Wisdom tooth extraction in Brussels and Walloon Brabant

Wisdom tooth extraction is performed at Molière Longchamp Hospital (Brussels) and at the Cabinet Médico-Dentaire Les Bons Villers, a few minutes from Nivelles, Genappe and Villers-la-Ville.

The procedure is performed under local anaesthesia, or under sedation as day surgery at Molière. Sedation is an intermediate state between local and general anaesthesia: a light sedative given intravenously, combined with local anaesthesia. You are deeply relaxed and drowsy, unaware of noises or pressure, while breathing on your own. Performed in a hospital setting, it offers excellent comfort with far fewer risks than general anaesthesia. It is the most comfortable option for removing all four teeth in one session.

Do wisdom teeth need to be removed?

Wisdom teeth (third molars) come through between the ages of 17 and 25. Some people never develop any, others may have up to eight. They are often poorly positioned for lack of space: impacted in the bone, trapped under the gum or tilted against the second molar, and they can cause pain, infection or displacement of the other teeth.

Extraction is indicated in case of:

pericoronitis (infection of the gum around the tooth), especially if recurrent;
decay of the wisdom tooth or of the neighbouring tooth that cannot be treated;
a cyst or lesion around the crown (visible on X-ray);
resorption of the root of the second molar;
pain or discomfort when opening the mouth;
planned orthognathic surgery, or as part of orthodontic treatment.

A wisdom tooth that has fully erupted, is healthy and can be cleaned does not necessarily have to be extracted. The decision is based on a clinical examination and a panoramic X-ray, completed if necessary by a CBCT (3D scan) to assess precisely the position of the roots in relation to the inferior alveolar nerve or the sinuses.

At what age should wisdom teeth be removed?

Ideally between 15 and 25: the roots are not yet fully formed, the bone is more flexible, and recovery is faster. After 30, extraction remains possible but recovery may take a little longer.

Local anaesthesia, sedation or general anaesthesia?

Local anaesthesia — the classic, effective solution. The area around the tooth is numbed by an injection; there is no pain, but pressure and noises are still perceived. The procedure is quick and you go home immediately, from the practice in Les Bons Villers or from Molière Hospital.

Sedation — a light sedative given intravenously, combined with local anaesthesia. You are deeply relaxed and drowsy, unaware of noises or pressure, while breathing on your own. It is the most comfortable option, particularly suited to removing all four teeth in a single session or to anyone who prefers not to be aware of the procedure. It is performed as day surgery at Molière, with far fewer risks than general anaesthesia and a quick recovery: discharge in the late afternoon, accompanied.

General anaesthesia — total absence of sensation and consciousness. It is exceptional for wisdom teeth and reserved for particular situations, as day surgery at Molière.

In summary:

Local anaesthesia — for whom: most patients · where: Molière, Les Bons Villers · going home: immediately · driving: allowed
Sedation — for whom: maximum comfort, all 4 teeth in one session · where: Molière, day surgery · going home: late afternoon, accompanied · driving: not the same day
General anaesthesia — for whom: particular situations · where: Molière, day surgery · going home: late afternoon, accompanied · driving: not the same day

Step by step

Consultation: clinical examination, 2D X-ray completed by a 3D scan if necessary, explanation of the procedure, the risks and the recovery.
Procedure (30 to 45 minutes): anaesthesia; incision of the gum to expose the tooth and the bone; removal of the bone blocking access to the impacted tooth; sectioning of the tooth if necessary to make extraction easier; cleaning of the site; resorbable stitches; gauze to control bleeding and help the clot form.
Discharge: under local anaesthesia, you leave immediately with the prescription and written instructions. Under sedation or general anaesthesia, you are monitored in the day surgery unit until the late afternoon. For day surgery, the admissions department calls you the day before to give you the exact arrival time.

There is no systematic check-up unless you wish one. If you have any question or concern, a quick check-up is possible without an appointment.

All four teeth are generally removed in a single session to avoid two recovery periods; they can be removed in two stages (one side, then the other) if you prefer.

Post-operative guide day by day

Day 0 (day of the procedure)

Bite on the gauze for 30 minutes, then remove it. Slight bleeding tinged with saliva is normal until the next day.
Cold: cold pack with a bandage on the cheeks (provided during the day surgery stay, or available at the pharmacy for outpatient extractions under local anaesthesia), or an ice pack wrapped in a cloth. Cold is most effective during the first two days.
Start the painkillers before the anaesthesia wears off (2 to 3 hours after the procedure), without waiting for pain. The prescription is registered on your identity card and usually includes an antibiotic, an anti-inflammatory, a painkiller and a mouthwash, generally taken three times a day after meals. The course of antibiotics must be completed.
No alcohol, no hot food or drinks during the following week.
Do not spit, do not rinse vigorously, do not drink through a straw: the clot must stay in place.
Do not smoke. Tobacco multiplies the risk of dry socket and delays healing: no cigarettes for at least 72 hours, ideally a week.
Sleep on your back, head raised on two pillows.
Hygiene: brush your teeth from this evening, gently, taking care with the stitches. Prescribed mouthwash from this evening, without force.
Diet: cold or lukewarm, no chewing, as soon as the anaesthesia has worn off. In the day surgery unit, cold yoghurts are served. At home: yoghurt, fruit compote, smooth seedless smoothies, lukewarm blended soup, smooth purée, dessert cream, ice cream without pieces. Nothing hot.

Day 1

Swelling increases on days 1 and 2: this is expected. Continue the cold.
Gentle brushing avoiding the operated area, mouthwash after each meal.
Rest. No sport, no carrying heavy loads.
Diet: lukewarm, soft, no chewing. Examples of meals: buttered mashed potato with flaked steamed fish; very soft scrambled eggs; vegetable purée (carrot, courgette, sweet potato) enriched with fromage frais; mashed avocado; porridge; mashed banana; pumpkin soup with cream.

Days 2–3

Swelling and stiffness on opening are at their peak; facial bruising resolves in about 5 days. A bruise may appear on the cheek; it disappears in 7 to 10 days.
A slight rise in temperature (below 38 °C) is possible and normal.
Diet: soft, lukewarm. Well-cooked pasta, risotto, omelette, fish, minced meat in sauce, blended lentils, custard, mashed potato gratin. Avoid seeds, crusty bread, chips, nuts, spicy or acidic foods.

Days 4–7

Pain clearly decreasing. Gradual reduction of painkillers.
Mouth opening returning: gentle opening exercises 3 times a day.
Diet: normal but tender. Chew on the non-operated side. Rice, pasta, tender meat, cooked vegetables, sandwich bread.

Days 7–14

The stitches dissolve on their own between 10 and 15 days.
Mouthwash until day 7–10, then back to your usual hygiene. Irrigation syringe, mouthwash or a gentle water flosser if food gets lodged in the socket.
Sport can be resumed from day 14.
Diet: normal. Reintroduce crunchy foods after day 14.

When to ask for a check-up

A quick check-up is possible without an appointment in case of:

significant pain that returns around day 3–5, with a bad taste: this is the sign of a dry socket, which is simply treated at the consultation;
fever above 38.5 °C, swelling that increases after day 3, difficulty swallowing;
heavy bleeding that does not stop after 30 minutes of pressure.

Reimbursement

Extraction of impacted wisdom teeth is reimbursed by the health insurance fund (INAMI/RIZIV stomatology nomenclature). At Molière Hospital, the procedure is performed at the agreed (conventioned) rate. At the Les Bons Villers practice, fee supplements may apply.

FAQ — Wisdom teeth

How long does wisdom tooth extraction take?

From 20 minutes for one tooth to 45 minutes for four impacted teeth. Under local anaesthesia, allow 1 h 30 on site including reception and instructions. For day surgery (sedation), allow the whole day: the admissions department calls you the day before to give you the arrival time, and discharge is in the late afternoon.

Does it hurt?

No pain during the procedure: you feel that work is being done, some pressure, but no pain. Under sedation, you are aware of neither noises nor pressure. The first 48 to 72 hours are the most uncomfortable; the pain is well controlled by the prescribed painkillers, taken at fixed times.

Can all 4 wisdom teeth be removed at the same time?

Yes, this is the most common approach, under local anaesthesia or sedation. It avoids going through the recovery twice.

How many days off?

One week off work or school, two weeks without sport. A certificate is provided on the day of the procedure.

How long does the swelling last?

At its peak on days 2–3, it decreases markedly from day 4 and disappears around day 7–10.

When can I eat normally?

Soft diet until day 7, normal but tender until day 14, no restrictions afterwards.

Can I smoke after an extraction?

Not for at least 72 hours, ideally 7 days. Tobacco multiplies the risk of dry socket (significant pain due to loss of the clot) and delays healing.

Can I drink alcohol?

Not while you are taking painkillers or antibiotics, i.e. 5 to 7 days.

What are the risks?

Dry socket (2 to 5% of cases): the clot protecting the socket comes away, leaving the bone exposed. Significant pain around day 3–5 with a bad taste. Treated at the consultation by cleaning and a dressing; heals in a few days.
Infection: rare, favoured by smoking or inadequate hygiene. Swelling that increases after day 3, fever, discharge. Treated with antibiotics and possibly drainage.
Bleeding: oozing is normal on the first day; heavy bleeding is rare and is controlled by pressure, or at the consultation if necessary.
Damage to neighbouring teeth: exceptional, particularly on a second molar already weakened by decay or a large filling.
Limited mouth opening (trismus): stiffness of the chewing muscles for a few days, which recovers with opening exercises.
Numbness of the lip or tongue: for lower teeth whose roots are close to the inferior alveolar nerve or the lingual nerve. Almost always temporary (weeks to months). The 3D scan makes it possible to assess this risk in advance and adapt the technique.
Communication with the sinus: for upper teeth whose roots touch the maxillary sinus. Closes spontaneously or with a stitch; do not blow your nose hard for two weeks.

What is a coronectomy?

When the roots wrap around the inferior alveolar nerve, only the crown of the tooth is removed and the roots are left in place. This avoids any risk to the nerve.

Do wisdom teeth need to be removed before orthognathic surgery?

Yes for the lower wisdom teeth: they are removed at least 6 months before a mandibular osteotomy so that the bone has healed at the level of the osteotomy line.

Can I drive after the procedure?

Yes after local anaesthesia alone. Not on the same day after sedation or general anaesthesia.

What if a stitch falls out?

The stitches are resorbable and come away between day 7 and day 15: nothing to do. If a stitch comes out earlier, while eating or for another reason, the socket may open slightly: clean it gently after each meal with the mouthwash, the irrigation syringe or a low-power water flosser. The gum closes gradually over 2 to 3 weeks and the hole fills in over 4 to 6 weeks.

What if food gets stuck in the hole?

Rinse gently with the irrigation syringe using lukewarm water or mouthwash from day 3. The hole fills in over 4 to 6 weeks.

Where to consult

Molière Longchamp Hospital, Rue Marconi 142, 1190 Forest — 02 432 81 90 — local anaesthesia or sedation as day surgery.
Cabinet Médico-Dentaire Les Bons Villers, Chaussée de Bruxelles 798, 6210 Frasnes-lez-Gosselies — 0493 98 00 73 — local anaesthesia, on Wednesdays.

Recovery

Swelling

Facial bruising appears a few hours after the extractions and resolves after about 5 days.
Ice packs

Applying ice packs to the cheeks, especially during the first 48 hours, helps control the swelling.
Pain

Mild pain or discomfort is common. It is relieved by the prescribed painkillers.
Semi-sitting position

Keeping the head raised with several pillows during the night helps relieve discomfort and control the bruising.
Stitches

The stitches usually dissolve within two weeks.
Diet

Keep to a soft, cold or lukewarm diet during the first few days after the extractions: smoothies, purées, pasta…
Oral hygiene

Brush the teeth gently and use the prescribed antiseptic mouthwash gently from the first evening after the procedure.
Medication

The prescription is registered on your identity card and usually includes an antibiotic, an anti-inflammatory, a painkiller and a mouthwash. It is recommended to take three tablets a day of each medication, ideally after meals. The course of antibiotics must be completed.
Physical activity

Avoid intense physical activity for two weeks, as it increases the risk of swelling.
Restrictions

Avoid smoking, drinking alcohol and eating or drinking anything hot during the week following the procedure.