Dentistry & Oral Health - Toothpick
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Referral Advice

Advice for 30 year old female.Iu have an Impacted Lower Back Wisdom Tooth that is painful at times.

The X-ray shows no infection.

I would like any advice and opinion to a question please.

i feel like i have dented my Dentist Ego, As my Dentist will not refer me to an NHS Oral Surgeon and stated even if referral was sent to NHS it would be returned and refused, but i was not given that opportunity for the referral to be sent All this could be done in a third world country. I have read and been advised Dentist's would normaly refer patients to an Oral Surgeon for an Impacted Wisdom Tooth.As it is a Higher Risk procedure and at hospital there are much more staff and equipment in place for any unforseen circumstances or complications at the time of the Wisdon Tooth Extraction.

Also the Oral Surgeon (as it is and operation to the mouth) is doing a high volume of these each day. I asked to be referred to a more experienced professional for this procedure because of the implications of permanent nerve damage to the mouth and tongue due to the Wisdom Tooth being impacted.My last Dental Practice, a year ago wanted to refer me to an Oral Surgeon at NHS Hospital but as it wasn't too bad explained i could also wait as it had settled down .

Advice would be very helpful.

5 Replies


An 'impacted wisdom tooth' can be of varying degrees of difficulty to removal and doesn't automatically signal a referral to Oral Surgery. Normally, if the dentist is happy to do it themselves without a referral, it means they feel they are competent enought to do the extraction.

Your old dentist may have wanted to refer you, because a lot of dentists do not feel confident doing ANY extractions, even easy ones. It may be that your new dentist excells in this particular area!

In regards to the nerve damage, not ever wisdom (or lower back) tooth carries a significant risk, your dentist will have evaluated this from your x-ray and must feel that it is safe enough for them to do. We are under legal obligation to warn you of ALL risks, even if they are miniscule. Often, referras to Oral Surgery are lengthy and in many hospitals are carried out by students.

1 like

Hi AnotherDentist Thank you very much for taking the time to reply to my question much appreciated .I take your points but even so i would

prefer someone with more than 2yrs experience .this dentist doesn't unfortunately excell in this procedure being registered with GDC

Qualification is BDS but not Speciality as Oral Surgeon which would be stated on the GDC registar.Also this Dentist cut the front of another family members lip with a simple filling but they did not complain.Which shows lack of experience in my opinion.

Many recent replies i have received ,especially from America have explained with this procedure you need a specialist Oral surgeon as they are trained many more years than a Dentist to perform this procedure many times a day and much more management options are in place for any unforseen complications in a hospital setting being able to treat medically compromised patients with more support available in a Hospital compared to a single Dentist .An Oral Surgeon is better at dealing with medical problems arising Like you say some extractions are difficult.

So there is a good reason to see a Oral Surgeon.

Thank you for providing your views .


Seems like your mind has already been made up - so you don't really need advice!


America is not the best country to be taking note from in regards to dentistry as the way they do things there is very different (and financially driven?! - I know as I have worked there.

Many student/recently qualified dentists are better than those that have been practicing for decades, mainly because they are super cautious and all the theoretical information is fresh in their minds!

There is normally a good reason that a dentist doesn't see a need to refer you to a hospital specialist, for example, that your tooth removal is simply not complex enough and hence would be taking up the time of someone who truly needs a specialist to remove a tooth.

I think if you feel this strongly about seeing an oral surgeon, you can always find a private specialist who will see you immediately.


Or ....maybe the Dentist doesn't Excell in impacted wisdom teeth and takes 1 out every 6 months over the very few years of being a Dentist.Hardly high volume either and so that is why i err on the side of caution .Obviously the Dentist will not disclose this info from my experience.


Hi AnotherDentist

I didnt actually ask you to answer my question in the first place either!How do assume my mind is made up?I am still in the process of making it up... carefully .

The Wisdom tooth is complex impacted and nerve damage could easily happen .This Dentist also cut across the mouth of a family member while taking out a straight forward back molar

which should never of happened.

The dentist has less than

the usual amount of experience

and is not dealing with Wisdom teeth on a daily basis .

Yes ,i can go private i don't have a problem with finances but even some private Dentist have been found to have problems which can be found by visiting The Quality

Care Commision website ,from hygiene standards .Also I have been to some dentist's that don't wear gloves or use a mouth mask while being seen and treated

but they do use these in a third world Country!

It appears there is a lot Ego's

in Dentistry instead of simply putting the patient first in the UK in my humble opinion.If an Oral Surgeons in America has explained it is complex i will take their professional advice as they are not charging me they are freely advising me which i am very grateful to them .


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