Pull wisdom tooth under general anesthesia


More and more often the dentist expresses the wish to have the wisdom teeth pulled under general anesthesia.
General anesthesia is a method of putting the patient's brain and body into a state of rest so that pain awareness and the ability to move are suppressed. This makes it easier for the dentist to extract or drill out the wisdom teeth because the patient does not feel any pain, the muscles are relaxed and the mouth can be opened as wide as possible.

Performing general anesthesia

The sleeping pills are injected into the bloodstream so that the anesthesia works quickly and inhibits the transmission of pain and the processing of other stimuli.
The operation of the wisdom teeth is accompanied and supervised under general anesthesia by a special anesthetist, an anesthetist. During a difficult wisdom tooth operation, you are also artificially ventilated through a tube.

When does general anesthesia make sense?

As a rule, there are five cases that are an indication for general anesthesia for the extraction of wisdom teeth and that are medically justified.

  1. In the case of displaced wisdom teeth that are difficult to access and where simple local anesthesia cannot switch off the pain, stronger anesthesia must be used. It is also worthwhile if additional treatments can be carried out under general anesthesia in the same step.
  2. The second case is that patients present a certificate for a dental phobia. A psychotherapist must therefore prove a dental fear that has already been treated psychotherapeutically.
  3. If you have allergies to the local anesthetic, but not to the anesthetic of general anesthesia, you have to resort to it.
  4. Children who cannot keep still, because of a disability or fear, or in general children who cannot be calm down once they are on the dentist's chair, must be immobilized with general anesthesia.
  5. Patients with mental or physical disabilities are usually just as difficult to treat. On the one hand, general anesthesia is the faster way, on the other hand, it is safer to work when the patient is immobilized. The risk of injuries for the patient, dentist and team is minimized.

Learn more about this at: General anesthesia at the dentist

Fear of the dentist

Those who suffer from dental phobia are usually afraid of going to the dentist in early childhood. In addition to psychotherapeutic treatment, general anesthesia is particularly useful for larger operations. Even if you are simply afraid of the treatment itself, you may want to have general anesthesia.

Under general anesthesia, you are put into a state of sleep so that you do not notice the treatment. In normal wisdom tooth surgery, only local anesthesia is normally used. You don't feel any pain, but you can hear the noises of the treatment.

Another method is treatment with laughing gas or some kind of sedation. In these cases one falls into a light sleep or trance state. The treatment is painless and the feelings of fear disappear.

Find out more at: Fear of the dentist

Benefits of general anesthesia

  • Time saving: under general anesthesia, all wisdom teeth that need to be removed can be pulled at once. If you were to operate under simple local anesthesia, you should not pull 4 teeth at once, but plan several sessions.
  • In addition to the freedom from pain, it is also pleasant for the patient that he is not aware of the noises, conversations and any complications that may arise under general anesthesia. Since the entire feeling cannot be switched off under local anesthesia, you still feel an uncomfortable feeling of pressure. Because the nerves that are responsible for the transmission of strong feelings of pressure cannot be switched off by the local anesthetic.
  • Easier work: One advantage for the dentist is that the patient cannot move around at will under anesthesia. That means he participates in the operation without reluctance. The mouth can be kept open as much as possible, so that a good view is guaranteed.
  • Protection against injuries: In addition, the dentist does not need to be afraid that the patient will make any movements. Unexpected jerks can cause the dentist to slip with the drill or other instruments. It can also frighten him, which can lead to dangerous injuries for patients and practitioners.
  • It should be noted that the pain and swelling after the operation are usually just as severe as under local anesthesia.

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Disadvantages of general anesthesia

The disadvantages overlap to a certain extent with the risks, as complications can also arise with treatment under general anesthesia that are not common with local anesthesia. There are few other disadvantages compared to treatment while awake.

  • In patients who are under general anesthesia and who are not aware of the treatment, the corners of the mouth can tear when the hooks on the cheek are pulled too hard.
  • In addition, you have to stay in the recovery room after the anesthesia until you come to. So you can't go home straight away, as is common with local anesthesia.
  • After general anesthesia, you usually stay in bed for the rest of the day because the anesthetics tire the body and dizziness and nausea are not uncommon. The use of machines and participation in road traffic is prohibited for the following 24 hours.
  • Venous access is necessary during the operation so that emergency medication can be administered directly in the event of complications.
  • Overall, general anesthesia means more work, as suitable rooms and staff (namely the anesthetist) are required.
  • The typical sore throat and hoarseness after general anesthesia usually do not occur, as one is ventilated through the nose during the wisdom tooth operation. The post-operative sore throat mostly comes through the ventilation mask.

What are the risks?

In addition to the risks that can normally occur with a wisdom tooth extraction, there are also risks from the anesthesia and narcotics, especially when treating under general anesthesia. According to statistics, problems can occur in 1 in 10,000 anesthetics.

Not every person may be treated under general anesthesia without first checking the entire organism. Some patients belong to risk groups who should only be given general anesthesia in exceptional cases.

  • This includes patients with respiratory infections such as pneumonia. Artificial ventilation can lead to hoarseness and difficulty breathing after the operation.
  • Patients who are treated with cytotoxic drugs pose a risk because they are very susceptible to infections.
  • Patients with cardiovascular problems are reluctantly put under general anesthesia for a wisdom tooth removal. In patients with heart failure due to a congenital heart defect or severe high blood pressure, general anesthesia is far more risky than in healthy patients.

Read on under: These are the risks of general anesthesia


Every patient is different and every operation is different. Therefore, you cannot give any specific information about the duration. The duration depends on how many teeth have to be extracted and how they are located in the jaw.

If the teeth have already erupted and the crown is completely visible, the tooth can simply be extracted.
If the teeth are still completely in the bone, this must first be drilled. Another problem occurs when the wisdom teeth lay horizontally in the bone and cannot be grasped. Even with erupted teeth, delays can occur if the roots break off and get stuck in the bone.

The duration of the operation varies depending on the experience and skill of the practitioner. During the operation there can always be complications or unforeseeable changes to the plan. For example, in some cases it is necessary to lay several sutures, which also requires additional time.

Since it takes a certain amount of time to induce the anesthesia and to wake the patient up again after the operation, the treatment takes a little longer overall. The shortest surgery takes about 30 minutes if everything goes according to plan. However, if the teeth are displaced as described above, a wisdom tooth operation can take 3 hours.

After the operation you have to stay in the recovery room until you have recovered. After a local anesthetic, you can usually go home straight after the treatment.

What does tooth extraction cost under general anesthesia?

Extra costs are incurred for pulling wisdom teeth under general anesthesia. The dentist receives a fixed amount for the extraction from the health insurance company. The treatment around it, namely general anesthesia, must be financed additionally.
The anesthetist has to be there all the time, all anesthetic instruments must be available. Therefore, the cost of the operation under general anesthesia varies depending on the duration of the treatment.

As a guide, one hour of operation time costs around € 200-300. With longer treatment, the price does not increase as much. For each additional hour around 50-70 € are charged. Every dentist calculates a different price, so you shouldn't stick to these numbers, just orient yourself. In the consultation with the doctor, a certain approximation can take place because the dentist knows how long the operation will take.

What does the health insurance company pay?

As a rule, the statutory health insurance does not pay for general anesthesia. The real treatment of removing the wisdom tooth is of course paid for by health insurers. The private health insurance companies more often take over at least some of the treatment under general anesthesia. You have to ask your private insurance company whether this is the case.

In special exceptional cases it can happen that the anesthesia is completely covered by the statutory health insurance. Such cases must be justified as medically necessary.

  • For children or people with physical or mental disabilities, the anesthesia will be reimbursed if the patient cannot participate in the treatment while awake.
  • In some cases, patients with severe fears about dental treatment can submit a psychological certificate proving that they have a dental phobia that has already been treated by psychotherapy. In these cases, the health insurance company should cover the costs for the general anesthesia, as treatment would probably not be possible while awake.
  • In a few cases, patients may be allergic to local anesthesia. If no suitable local anesthesia can be used, the general anesthesia must be paid for by the health insurance company.

The terms and conditions of the respective health insurance company are binding. We recommend that you contact the health insurance company directly if you have any questions or are unclear.

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