June 19, 2023

Should I go under for my wisdom teeth removal or stay awake?

By Akeem Ajayi D.D.S

Do i need to be put to sleep for my wisdom teeth removal ?

You do not necessarily have to be put to sleep for your wisdom teeth extraction. Wisdom teeth extraction can be done while the patient is fully awake with the mouth Numbed with local anesthesia. Wisdom teeth are the molars (back teeth) that come through last, usually in your late teens or early 20s. There are normally four wisdom teeth – two in the upper jaw and two in the lower jaw – but some people have more, fewer, or even none at all.

Table of Contents

You can be awake during your wisdom teeth removal?

You can be awake during your wisdom teeth removal. Being awake during your wisdom teeth removal does simply implies that you will know the dentist is working on you but you will not feel any pain. The procedure goes something like this:

First, the Dentist would rub a topical anesthesia on your gum to ease the pain of the needle with which the local anesthesia is administered to numb you. Then, the doctor uses a sharp object to poke you in the gums and asks you if you feel anything. When you don’t feel anything, the fun begins if you feel anything they add more anesthesia or simply give it more time to take effect every patient is different.

Wisdom Tooth Removal without Sedation

If you choose to get your wisdom tooth removed without sedation, an anesthesia-free procedure significantly reduces the overall procedure time. Without the need for sedation, preparation and recovery periods are shorter, making it possible to return to your routine more swiftly. It also eliminates any risks associated with anesthesia, including allergic reactions or complications from underlying health conditions.

This approach also ensures full patient consciousness and responsiveness, offering you the ability to communicate with our dentist and assistant throughout the procedure. Your real-time feedback can help guide the Dentist. It also provides you with the ability to better understand the process and you are able to drive yourself home and take care of yourself.

dentist no insurance

You can choose to be sedated for your wisdom teeth removal.

There are different levels of sedation that are offered by Dentists. Several factors are taken into consideration, such as the length of the procedure and your personal pain and anxiety threshold, before you and your dentist decide which sedation level is best for you. These levels range from minimal sedation to deep sedation. Minimal sedation will always be preferred because it reduces patients’ anxiety and pain reception while maintaining their ability to respond to the dentist’s instructions or questions if needed. Deep sedation is used less often for wisdom teeth extractions and only considered after mild or moderate sedation is ruled out.

How Painful is Tooth Extraction Without Anesthesia


We rarely would ever pull a patient’s tooth without some form of anesthesia or sedation. A rare exception might be a very !!! loose tooth. It is safe to assume that you want to know what the experience would be like to have a tooth pulled with local anesthesia or numbing alone . Well, understand that Local anesthetic is probably the greatest discovery for the alleviation of pain ever developed in the history of humanity. This numbing esthetic injection is given to block the nerve sensation that transmits pain so you should not feel pain. Having said that, there can be times when a patient’s tooth or surrounding tissues simply haven’t been numbed up adequately. It’s never the dentist’s intention, it’s just something that statistically happens. Our Dentist will test with a sharp object in your exams before he attempts to pull your tooth.

Types of Sedation/Anesthesia available for Tooth Removal

When considering sedation or anesthesia for tooth extraction, know that each option ensures patient comfort and has its own risks and benefits. While a large number of patients find local anesthesia entirely adequate for their needs, we recognize that every individual is unique, each with varying levels of anxiety or discomfort. This is why personalizing your dental care is of the utmost importance to us.

You can take comfort in knowing that tooth extraction is a routine procedure and that with Dr. Ajayi, you are in very capable hands. Boasting over 20 years of extensive experience in the field, Dr. Ajayi is more than equipped to ensure your procedure is as smooth, comfortable, and pain-free as possible. Trust in his expertise to guide you through this process with care and professionalism.

Local Anesthesia:

dentist tray with exam set and syringe to administer local anesthesia

This type of anesthesia numbs only the specific area where the extraction will take place. It’s administered via a direct injection into the site. Patients remain completely conscious and can respond to touch and pressure, but they won’t feel pain.  A major advantage of local anesthesia for tooth extraction includes It is Safe and effective to use * Easy to administer and relatively inexpensive. It is however not suitable by itself alone for patients with high anxiety.

Nitrous Oxide (Laughing Gas):

Nitrous oxide, combined with oxygen, is inhaled through a mask placed over your nose. This form of sedation induces a relaxed, euphoric state. It’s often used in conjunction with local anesthesia and wears off quickly, allowing patients to drive themselves home post-procedure.

Oral Conscious Sedation:

oral sedation involves taking a prescription medication, like Ativan, before your procedure. The medicine helps patients relax while they remain awake but drowsy. The degree of sedation depends on the dosage given. Oral sedation often requires a companion for transportation to and from the dental office.

IV Sedation:

Intravenous sedation provides a deeper level of relaxation. Administered directly into the bloodstream, the effects are immediate. Patients under IV sedation are conscious but extremely relaxed, often remembering little to nothing about the procedure afterward.

General Anesthesia:

This method, used for extensive surgical cases or for patients with high anxiety or special needs, renders the patient completely unconscious. Given through inhalation or IV, it requires careful monitoring of vital signs and often requires several hours of post-procedure recovery.


Is it an Impacted wisdom teeth ?

Be informed that wisdom teeth removal is not all the same hence, the required technique and time it would take to remove each would be different. Generally, wisdom teeth can be fully buried in bone  (completely bony), partly buried in bone (partial bony) and only covered by gum or showing in the mouth just a little bit (Soft tissue). So you need to know which category you belong by taking an Xray. When you do know, Completely bony extractions require more effort and time because of the need to remove some bone around the tooth. Partial bony not so much and soft tissue the least. Of this 3 major category of wisdom teeth impaction, Completely bony comes out on top.


How is my wisdom teeth growing?

It is often recommend that adult take an x-ray just to understand how their wisdom teeth is growing. If you are insured, most insurances will cover the full mouth panoramic x-Ray at least once in a 5 year period here in the USA. Luckily, if you are a no insurance patient in Houston TX looking to extract your wisdom teeth, we at Keem smile dentistry can offer a free consultation with Panoramic x-ray.

More often than not the wisdom teeth is probably not growing the way it’s supposed to be and it’s most likely going to cause some pain and some damage if it’s not probably dealt with on a timely basis. Most of the time, the wisdom teeth is not growing correctly! It should also be noted that a wisdom tooth can grow impacted and not cause damage or have a tendency to in which case We would just recommend that you let it be, the best way to know is to take that x-ray.

should i go under for my wisdom teeth removal or stay awake Impacted-Wisdom-Teethshould i go under for my wisdom teeth removal or stay awake Impacted-Wisdom-Teeth

What is your Pain Threshold ?

I would also like to point out that no two persons are the same when it comes to pain threshold. Some people require more numbing than the others. Others have a history with pain medications and some recreational drugs all of which can affect our pain tolerance. That been said, when you have your wisdom teeth removal while under or awake, you should not feel any pain other than the injection anyway in the case of numbing/Local anesthesia. If you cannot tolerate the pain from the injection (Yes it stings, just like a regular injection anywhere in the body) and pressure with being awake during wisdom teeth removal you might want to be put to sleep. Most of  the time, it is not really pain but anxiety and the fear of the dentist. You might want to get nitrous oxide/Oral Sedation to calm you down instead of being put to sleep. Nitrous oxide is no longer commonly used for wisdom teeth removal because it can cause nausea and vomiting in some people.

Location of the wisdom teeth matters


Depending on the location of the wisdom teeth: Mandible (lower teeth) or Maxillary (top teeth). The lower jaw bone(mandible) is denser than the top jaw bone (maxilla), so it’s much easier to extract wisdom teeth from the top than it is from the lower. So if you have a top Wisdom teeth and a bottom wisdom teeth of similar condition to extract and you had to pick one, the odds are it  would be much easier to remove the top one.

What’s your budget ?

3 bottles of money jar filled with coins lablled budget and savings for wisdom teeth removal while under

After all is said and done you still need to factor in the cost of the procedure. Going under (IV Sedation) for a wisdom teeth removal would definitely cost you much more than local anaesthesia / Numbing alone. If your budget is under $500 in Houston or any nearby City like Katy, Cypress, or Spring, the odds are you might not get a Dental Office to pull your teeth for the price under IV sedation and you have to save up some more. The cost of sedation is the single most important factor that can increase the cost of wisdom teeth removal  by up to 50%. In the greater Houston area, Sedation alone costs on average $1200 while wisdom teeth removal starts from $150 and stops at $400 at Keem Smile Dentistry Houston TX 77084 as at the time of writing this article.

How Long would it take to remove the Wisdom tooth?


I have seen Wisdom tooth come out in 15 Seconds !! Yes a wisdom teeth extracted in 15 Sec and i have also seen wisdom teeth removal that took an hour. Sometime you can easily pull the wisdom teeth out with a Dental forceps other times you have to cut it outand remove in pieces.  Although this would be dependent on the skill level of your dentist and the condition of the tooth. However If you do not feel comfortable staying up for so long, mouth wide opened  while work is being done in your mouth, you might want to think about your wisdom teeth removal while under. It is very rare that a single wisdom tooth removal regardless of the condition would take an hour if you have an experienced Dentist. Our Dentist have Over 10 years Oral surgery Experience. Talk to us, we are here to serve you. Wisdom teeth removal takes on average 10 Minutes or at most 30 minutes based on location (top or bottom), position of the tooth (buried in bone or not) among other factors.

Getting wisdom teeth removed without being put under!

Getting your wisdom removed while awake i.e without being put under can be a very smooth and pleasant experience just as much as if you slept through it. It can be safer when you consider the risks associated with some types of sedation and it can be less costly too getting your wisdom teeth out without being put under. For most patients, a well administered local anesthesia is just enough to numb a patient well enough such that She/he would not feel any pain while the Dentists pull the wisdom teeth. Patients can drive themselves home after the procedure.

Getting Wisdom teeth removed While Under / put to sleep


While Most patients are just fine with a local anesthesia to pull there wisdom teeth, this is not always so for all patients especially those who have had a terrible experience or have a very high level of anxiety and low tolerance for pain. Even though the Dentist would administer local anesthesia before giving the shot some patients still cannot stand the residual pain of the needle. For these kind of patients, more comfort and less anxiety might be the only resolute for them. IV Sedation can be administered for patients like this to put them to sleep. While under, local anesthesia is still administered with injection and the Dentist would pull the teeth just like he would while you are awake the only difference being that you are deep asleep unaware of whats going on.
Pateints would need someone to drive them home as they would not be able to drive untill the effect of the sedation wears off.

Request an Appointment

Free Wisdom Teeth Consultation