Wisdom Teeth Removal
Wisdom teeth removal
in Murwillumbah.
Sore, swollen, or just been told a wisdom tooth is causing trouble? At Biltoft Dental we assess wisdom teeth honestly — sometimes they need to come out, sometimes they do not. When removal is the right call, we do it in our Murwillumbah practice under local anaesthetic with clear, upfront pricing.
What they are
A quick word on what wisdom teeth actually are
Wisdom teeth are your third molars — the very back teeth, top and bottom, on each side. Most people have four. Some people have one or two. Some have none at all, and that is perfectly normal. They generally come through between the ages of 18 and 25, though we see them try to push through earlier and later than that too. Healthdirect Australia describes the typical eruption window as 18–25.
Here is the honest version: in modern jaws, there is often not quite enough room at the back for these teeth to come through cleanly. That is not a failure of your mouth — human jaws have shortened over the past few thousand years while the teeth themselves have not. So a fair number of patients walk through our door in their late teens or twenties wondering whether the niggle at the back is something to worry about.
Sometimes it is. Sometimes it is not. The point of this page is to give you a straight answer about how we look at wisdom teeth at Biltoft Dental in Murwillumbah, what the assessment and procedure actually involve, and what it costs — so you can make a calm, informed decision rather than a scared one.
I am Dr Daniel Johnston, the dentist at Biltoft. I have been doing wisdom teeth in this practice for years, on locals from Murwillumbah, Tweed Valley, Uki, Pottsville and Kingscliff. Most of these are routine and finished within the hour. The cases we do not feel are right for our chair get referred — and I will explain that further down.
Signs they need looking at
When a wisdom tooth is genuinely causing trouble
If you are noticing any of the following, it is worth booking an assessment. None of them are emergencies on their own, but together they paint a picture of a tooth that is not playing nicely with the rest of your mouth.
Persistent ache at the back of the jaw
A dull, throbbing soreness behind your last molar — sometimes radiating up the side of the face or into the ear. Often worse at night. This is the most common reason people call us about wisdom teeth.
Swollen, tender gum flap
Often the wisdom tooth has only partially come through and a flap of gum sits over part of it. Food and bacteria get trapped under the flap and the gum becomes inflamed. The medical name is pericoronitis. Healthdirect lists this as a common wisdom tooth problem.
Recurrent infections
If you keep getting flare-ups in the same spot — antibiotics from your GP help for a few weeks, then it comes back — that is the tooth telling you it cannot be cleaned properly long-term.
Decay you cannot reach
Wisdom teeth sit so far back that even a careful brusher struggles to clean the back surface. We sometimes see decay starting on the wisdom tooth and, more concerning, on the back of the perfectly healthy molar in front of it.
Crowding or pressure on neighbouring teeth
If a wisdom tooth is angled forward into the molar in front, it can cause damage to that healthy tooth. Worth noting: the old idea that wisdom teeth shove your front teeth crooked is largely a myth — but pressure on the immediately adjacent tooth is a real thing we see on x-rays.
Cyst formation around an unerupted tooth
Less common, but important. Wisdom teeth that are fully buried can occasionally develop a fluid-filled sac (cyst) around them, which over time can damage the jawbone. We pick these up on the OPG x-ray and they are a clear indication for removal.
If pain is severe, swelling is spreading down your neck, or you are running a fever — that is an urgent dental issue. Call us on (02) 6672 1980 or attend an emergency department.
The conservative view
When wisdom teeth do not need to come out
This part matters. Not every wisdom tooth needs to be removed, and there is a real risk in over-treating them.
The current best-evidence position — backed by the NHS and reflected in mainstream Australian dental practice — is that asymptomatic wisdom teeth that are sitting properly should generally be left alone and monitored. The NHS guidance is clear: "If it's not causing problems, the tooth will usually be left where it is and monitored at your routine dental check-ups."
In plain English, if your wisdom tooth ticks all of these boxes, the right answer is usually to leave it where it is:
- It has come through fully and is in a normal upright position
- It has an opposing tooth to bite against
- You can brush and floss it adequately
- There is no sign of decay, gum disease, or cyst on the x-ray
- It is not damaging the tooth in front of it
- You are not getting recurrent infections around it
Routine prophylactic removal of healthy wisdom teeth — taking them out "just in case" — is not something we do at Biltoft. If a tooth is healthy and behaving itself, the surgical risk and cost of removing it outweigh any speculative future benefit. We will tell you that even if it means we do not do a procedure today.
The flip side is also true. If you have had two flare-ups in six months, can see decay starting on the x-ray, or there is a cyst forming — sitting on it is the wrong call too. The honest assessment is the whole point.
Step 1 — The assessment
What happens at your first visit
Before any decisions are made, we need to actually look at what is going on. The first appointment is about information — yours and ours.
A proper conversation
We start by listening. How long has it been bothering you? What does the pain feel like? Have you had infections before? Are you on any medications, including blood thinners or bisphosphonates? Any conditions we should know about? This part is unhurried because the medical history actually matters when planning a surgical procedure.
Clinical exam
A look at the tooth itself, the surrounding gums, your bite, the opposing tooth, and the rest of your mouth. We check for the gum flap, signs of infection, and how easy or hard it is for you to clean the area.
OPG x-ray
An OPG (orthopantomogram) is a single panoramic x-ray that shows all your teeth, the jawbone, and crucially, the relationship between the wisdom teeth roots and the inferior alveolar nerve in the lower jaw. We need this image before recommending removal of any lower wisdom tooth — it is how we judge surgical difficulty and risk. If you have had a recent OPG elsewhere, bring it; it saves you the cost.
A clear recommendation, in writing
After the exam and the x-ray, we walk you through what we are seeing. If a tooth needs to come out, we explain why. If we recommend leaving it alone, we explain that too. You leave with a written quote, an aftercare sheet, and time to think it over. No pressure to book on the spot.
Step 2 — The procedure
What removal actually involves, honestly
No mystery, no surprises. Here is exactly what happens on the day, in the order it happens.
1. We confirm the plan
A quick recap of which tooth (or teeth), confirm your medical history is unchanged, and answer last-minute questions. You sign the consent form once you are happy.
2. Local anaesthetic
We numb the area completely with local anaesthetic. There is a small sting as it goes in, then within a few minutes the tooth, gum, lip and part of your tongue (for lower teeth) feel heavy and numb. We test the area thoroughly before starting — if you feel anything sharp, we add more. You should never feel pain during the procedure itself.
3. The removal
For a fully erupted upper wisdom tooth, this can be over in under five minutes — a few minutes of pressure and rocking and the tooth lifts out. For a partially impacted lower tooth, we may need to make a small incision in the gum, remove a little bone, and section the tooth into pieces to ease it out without damaging the nerve or the next tooth. You will feel pressure and hear sounds. You should not feel pain.
4. Stitches if needed
For surgical extractions we usually place a couple of dissolving stitches. They fall out on their own over the following 7–14 days. Simple extractions often need none.
5. Aftercare briefing
Before you leave, we go through the aftercare in detail — bite on the gauze for 30–60 minutes, no vigorous rinsing for 24 hours, no smoking, no straws, soft food, ice pack on the cheek, what to take for pain. You get a printed sheet and our after-hours number.
6. You drive yourself home
Because we use local anaesthetic only, you are not sedated and you can drive home and resume normal (non-strenuous) activity. Most patients are back at their desk the following day.
An important note on sedation
Local anaesthetic only — and why we are upfront about that
At Biltoft we do all our wisdom teeth work under local anaesthetic. We do not offer IV sedation or general anaesthetic in the practice. For most patients, that is a feature rather than a limitation — it means a faster appointment, a same-day return to work for many, no hospital admission, and a noticeably lower bill.
If your case is genuinely better suited to IV sedation or a hospital general anaesthetic — for example, all four impacted wisdom teeth in one sitting, severe dental anxiety that does not respond to other measures, or unusually complex anatomy — we will say so and refer you on to a specialist oral and maxillofacial surgeon. That is the right call for those cases and we are not interested in stretching ourselves into work better done elsewhere.
The honest reality is that the great majority of one- and two-tooth wisdom extractions are perfectly comfortable under local. We would rather you knew that going in.
Recovery
A realistic day-by-day picture
Recovery varies from person to person and from tooth to tooth, but here is a fair guide for most straightforward cases. For a more detailed walkthrough, see our wisdom teeth recovery guide.
First 24 hours
The numbness wears off over 2–4 hours. Take the first dose of pain relief (paracetamol and ibuprofen, alternated, work well for most people — we will check with you if there are any reasons not to use them). Some bleeding is normal — bite on fresh gauze for 20-minute blocks if it persists. Keep your head elevated, use ice on the cheek, and eat soft cool food. No rinsing, no spitting, no smoking, no straws. This 24-hour window is when the protective blood clot forms, and protecting it is the single biggest thing you can do to avoid dry socket.
Days 2–3
Swelling typically peaks around day 2 or 3 and then begins to settle. Bruising on the cheek and a bit of jaw stiffness are normal. Start gentle warm salt-water rinses after meals from day 2. Most people are back at desk work or school by day 2 — heavier physical jobs may need an extra day or two. The NHS notes pain and swelling usually start to improve after one to two days; individual recovery varies.
Days 4–7
Soreness easing each day. You can usually move from soft food (pasta, eggs, mash) back towards a more normal diet, just avoiding the surgical side. If you suddenly get a deep, throbbing ache around day 3–5 — especially in a lower socket — that can be dry socket. Call us. It is fixable in one quick visit.
Week 2
Most of the soft tissue feels close to normal. Stitches, if you had them, are usually gone by now. You can eat normally on the surgical side again. For complex extractions, jaw stiffness can take a little longer to fully resolve. The bone underneath continues remodelling for several months — that is invisible to you and not something to worry about.
Transparent pricing
$500 to $650 per wisdom tooth
Wisdom teeth removal at Biltoft Dental ranges from $500 to $650 per tooth. Where you fall in that range depends on how the tooth is sitting and how much surgical work is involved.
What that price includes
- ✓Local anaesthetic and the procedure itself
- ✓Stitches if required (dissolvable, no removal appointment needed)
- ✓Printed aftercare instructions
- ✓A follow-up review if you have any concerns
What is extra
- +The initial consultation
- +OPG x-ray if you do not already have a recent one
- +Any antibiotics (rare — only when clinically needed)
Every patient leaves the assessment with an itemised written quote before any procedure is booked. If we cannot give you a clear price for your case in advance, we have not done the assessment properly. Individual circumstances vary.
Book an AssessmentFunding and rebates
Private health, Medicare and CDBS — the honest version
Private health insurance. If you have extras cover that includes major dental, you will usually get a meaningful rebate on wisdom tooth removal. The amount depends entirely on your fund, your level of cover, and how much of your annual limit you have already used. We process HICAPS on the spot, so you only pay the gap on the day. We are happy to give you the item numbers in advance so you can call your fund for an exact quote.
Medicare — adults. General dentistry, including routine wisdom teeth removal, is not covered by Medicare for adults. There are very narrow exceptions (some chronic disease referrals, hospital-based surgery for medically complex cases), but for the typical patient walking into our practice, the answer is no.
CDBS — children. The Child Dental Benefits Schedule covers eligible children aged 0–17 for up to a capped amount of basic dental services over a two-year period. Wisdom teeth in this age group are uncommon but possible, and CDBS may apply. We will check eligibility for you.
Public dental. NSW Health public dental services exist for eligible concession card holders, but waitlists for non-emergency procedures can be long. If wisdom teeth are causing you genuine ongoing problems and cost is the barrier, talk to us — we can help you understand your options.
For official information, see the Australian Government Child Dental Benefits Schedule page.
Why Biltoft
A local family dental practice in Murwillumbah
What you can expect from us
- ✓An honest assessment first. If a tooth does not need to come out, we will say so.
- ✓Clear written pricing. No surprise add-ons after the procedure.
- ✓Local anaesthetic only. Lower cost, no hospital admission, same-day return home.
- ✓Sensible referral when warranted. Complex cases go to a specialist oral surgeon — we do not push beyond what is right for you.
- ✓An after-hours number on your aftercare sheet. If something is not tracking right post-op, we want to know.
- ✓A practice that has looked after Murwillumbah families for decades. You are not a stranger to us.
If you eventually need a tooth replaced — either after a wisdom tooth extraction damages a neighbour, or for any other tooth — we also offer dental implants. Individual outcomes vary; suitability is determined at consultation.
FAQs
Questions people usually ask
Do all wisdom teeth need to be removed?
No. If a wisdom tooth has come through properly, lines up with the opposite tooth, and you can clean it, there is usually no reason to take it out. Healthdirect Australia and the NHS both recommend a conservative, symptom-based approach — we monitor it at your routine check-ups and leave it alone unless something changes. Removal is for teeth that are causing pain, repeated infection, decay, gum problems, or showing signs of cyst formation.
How much does wisdom teeth removal cost at Biltoft?
Wisdom teeth removal at Biltoft Dental ranges from $500 to $650 per tooth. The price depends on how the tooth is sitting — a fully erupted upper wisdom tooth that lifts out cleanly sits at the lower end; a partially impacted lower one that needs sectioning sits at the higher end. An OPG x-ray, if you do not have a recent one, is an additional cost. We give you an itemised quote in writing after your assessment so there are no surprises.
Do you offer sleep dentistry or general anaesthetic?
No — and we are upfront about that. At Biltoft we do all wisdom teeth removals under local anaesthetic only. For most patients that is honestly all that is needed: the tooth is fully numb, you are awake but comfortable, and you go home the same hour. If your case genuinely needs IV sedation or a general anaesthetic — for example, all four deeply impacted teeth in one go — we will refer you to a specialist oral and maxillofacial surgeon. Doing it this way keeps the cost down and avoids hospital admission for cases that do not need it.
Will the removal hurt?
During the procedure, no — the area is fully numb from local anaesthetic and you should not feel pain, only some pressure. Afterwards there is some soreness and swelling, which most people manage well with paracetamol and ibuprofen. The NHS notes pain and swelling usually start to improve after one to two days. Individual recovery varies.
How long is the recovery?
Most people are back to desk work or school the next day if it was a straightforward extraction. Soft food for around 3 to 5 days, gentle rinsing with warm salt water from day two, and no smoking or vigorous spitting for at least a week. Soft tissue feels mostly normal by 2 weeks, though the bone underneath continues remodelling for several months. We hand you a printed aftercare sheet and our number to call if anything is not tracking right.
What is dry socket and how likely is it?
Dry socket (alveolar osteitis) is when the blood clot in the healing socket gets dislodged or does not form properly, exposing bone. It is uncomfortable and usually shows up 2 to 4 days after the extraction as a deep, throbbing ache. It is more common in lower wisdom teeth and the biggest risk factors are smoking, vigorous rinsing in the first 24 hours, and using straws. If you get it, come back and see us — we pack the socket with a medicated dressing and the pain settles quickly.
What age should wisdom teeth come out?
Wisdom teeth typically come through between ages 18 and 25, according to Healthdirect Australia. There is no magic age to remove them — we look at the actual tooth, not the birthday on your file. That said, if removal is needed, younger patients tend to recover a bit faster because the roots are not yet fully formed and the bone is more forgiving. We assess each case on its own merits.
Do I need a referral to come in?
No referral needed. Just call us on (02) 6672 1980 or book online and we will arrange an assessment. If you already have an OPG x-ray from another dentist, bring it (or ask them to email it through) and we can save you the cost of repeating it.
Ready to get it sorted
Book a wisdom teeth assessment in Murwillumbah
If a wisdom tooth is bothering you — or another dentist has told you it should come out and you would like a second look — book in with Dr Daniel Johnston for an honest assessment. You will leave knowing exactly what is going on and what your options are, with a written quote in your hand.
Or visit our contact page for opening hours and directions.
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Whether it has been months or years since your last visit, we are here to help you get back on track. No judgement, just gentle, attentive care.