ENA patient is usually sent to an oral surgeon with one sentence from the dentist: “this one has to be taken out”, “there is a cyst under the root”, “there is not enough bone” — and no idea whether that means a fifteen-minute visit or an operation under general anaesthesia.
This page explains what oral surgery in Germany covers, which operations are common, how a German practice plans them, what anaesthesia is offered and what fits into one trip. Implants, gum disease and root canals have their own pages; for the whole field, see dentistry in Germany.
What oral surgery covers and what it does not
Oral surgery means operations inside the mouth on the teeth, the alveolar bone and the mucosa. Oral surgery in Germany is done both by dentists with the additional qualification in oral surgery (Oralchirurgie) and by maxillofacial surgeons; for patients, the difference is the setting, not the title.
Orthognathic surgery for a misaligned bite, jaw joint operations, facial trauma and tumours of the facial skeleton belong to maxillofacial surgery. Dental implants in Germany, periodontal surgery and root canal work have their own pages too, so look for those answers there.
The operations people come for
Most come for teeth that cannot be removed in an ordinary chair. An impacted wisdom tooth has not fully come through, so the gum is opened and bone removed over it. A displaced one grows the wrong way and is sometimes divided. A root broken under the gum gives forceps nothing to grip and is reached through an incision. A tooth in the way of a planned prosthesis is removed while sparing the bone beneath it.
Next comes work under the root and in the bone. An apicoectomy, removing the root tip and the inflamed tissue through a small incision, is done when a re-treated root canal keeps failing and is normally discussed only after root canal treatment has been considered. A radicular cyst is removed whole. A retained canine is exposed and fitted with a button the orthodontist pulls on.
Third, the bone is prepared for a prosthesis: a sinus lift adds bone under the raised sinus floor to give an implant enough height, bone augmentation builds up thin bone, and smoothing the alveolar ridge removes edges that would rub under a denture. Small diagnostic operations complete the list: a biopsy of a mucosal lesion that has not healed for weeks and removal of a salivary stone from its duct.
How the operation is planned
Planning starts at the first appointment: examination, a panoramic X-ray and, where roots sit close to the mandibular nerve or the sinus floor, a cone beam CT, which shows in three dimensions what a flat image only hints at. The surgeon shows the patient the picture and names the risk before, not after.
Most of this surgery is done under local anaesthetic. Sedation and general anaesthesia are available and chosen for anxiety, long combined operations and children; they change where the operation takes place and how the day runs.
The patient is told in advance what swelling to expect, which medicines to pause (only with the prescribing doctor’s agreement), when the stitches come out and what to eat in the first days. For wisdom teeth, the guideline of the German oral and maxillofacial surgery and dental societies (in German) covers examinations, complications and anaesthesia; its 2019 version was valid until August 2024.
Where it is done and by whom
Settings differ: routine operations are done in a dental practice or outpatient surgery; complex cases, general anaesthesia and patients on blood thinners or after radiotherapy go to a hospital dental centre. University centres include the dental, oral and maxillofacial centre at the Charité in Berlin. There the department of periodontology, oral medicine and oral surgery sits alongside the prosthodontics department headed by Prof. Florian Beuer. Others are the dental centre at the university hospital in Hamburg-Eppendorf and the one at the Carl Gustav Carus university hospital in Dresden; see also dental clinics in Germany.
Before agreeing, ask whether a cone beam CT is on site, who will operate, whether general anaesthesia is possible and who is on call if bleeding starts at night.
One trip: what realistically fits
One trip fits the consultation, the operation and the removal of stitches. Typically, consultation and imaging take day one, the operation day two or three, and the review with stitches out follows after seven to ten days. So a short trip usually means staying, and a return flight on day three is the most common mistake.
The rest depends on the plan: bone augmentation before implants means the implant comes months later, in a second trip; an apicoectomy usually does not. The clinic names sums, dates and stage counts in its written estimate, not this page; for money, see dentistry prices in Germany.
Frequently asked questions
Does wisdom tooth removal hurt?
Not during the operation: the area is numbed, and for strong anxiety sedation or general anaesthesia can be discussed. Pain and swelling follow as the numbness fades and last a few days, eased by painkillers and cooling. If they worsen instead, see the surgeon at once.
Should blood thinners be stopped before the operation?
Not on your own: that is decided with the doctor who prescribed them. Many smaller operations go ahead without a pause, with bleeding stopped by pressure, stitches and haemostatic agents. Send the surgeon your list of medicines and doses in advance; with a high bleeding risk, a hospital centre operates.
Can a tooth be removed under general anaesthesia?
Yes, if there is a reason: strong anxiety, a long operation combining several procedures, or a child who cannot cope in the chair. An anaesthetist gives it, so it is planned where that is possible, and the choice is made with the surgeon after the examination.
How AlenMed arranges oral surgery
AlenMed sends the panoramic image, the cone beam CT if there is one, the dentist’s letter and the list of medicines to a German dental surgery department, which answers whether the operation is needed, what must be repeated on site and how many days it takes. Then come a written estimate, a visa invitation, appointments in one block and an interpreter in the chair, where a misunderstood instruction costs a week of healing.
Plan for lodging until the stitches are out, soft food for the first days, translated written after-care rules and a final report for your home dentist.
This material is for information only and is not an offer. The indication for surgery is decided by a doctor after an examination in person.