pushing on or starting to damage the healthy molar in front of it. That neighbour is often the real reason to act.
- Signs of trouble already there: Decay, infection around the crown, or the odd cyst or dark patch that needs a closer look. Some of this you’d never feel until it’s well advanced.
- The roots themselves: Their shape and number, and whether they’re curved or hooked. This tells us how straightforward — or fiddly — the removal is likely to be.
The Risks We Won’t Let You Sign Without Hearing
The team at Pure Dentistry don’t hand you a consent form and point at the line. Before anything happens, we talk through what could go wrong — properly. For the patient in this case, every one of these was explained, questions answered, and consent given in writing before we started.
Here’s what that conversation covers:
- The common stuff, every time: Pain, swelling, bruising, some bleeding, a stiff jaw for a few days, and a chance of infection. This is normal after any extraction and usually settles for most people within a week.
- Dry socket: When the blood clot in the socket comes loose too early and leaves the bone exposed. It’s more likely with the lower teeth, and it hurts — but it’s manageable, and we tell you how to lower the odds.
- The nerve in the lower jaw: The lower wisdom teeth sit near the nerve that gives feeling to your lip and chin. Disturbing it can leave numbness or tingling there. Usually temporary — rarely, it lasts.
- The nerve to the tongue: A separate nerve near the lower teeth affects sensation and taste on part of the tongue. The same applies — usually it settles, occasionally it lingers.
- The sinus above the upper teeth: The roots of the top wisdom teeth can sit right against the sinus. Removing them can open a small connection into it, which sometimes needs a little extra effort to close.
- When surgery is involved: If a tooth needs the gum lifted, a little bone removed, or the tooth split to come out, expect more swelling and a slightly longer recovery than a simple extraction.
How Recovery Usually Goes
Here’s the shape recovery usually takes, the same guidance we gave the patient in this case:
- The first hour: Bite firmly on the gauze for 30 to 60 minutes to settle the bleeding. A bit of oozing afterwards is normal, not a problem.
- Get ahead of the pain: Start your pain relief before the numbness wears off — this is the single most useful thing you can do. Chasing the pain after it’s set in is much harder.
- The first day — ice: Ice on the cheeks, 15 minutes on and 15 off, for the first 24 hours. It keeps the swelling down before it builds.
- Days two and three — the peak: Swelling and stiffness usually peak around 48 to 72 hours, not on day one. So if day three looks worse than day one, that’s expected.
- Keeping it clean: No rinsing at all for the first 24 hours. After that, gentle warm saltwater rinses a few times a day, and brush carefully around the area.
- What to avoid: No smoking, no straws, no forceful spitting. All three can pull the clot loose and trigger a dry socket — the thing you most want to avoid.
- Eating and resting: Soft food for several days, skip the hot and crunchy stuff, and take it easy for the first day or two before easing back to normal.
- Stitches: If you have them, they either dissolve on their own or come out around 7 to 10 days.
Frequently Asked Questions
How long will wisdom tooth removal under general anaesthesia take?
The surgery itself is usually fairly quick — often under an hour once you’re asleep — though removing all four, or teeth that are buried and need a bit more work, takes longer than one or two simple ones. Plan for most of the day at the hospital, though, not just the operating time: there’s checking in and getting ready beforehand, and an hour or two waking up properly in recovery afterwards. Your exact timing depends on your teeth, so we’ll give you a clearer idea once we’ve seen your X-ray.
Is general anaesthesia safe for wisdom teeth removal?
For a healthy patient, a general anaesthetic for wisdom teeth is considered safe — you’re in a hospital, fully monitored, and looked after the whole time by a specialist anaesthetist whose only job is your sleep and your safety. Like any procedure, it isn’t completely without risk, which is why we go through your health history first and talk everything through before you agree to anything.
Can I drive myself home afterwards?
No — and this isn’t optional. A general anaesthetic stays in your system for the rest of the day, so it isn’t safe to drive, and you’ll be groggy even if you feel fine. You’ll need a responsible adult to take you home and ideally stay with you for the first several hours, so it’s worth sorting out your lift before the day of surgery.
How much time off work should I take?
Most people take a few days. While it may be different from person to person, planning for two to three days off seems sensible. If you’re at a desk, you may feel up to it sooner; if your work is physical or strenuous, you may need to give yourself longer. Everyone heals at their own pace, so it’s fine to book the time off and see how you go rather than rushing back.
What can I eat after wisdom teeth removal, and for how long?
Stick to soft foods for the first several days — things like yoghurt, mashed potato, soup that isn’t too hot, scrambled eggs, and smoothies (spoon them, don’t use a straw). Steer clear of anything hot, spicy, crunchy, or chewy while the area settles, since those can irritate the sockets or dislodge the clot. Most people ease back to normal eating over about a week as the swelling goes down. Keeping your fluids up the whole time helps you heal.
When can I exercise or go back to the gym?
Take it easy for the first couple of days —we usually advise resting and avoiding strenuous activity early on, since raising your heart rate too soon may worsen bleeding and swelling. Light movement like walking is usually fine within a day or two, but hold off on the gym, running, and heavy lifting for around a week. Ease back in gradually, and if anything starts throbbing or bleeding, that’s your cue to pull back and give it more time.
Can I smoke or vape after the procedure, and how long should I wait?
It’s best to avoid both for as long as you can. Smoking is a real dry-socket risk, and vaping is no safer here — the suction can pull the healing clot out of the socket, and the chemicals slow healing down. As a general guide, hold off for at least 72 hours, and longer if you can manage it. Dry socket is one of the most painful things that can go wrong after an extraction, so a few smoke-free days genuinely pay off.
Do the stitches dissolve, or do they need to be removed?
It can be either, depending on the type used — some dissolve on their own over a week or two, while others need a quick, simple visit to take out, usually around 7 to 10 days afterwards. We’ll tell you which kind you’ve got before you leave, so you’re not left wondering. If they’re the dissolving sort, there’s nothing you need to do but let them go on their own.
Not Sure If Yours Need to Come Out? Let’s Take a Look First
Everything on this page comes back to one thing: we don’t decide until we’ve seen what’s actually going on. If your wisdom teeth have been flaring up, or someone’s told you all four should go, and you’re not sure, the sensible first step is a proper assessment and an X-ray — so you get a straight answer based on your teeth.
That answer might be surgery under general anaesthetic. It might be a simpler removal. And sometimes it’s “leave them alone and keep an eye on them.” We’ll tell you honestly which one it is.
Book a consultation or call us on 07 3343 4869 and we’ll help you work out the next step.
