General Dentistry · Oral Surgery · Last reviewed May 2026
Wisdom Tooth Removal: Done Properly
Healed Faster.
Picasso Dental removes wisdom teeth in Vietnam for a simple fully erupted tooth, for an impacted tooth requiring sectioning, and up to for near-nerve cases planned on CBCT 3D imaging. IV sedation is available at our Vinmec Da Nang and Link General Da Lat hospital branches. Routine cases are handled by our general dentists; complex and near-nerve cases are referred to Dr. Hung Le, our Implant Specialist who also performs complex oral surgery.
What is Wisdom Tooth Extraction?
Wisdom tooth extraction is the surgical removal of a third molar that is causing pain, infection, decay, damage to its neighbour, or pathology. The procedure ranges from a 10-minute simple lift of a fully erupted tooth to a 60-minute surgical removal of a deeply impacted tooth requiring sectioning, bone removal and suturing. Modern wisdom tooth surgery is performed under local anaesthetic with optional IV sedation at hospital branches; CBCT 3D imaging is mandatory for any case approaching the inferior alveolar nerve.
Why Picasso for Wisdom Teeth
CBCT 3D Mandatory for Near-Nerve Cases
Any wisdom tooth approaching the inferior alveolar nerve is mapped on a Cone Beam CT scan before surgery. The nerve canal is visualised in 3D so risk is quantified, not estimated. We do not operate near the nerve on a flat X-ray alone.
Hospital-Grade Branches Available
Two of our six branches operate inside accredited hospitals: Vinmec International Hospital Da Nang and Link General Hospital Da Lat. For long surgical cases, full-mouth removal in one session, or patients with complex medical histories, on-site emergency support is built in.
IV Sedation for Anxious Patients
IV sedation administered by qualified anaesthesiologists is available at our hospital-partner branches. You drift through the surgery and remember little; we handle the procedure on the other side of your awareness. Full recovery monitoring before discharge.
Bone Preservation for Future Implants
Atraumatic sectioning and gentle elevation rather than crude leverage. Bone walls and adjacent second-molar support are preserved as much as possible, important if a wisdom tooth socket later becomes an implant site or if the second molar needs future restoration.
English-Speaking Surgeons
All wisdom tooth surgery at Picasso is performed by English-speaking dentists, with consent, planning and post-operative instructions given in plain English. International patients understand every step before signing.
We Will Tell You No
If your wisdom tooth is fully erupted, asymptomatic and you can clean it, we will say so, even when removal is on the table. We are not interested in operating on teeth that do not need to come out.
Should Your Wisdom Tooth Be Removed?
The honest indications. We confirm the call only after clinical exam, panoramic X-ray, and CBCT where indicated, not from a website or a photograph.
Recurrent Pericoronitis
Repeated episodes of gum infection around a partly erupted wisdom tooth. The flap of gum traps bacteria you cannot clean out; antibiotics calm each flare-up but the cycle repeats. Removal ends the cycle.
Decay You Cannot Clean
Decay in the wisdom tooth itself, or in the back surface of the second molar caused by the wisdom tooth's impossible-to-clean position. If the angulation prevents proper hygiene, restoration alone is a short-term fix.
Cyst or Pathology on CBCT
A radiolucency or cyst around an unerupted wisdom tooth detected on panoramic X-ray or CBCT. Pathology of this kind is a clear indication for surgical removal regardless of symptoms.
Crowding or Damage to Second Molar
The wisdom tooth is pushing into the back of the second molar, causing root resorption, pocket formation or visible damage. Removal protects the more important neighbour.
Repeated Abscesses or Food Trapping
Persistent food impaction, bad taste, soft-tissue swelling, or recurrent abscesses around a wisdom tooth that resist hygiene improvement. Quality of life justifies removal.
Orthodontic Considerations
Where your orthodontist requests wisdom tooth removal as part of an alignment plan, typically because eruption space is inadequate or to protect a finished result.
When NOT to Extract
The honest counterweight. Watchful waiting is sometimes the right answer; surgical removal of an asymptomatic, well-cleaned wisdom tooth on the assumption that it must come out one day is not.
Fully Erupted & Healthy
A wisdom tooth that is fully erupted, in a normal occlusal position, with no decay, no pericoronitis and that you can clean adequately, does not need to come out. Six-month monitoring is the right plan.
Asymptomatic Deep Impaction
In an older patient with a deeply impacted tooth, no pathology on imaging, and no symptoms, the surgical risk of removal can exceed the risk of leaving it. Discussed honestly, case by case.
Active Infection First
An acutely infected wisdom tooth (cellulitis, soft-tissue swelling) is treated with drainage and antibiotics first. Surgical extraction is then performed once the infection is controlled, typically 7–10 days later.
Wisdom Tooth Pricing
Per-tooth pricing across four difficulty categories. Difficulty is decided after clinical exam, panoramic X-ray and CBCT where indicated, not on the phone.
| Service | Price |
|---|---|
| Wisdom tooth, simple (fully erupted) | |
| Wisdom tooth, soft tissue impacted | |
| Wisdom tooth, bone impacted (sectioning required) | |
| Wisdom tooth, near nerve canal (CBCT-guided) | |
| Coronectomy (nerve-sparing alternative) | |
| CBCT 3D scan | |
| IV sedation add-on (hospital branches) | from 3,000,000 |
| Stitches (per suture, if non-dissolvable) | |
| Suture removal / irrigation visit |
CBCT is often included in the surgical fee for near-nerve cases. See our full extraction price list for non-wisdom cases.
The Four Impaction Types
Wisdom tooth angulation drives surgical difficulty, recovery time and price. Your CBCT or panoramic X-ray identifies which pattern applies before any decision.
Vertical
The tooth points straight up in a normal eruption direction but is partly or fully buried. Surgical access is straightforward; sectioning is sometimes needed for deep cases.
Mesioangular
The tooth tilts forward into the second molar, the most common impaction pattern. Almost always requires sectioning and a small amount of bone removal. Higher risk of damage to the second molar if rushed.
Distoangular
The tooth tilts backward, away from the second molar. Often the most surgically demanding, access is restricted by the ramus of the mandible and sectioning is technically harder.
Horizontal
The tooth lies on its side, fully buried with the crown pointing horizontally into the second molar. Always requires sectioning; CBCT recommended to map the relationship to the nerve canal.
How a Wisdom Tooth Extraction Works
Five steps from CBCT to aftercare. Most simple cases take 30 minutes total chair time; impacted cases run 45–60 minutes.
Consultation + CBCT 3D Scan
Clinical exam, panoramic X-ray, and CBCT where indicated. Nerve canal mapped in 3D for any near-nerve case before surgery is approved.
Day 1 · 30 minDigital Surgical Planning
Sectioning lines, flap design and root retrieval strategy planned on the CBCT. Case staged in writing before you sit in the chair.
Day 1 · 15 minLocal Anaesthetic + Optional Sedation
Targeted local anaesthetic. IV sedation arranged in advance at our Vinmec or Link General hospital branches for anxious patients or long cases.
Surgery · 5–10 minAtraumatic Sectioning + Removal
Tooth sectioned where required and elevated in pieces to preserve bone. Periotomes and gentle technique rather than crude leverage.
Surgery · 15–45 minSuturing + Aftercare
Dissolvable sutures placed. Gauze pressure 30–60 minutes. Written aftercare, antibiotics where indicated, follow-up call at 48h, review at 1 week.
Same day · 15 minWhat to Expect After
The recovery curve is predictable. Knowing what is normal, and what is not, makes the first week easier.
First 24–48 Hours
Ice on the cheek in 20-minute cycles. Soft, cool food only: yogurt, smoothies (no straws), mashed potato, soup once cooled. Pain peaks in the first 24 hours and is controlled with the prescribed pain relief.
Swelling Peaks Day 3
Visible facial swelling typically peaks at day 3 before resolving. From day 3, switch to warm compresses and gentle saline rinses. Swelling is usually gone by day 7.
Sutures Dissolve Day 7–10
We use dissolvable sutures by default. They soften and disappear over 7–10 days. If a non-dissolvable suture was used, removal at the 1-week visit is.
Dry Socket: Rare with Our Protocol
Around 3% incidence in our hands versus the 30% reported in some studies of impacted lower wisdom teeth. Driven by no smoking for 48 hours, no straws, no aggressive rinsing, and a chlorhexidine option for high-risk cases.
Follow-Up Call at 48 Hours
We call to check pain, swelling and bleeding at 48 hours. International patients get the same call on WhatsApp. Anything unusual, you come back the same day.
Review Visit at 1 Week
In-person check at 7 days: socket healing, suture status, soft-tissue review, photographs. International patients on a 10-day trip can fit this comfortably before flying home.
Risks & Honest Tradeoffs
Most wisdom tooth extractions heal uneventfully in 7–10 days. Here is what the literature reports, what can go wrong, and how Picasso minimises every avoidable risk.
Dry Socket (~3% Incidence)
A painful exposure of bone when the protective blood clot breaks down too early. Published rates are 2–5% overall and around 30% in some studies of impacted lower wisdom teeth (Blum 2002). Our protocol keeps incidence around 3%: no smoking 48h, no straws, gentle saline from day 2, chlorhexidine for high-risk cases.
Nerve Paraesthesia
Numbness or altered sensation in the lip and chin from inferior alveolar nerve irritation. Rare with CBCT planning, transient (resolves in weeks to months) in the great majority of cases. Permanent rates published below 1% in CBCT-planned hands. Coronectomy is offered when risk is unacceptably high.
Sinus Communication (Upper Molars)
Upper wisdom tooth roots can sit close to the maxillary sinus floor. A small communication can occur during extraction; it is identified and managed in the chair the same day, typically with a figure-of-eight suture and sinus precautions for 1–2 weeks.
Bleeding: Controllable
Some bleeding for the first hours is normal. Persistent or heavy bleeding is rare and managed with additional sutures, haemostatic dressings or, if relevant, review of any anticoagulant medication. Our medical history screening flags this risk before surgery.
Infection Rate Below 2%
Post-operative infection rate below 2% with our protocol: autoclave sterilisation, antibiotic prophylaxis for surgical impactions, chlorhexidine rinse from day 2, 48-hour follow-up call. Most early swelling is normal post-operative inflammation, not infection.
What We Will Tell You No To
Removing an asymptomatic, fully erupted wisdom tooth that you can clean. Operating on a high-risk patient without proper medical clearance. Pulling a near-nerve tooth on a panoramic X-ray alone, without CBCT. We say no when no is the right answer.
Who Performs Your Wisdom Tooth Surgery
Routine and soft-tissue impacted cases are performed by our general dentists; complex bone-impacted and near-nerve cases are referred to our Implant Specialist who also handles complex oral surgery.
Dr. Thao Tran · General Dentist
Routine wisdom tooth extractions, fully erupted teeth, and straightforward soft-tissue impactions. Atraumatic technique and post-operative care.
Dr. Nhung Duong · General Dentist
Routine wisdom tooth extractions and soft-tissue impactions. English-speaking, with a calm chair-side manner valued by anxious patients.
Dr. Hung Le · Implant Specialist
Complex bone impactions, near-nerve cases planned on CBCT, full-mouth removal under IV sedation, coronectomy where indicated. Also handles complex oral surgery group-wide.
Dr. Emily Nguyen · Founding Clinical Director
Sets surgical protocols and case-selection standards group-wide. Founded the original clinic in Hanoi in 2013; led the 2023 rebrand to Picasso Dental.
Common Questions
Does it hurt?
Local anaesthetic is profound, you feel pressure during the procedure, not pain. Most patients describe the post-operative experience as 2–3 days of swelling and tenderness controlled with over-the-counter pain relief. Surgical impacted cases can be more uncomfortable for the first 48 hours, we provide a tailored pain plan and antibiotics where indicated. IV sedation is available at our Vinmec Da Nang and Link General Da Lat branches for anxious patients.
How long does recovery take?
Soft tissue closes in 7–10 days. Swelling peaks at day 3 and resolves over the following week. Most patients return to office work within 24–48 hours after a simple extraction; surgical impacted teeth typically need 3–5 days of reduced activity. Full bone fill in the socket takes 3–6 months.
Can I fly home the next day?
For a simple wisdom tooth extraction, short-haul flying after 24 hours is generally fine. For surgical impacted cases, we recommend waiting at least 48–72 hours and ideally staying for the 7-day suture and review visit. International patients should plan a 7–10 day window so post-operative review is in person.
Do I need all four removed at once?
Not necessarily. We assess each of the four teeth individually on CBCT. Only those that are causing problems, or are predicted to cause problems based on angulation and pathology, are removed. Bilateral upper or lower extractions in one visit are common; full-mouth removal in one session is offered under IV sedation at our hospital branches when indicated.
What about dry socket?
Dry socket (alveolar osteitis) is a painful exposure of bone when the protective blood clot breaks down too early. Published rates are 2–5% overall and notably higher (around 30% in some studies) for impacted lower wisdom teeth (Blum 2002). To prevent it: no smoking for 48 hours, no straws, no aggressive rinsing, follow the written aftercare exactly. Our protocol keeps incidence around 3%.
Can I keep a wisdom tooth I had decay in?
Sometimes. A fully erupted, well-positioned wisdom tooth with restorable decay can be filled or root-canal-treated like any other molar. The harder reality: if the angulation prevents proper hygiene, decay will recur and the long-term answer is usually extraction. We tell you honestly whether keeping it is realistic or just delaying the inevitable.
Do I need general anaesthetic?
The vast majority of wisdom tooth extractions, including impacted cases, are performed comfortably under local anaesthetic. IV sedation is offered at our Vinmec Da Nang and Link General Da Lat hospital branches for anxious patients, gag-reflex sufferers, or for full-mouth removal in one session. Full general anaesthetic is rarely needed.
When is a hospital branch better?
For long surgical extractions, IV sedation cases, full-mouth removal in one session, or patients with significant medical histories (anticoagulants, controlled cardiac conditions, complex anaesthetic requirements), our two hospital-partner branches are the right venue. Vinmec International Hospital Da Nang and Link General Hospital Da Lat have on-site emergency support and qualified anaesthesiologists.
Can I eat normally?
For 24–48 hours, soft and cool foods only: yogurt, smoothies (no straws), mashed potato, soup once cooled, scrambled egg. From day 3, gradually return to normal diet on the opposite side of your mouth. Avoid hot, spicy, crunchy or seedy foods that can disturb the clot. Most patients are back to normal eating by day 5–7.
Will I look swollen?
Some swelling is normal and peaks at day 3 before resolving over the following week. Surgical impacted lower wisdom teeth produce more swelling than simple upper ones. Ice for the first 24–48 hours, then warm compresses from day 3, helps. Visible facial swelling is usually gone by day 7. International patients should plan accordingly if photographs are scheduled.
Start Here
Get an Honest Plan
Before Anything Comes Out.
Book a free consultation. We will examine the tooth, take the right X-ray and CBCT where indicated, tell you whether removal is genuinely the right call, and quote the case in writing before any clinical decision is made.