Oral Surgery in Nasr City: Wisdom Teeth, Surgical Extractions and Bone Grafting

Oral surgery covers the treatments that involve working in the bone and soft tissue of the jaws rather than only on the visible part of a tooth. In practice, most people arrive for one reason: a wisdom tooth (ضرس العقل) that is impacted, repeatedly infected or impossible to keep clean. The same service also covers extractions that cannot be done simply — a broken-down tooth with no crown left to grip, a root that has fractured, a tooth trapped under bone — as well as preparing a site so an implant can be placed later, which is what bone grafting is for. It also includes recognising things that are not a dental problem at all: a persistent ulcer, a lump, a white or red patch that has not cleared. Those are examined, and where anything needs a biopsy or specialist opinion, the right step is a referral to an oral and maxillofacial service, not treatment on the spot. Almost all routine oral surgery is done under local anaesthetic, so you are awake, the area is numbed, and you go home the same day.

Who is a candidate

• •A wisdom tooth that has caused repeated episodes of pain, swelling or gum infection around it (pericoronitis).
• •A wisdom tooth that is partly through the gum and cannot be cleaned properly, so decay or gum disease keeps developing there or on the tooth in front of it.
• •Decay in a wisdom tooth, or in the second molar next to it caused by food and plaque trapped between them.
• •A tooth so broken down, decayed or fractured that it cannot be removed by a simple extraction and needs surgical access.
• •A root fragment left behind from an old extraction or fracture.
• •A retained baby tooth in an adult, or a permanent tooth that has not come through and is blocked by bone or another tooth.
• •A tooth that must be removed as part of an orthodontic plan to create space, on the orthodontist's assessment rather than on request.
• •A site that needs bone added or preserved before an implant can be planned there.
• •A tooth being removed where the socket will be grafted at the same appointment to keep the ridge shape for future treatment.
• •An ulcer, lump, white or red patch, or area of numbness in the mouth that has been present for more than about two weeks — this needs examining, and where indicated, referral.
• •Not everyone needs surgery. A wisdom tooth that has come through fully, meets its opposing tooth, is clean and has never caused a problem is usually left alone and monitored — removal is not automatic just because it is a wisdom tooth.

Problems addressed

• •Recurrent pain and swelling at the back of the jaw, often worse when you are run down or after a period of stress or illness.
• •Difficulty opening the mouth fully, or pain on swallowing, when the tissue around a lower wisdom tooth is inflamed.
• •A flap of gum over a partly erupted wisdom tooth that traps food and becomes tender and swollen.
• •Bad taste or bad breath coming from an area that cannot be cleaned.
• •Decay forming on the back surface of a healthy second molar because the wisdom tooth in front of it holds plaque against it.
• •A tooth broken at gum level that cannot be gripped for a simple extraction.
• •A tooth that has already had a failed extraction attempt elsewhere, or a retained root fragment.
• •A jaw ridge that has thinned or collapsed after a tooth was lost years ago, leaving too little bone for an implant.
• •A tooth that has to come out but where the patient wants to protect the option of an implant later — which is where socket preservation belongs in the conversation.
• •An impacted canine or another permanent tooth that has failed to come through and needs surgical exposure so orthodontics can bring it into line.
• •A lesion, ulcer or swelling in the mouth that has not settled and needs proper assessment rather than reassurance.

Treatment options

Diagnosis & planning

Nothing surgical is decided from looking in the mouth alone. The assessment starts with your history — how often the area has flared up, what the pain was like, whether you have had swelling, fever or difficulty opening your mouth — and your medical background, because blood thinners, diabetes, immune conditions, bisphosphonates and other bone medications, previous radiotherapy to the jaw and pregnancy all change either the plan or the timing. The examination then looks at the tooth, the gum around it, how far you can open, and the state of the neighbouring tooth, which is often the one actually at risk. Imaging is essential: a panoramic X-ray shows the whole shape and position of a wisdom tooth, its roots, and how close it lies to the nerve canal running through the lower jaw or to the sinus above the upper molars. Where that relationship looks close, a three-dimensional scan may be needed before a decision, because it shows the true position in a way a flat film cannot. The output of this appointment should be specific: whether removal is genuinely indicated or whether monitoring is reasonable, how the removal would be done, what the particular risks are for your anatomy, and what recovery is likely to involve for the days after.

Treatment process

Technology

• •PLACEHOLDER — not confirmed by the clinic. Which imaging is available on site for surgical planning: panoramic radiography, and whether CBCT is taken in-house or referred to an external imaging centre.
• •PLACEHOLDER — not confirmed by the clinic. Whether surgical extractions are performed with a conventional surgical handpiece, a piezoelectric device, or other equipment.
• •PLACEHOLDER — not confirmed by the clinic. Whether any sedation option is offered beyond local anaesthetic, and if so which, under whose supervision, and with what monitoring. Nothing about sedation may be stated on this page until this is confirmed.
• •PLACEHOLDER — not confirmed by the clinic. Whether an oral surgeon performs these procedures or a general dentist, and how referrals for biopsy and specialist assessment are arranged.

Materials

• •PLACEHOLDER — not confirmed by the clinic. The bone graft material used for socket preservation and augmentation, and its type (synthetic, xenograft, allograft).
• •PLACEHOLDER — not confirmed by the clinic. The barrier membrane used with grafts, where one is used.
• •PLACEHOLDER — not confirmed by the clinic. Suture materials used, and whether they are resorbable or need removing.

Aftercare

• •FIRST HOUR — Bite firmly and continuously on the gauze pad for the length of time you were told, usually around 30 to 60 minutes. Firm, constant pressure is what forms the clot; chewing on the gauze or lifting it every few minutes to check prevents exactly that.
• •FIRST 24 HOURS — Do not rinse your mouth, spit forcefully, or use a straw. The suction and the swirling both dislodge the clot, and the clot is the dressing your body made. Let saliva drain rather than spitting it out.
• •FIRST 24 HOURS — No smoking, no shisha, and no vaping. This is the single most avoidable risk factor for dry socket, and the longer you can extend it beyond 24 hours the better.
• •FIRST 24 HOURS — No hot drinks, no hot baths, no exercise, no heavy lifting, and no bending down for long periods. Anything that raises blood pressure in your head can restart the bleeding.
• •SWELLING — Apply a cold pack to the outside of the face over the area for about 15 to 20 minutes at a time, with breaks in between, during the first day. Sleep with your head slightly raised on an extra pillow for the first couple of nights.
• •SWELLING — Expect it to be worse on the second and third day than on the first. That is the normal pattern, not a sign of deterioration. It then improves steadily. Bruising on the cheek or jaw can appear a couple of days later and is not unusual.
• •PAIN — Start the painkillers you were advised to take before the anaesthetic fully wears off, rather than waiting for the pain to arrive. Take them at regular intervals for the first day or two instead of only when it hurts. Do not take anything you know you react badly to, and tell the clinic what you normally take.
• •BLEEDING — Some oozing that pinks your saliva for the first 24 hours is normal. For active bleeding, roll a clean piece of gauze or a damp tea bag, place it directly over the socket, bite firmly for 20 uninterrupted minutes, and sit upright. Repeat once if needed.
• •EATING — Soft, cool or lukewarm food for the first day, and keep drinking water. Avoid crunchy, seedy and crumbly foods that lodge in the socket, and avoid very hot or spicy food while the area is raw. Chew on the other side.
• •CLEANING — Brush your other teeth normally the same evening, keeping away from the surgical site itself. Avoiding brushing altogether makes infection more likely, not less.
• •FROM DAY TWO — Start gentle warm salt-water rinses (about half a teaspoon of salt in a cup of warm water) after meals and before bed, letting the water fall out of your mouth rather than spitting. Not before 24 hours have passed.
• •MOUTH OPENING — Stiffness and limited opening for several days after a lower wisdom tooth is common and eases gradually. Gentle movement is fine; forcing it is not.
• •STITCHES — Ask whether yours dissolve or need removing, and keep the review appointment. A loose stitch end that irritates your tongue is common and not an emergency, but mention it.
• •ANTIBIOTICS — Only take them if they have been prescribed, and if so, complete the course. They are not routine after every extraction.
• •CALL THE CLINIC IF — bleeding does not stop after two proper 20-minute attempts with firm pressure.
• •CALL THE CLINIC IF — pain gets worse rather than better from around day two to four, especially a deep, throbbing ache that spreads towards the ear and is not controlled by painkillers, often with a bad taste or smell and an empty-looking socket. That combination suggests dry socket, which is treatable at the clinic and should not be endured at home.
• •CALL THE CLINIC IF — swelling keeps increasing after day three, or you develop a fever, or the swelling spreads towards the eye or down the neck.
• •GO FOR URGENT CARE IF — you have difficulty swallowing, difficulty breathing, or cannot open your mouth more than a couple of centimetres alongside a spreading swelling. These need to be seen immediately, not at the next available appointment.
• •CALL THE CLINIC IF — numbness in the lip, chin or tongue is still present the day after the anaesthetic should have worn off, or if a sharp fragment of bone works its way through the gum, or if you feel the socket is not closing as expected.

Timeline

The surgery itself is normally a single appointment, and its length depends far more on how the tooth is positioned than on anything else — a straightforward upper wisdom tooth is a short procedure, while a deeply impacted lower one that has to be sectioned takes considerably longer in the chair. Recovery follows a fairly recognisable shape rather than a fixed schedule: bleeding settles within the first day, swelling builds to a peak around the second or third day and then declines, and the worst of the discomfort is usually in the first two to three days. Most people are managing normal activities within a few days, though a difficult lower wisdom tooth can leave stiffness and tenderness for a week or more, and everyone recovers at their own pace. The gum surface closes over the following weeks; the bone underneath fills in over months, which you will not feel happening. Where a bone graft was placed, the healing period before an implant can be planned is measured in months and is assessed on imaging rather than on how the site feels. Nobody can tell you in advance exactly how your recovery will go, but you should be told what the expected pattern looks like so you can recognise when yours is departing from it.

Removing a wisdom tooth, monitoring it, or treating it

What affects the cost

• •Whether the extraction is simple or surgical — that is, whether the gum has to be lifted, bone removed, or the tooth divided to get it out.
• •How the tooth is positioned. A fully erupted tooth, a partly erupted one and a deeply impacted one are three different pieces of work even when they are all called 'a wisdom tooth'.
• •How many teeth are being removed and whether they can be done in one appointment.
• •Which jaw and which side: lower impacted wisdom teeth are generally more involved than upper ones.
• •Whether a graft is placed at the same time, and how much graft material and whether a membrane is needed.
• •Whether bone augmentation is a separate, larger procedure in its own right rather than a step within the extraction.
• •Imaging required: a panoramic X-ray for planning, and a three-dimensional scan where nerve or sinus proximity has to be assessed — particularly if that scan is taken at an external centre.
• •Whether any anaesthesia beyond local anaesthetic is involved, which changes the resourcing of the appointment substantially.
• •Whether an oral surgeon or a general dentist performs the procedure.
• •Medical complexity requiring extra precautions or coordination with your physician, such as blood thinners or bone-modifying medication.
• •Follow-up appointments, suture removal where needed, and treatment of any complication such as dry socket.
• •This page carries no prices. What a case costs is determined after examination and imaging, and a quote given before the tooth has been seen on an X-ray is not a quote for your tooth.

Frequently asked questions