In short: healthdirect notes that most upper wisdom teeth can be removed under local anaesthetic, and that lower wisdom teeth are often harder to remove, so a sedative may be offered. The Better Health Channel says deeply impacted teeth, or other medical reasons, may call for a general anaesthetic. The choice depends on the teeth, your health and how you cope with dental treatment, and is made with your dentist or oral surgeon and the anaesthetist.
Why wisdom teeth are removed
healthdirect lists several reasons a dentist or oral surgeon may recommend removal, including repeated or serious gum infection, decay, a tooth damaging the cheek or gum, a position that makes cleaning difficult, cysts, and planned orthodontic or jaw surgery. Not every wisdom tooth needs to come out, and the decision to remove one is separate from the decision about anaesthesia.
The three anaesthetic options
Local anaesthetic alone
The area is numbed with injections and you are awake throughout. You will feel pressure and hear the instruments, but not sharp pain. It suits simpler extractions and people who are comfortable in the chair. You can usually leave without an escort, unless you have also had sedation.
Local anaesthetic with sedation
The surgeon numbs the area and a sedationist gives medicines through a cannula, so you are relaxed and drowsy while the teeth are removed. The Australian Society of Anaesthetists describes this as sometimes called “twilight anaesthesia”, and notes that you may remember parts of the procedure. You will need to fast as instructed and have an adult take you home.
General anaesthetic
You are unconscious for the surgery and the anaesthetist manages your breathing with a breathing tube. This is usually done in a day surgery or hospital. Most people go home the same day. The Australian Society of Anaesthetists notes that major jaw surgery often needs one or two nights in hospital.
What affects the choice
- The teeth: how many, upper or lower, and how deeply they are buried in bone.
- Your health: heart, lung and airway conditions, sleep apnoea, diabetes and the medicines you take.
- How you cope: previous experiences in the dental chair, anxiety and your gag reflex.
- The setting: what equipment, staff and recovery facilities are available.
- Costs: hospital and day-surgery fees, and what your health fund covers. Ask for written estimates.
Other oral surgery
The same three options apply to other oral surgery, such as surgical extractions, dental implants and bone grafting. Longer operations, and surgery on the jaw itself, are more likely to be done under a general anaesthetic in hospital.
Two kinds of risk
It helps to separate the risks of the anaesthetic from the risks of the surgery, because different people will explain them to you.
From the anaesthetic or sedation (explained by the anaesthetist): drowsiness, nausea and vomiting, a sore throat after a breathing tube, bruising at the cannula site, headache, and less commonly damage to teeth from airway equipment, breathing problems or an allergic reaction. Serious complications are rare.
From the surgery (explained by the dentist or oral surgeon): healthdirect lists bleeding, swelling, infection, dry socket, stiffness when opening the mouth, damage to nearby teeth and, for lower wisdom teeth, nerve injury that can cause numbness or altered taste in the lip or tongue. This is usually temporary but, according to healthdirect, can take up to 18 months to recover fully. Tell your dentist if you take bone-strengthening medicines or have had cancer treatment, as healthdirect notes these increase the risk of a rare jaw-bone problem.
The first days after oral surgery
Follow the written instructions from your surgeon and anaesthetist. Commonly given advice, drawn from the Better Health Channel and healthdirect, includes:
- bite firmly on gauze to control bleeding, as shown
- avoid vigorous rinsing, spitting and drinking through a straw, which can dislodge the clot
- start warm salt-water rinses only after the first 24 hours
- eat soft food for several days and take pain relief as advised
- avoid smoking for at least 48 hours, and limit alcohol and strenuous activity
- expect to need some days off work. healthdirect suggests most people are back to normal activities within about a week.
The general advice for the first 24 hours after any sedation or anaesthetic also applies: no driving, no alcohol and an adult with you. See after your procedure.
When to get help
Contact your dentist or oral surgeon if pain is getting worse rather than better, bleeding does not settle with firm pressure on gauze, or you notice signs of infection. The Better Health Channel lists difficulty opening the mouth or swallowing, facial swelling, pus, fever and tender swollen glands under the jaw. If you have trouble breathing or swallowing, or rapidly increasing swelling, call 000.
Sources
- healthdirect Australia. Removing wisdom teeth. Last reviewed Jan 2026.
- Better Health Channel (Victorian Department of Health). Wisdom teeth. Reviewed 3 Jun 2022.
- Australian Society of Anaesthetists. Anaesthesia for oral surgery (patient information pamphlet). Last reviewed 12 Mar 2024.
- ANZCA. PG09(G) Guideline on procedural sedation (sections 3, 5, 7.5, 9.3, 9.4, 13.4; Appendix III; Appendix V glossary). December 2023; links reviewed July 2025.
- healthdirect Australia. General anaesthetic. Last reviewed Dec 2025.
- Written by
- Altitude Creative, health content team, on behalf of Dr Walid Aly
- Clinical reviewer
- In progress
- Review date
- Clinical review in progress
- Next review due
- Set at clinical review
How this guide is written, reviewed and corrected: editorial policy.
In an emergency, call 000. This information is general and does not replace advice from your treating practitioner.