Wisdom Teeth Removal

Oral Examination for Extraction of Wisdom Teeth

With an oral examination and x-rays of the mouth, your dentist or  Drs. Virdi, Humber, MacLennan and Lalli in our office can evaluate the position of the wisdom teeth and predict if there are present or future potential problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients should generally be evaluated in the mid-teenage years by their dentist, orthodontist, or by an oral and maxillofacial surgeon.

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Our oral surgeons are trained, licensed, and highly experienced in providing various types of anesthesia for patients.

Why should I have my wisdom teeth removed?

We often hear “If my wisdom teeth don’t bother me, why do I need to have them removed?”. Most people do not have enough room in their mouth for third molars to fully erupt and be used as a healthy, functioning chewing tooth.  A number of problems can happen if wisdom teeth are left without treatment. Impacted wisdom teeth should be removed before their root structure is fully developed. In some patients it is as early as pre-teenage or early teenage years, and in others it may not be until the early twenties. Problems tend to occur with increasing frequency after the age of 30. Some of the possible problems related to not removing your wisdom teeth include:

A representation of a pericoronitis infection on a wisdom tooth

Infection:

The most frequent clinical problem we see is pericoronitis, (a localized gum infection). Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.

An example of a cyst formation on a wisdom tooth

Cyst Formation:

Non-infectious diseases may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jaw bone that develop as a result of impacted teeth and slowly expand destroying adjacent jaw bone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.

An illustration of teeth crowding causes by a wisdom tooth

Possible Crowding:

Impacted wisdom teeth may contribute to crowding of your teeth. This is most noticeable with the front teeth, primarily the lower front teeth and is most commonly seen after a patient has had braces. There are a number of factors that cause teeth to crowd after braces or in early adulthood. Retained, impacted wisdom teeth may be a contributing factor. Unless you have an active problem when you see the oral surgeon, the reason for removal is primarily to prevent long-term damage to your teeth, gums and jaw bone.

A visual of a wisdom tooth damaging an adjacent tooth

Damage to Adjacent Teeth:

If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the second molar, can be adversely affected resulting in gum disease, bone loss around the tooth, and/or decay.

What if I don’t have my wisdom teeth removed as a teenager or young adult?

As wisdom teeth develop, the roots become longer and the jaw bone more dense. When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the post-operative course can be prolonged and there is a higher complication rate. Treating these complications is often more difficult and less predictable than with a younger patient. Healing may be slower and the chance of infection can be increased. If your impacted wisdom teeth are not removed in your teenage years or early in your twenties and they are completely impacted in bone, it may be advisable to wait until a localized problem (such as cyst formation or localized gum disease and bone loss) develops. In general, you will heal faster, more predictably and have fewer complications if treated in your teens or early twenties.

What happens on the day wisdom teeth are removed?

Most people prefer to be unaware of the experience when they have their wisdom teeth removed and usually decide to be sedated. You will be provided with appropriate anesthesia options at your consultation or when the appointment is booked. All outpatient surgery is performed under appropriate anesthesia to maximize your comfort. Our office staff has the training, licensing, and experience to provide the various types of anesthesia. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment and a well trained experienced staff.

On the day of your procedure, you will be given medications to help minimize post-operative pain and swelling. We ask that a parent or responsible adult accompanies you to the office and plans to stay with you the rest of the day. The procedure will take about 30 to 60 minutes and you can expect to be in the office for approximately 90 minutes. Recent advances in medicine and technology allow patients to undergo wisdom tooth removal in a manner, which promotes rapid healing and minimal post-operative discomfort. State-of-the-art sterilization and infection control techniques are used at all times.

On the morning or afternoon of your surgery, it is essential that you have nothing to eat or drink (excluding prescription medications with a sip of water) for at least 8 hours (preferably longer). This does not mean you should try to fit in one “last meal” exactly 8 hours before your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications, including nausea and vomiting. Your procedure may be rescheduled if you have not adhered to these guidelines.  If you are a smoker, it is recommended that you try to quit prior to your surgery as it can lead to post-operative complications. When you are seated in the surgical room, we will make every effort to make you as comfortable as possible. If you are going to be sedated, we usually will place an IV prior to you seeing the surgeon so you are ready to go. This is a quick and nearly painless procedure that ensures optimal delivery of your medication. Local anesthesia is given to you afterwards to ensure comfort, and allow adequate time to travel home and rest. You will be sleepy for a significant portion of the day.

smiling teenage son with his mother

The Day of Treatment

Be sure to have an adult with you at the time of removal. Make plans to have a parent or responsible adult stay with you for the rest of the day, following wisdom tooth removal.

If your surgery requires stitches, these are usually the type that dissolve in 5 to 10 days and do not require removal. You may also notice a sensation of your gums feeling swollen and pulling away from your teeth. This is all part of the normal recovery, and will subside in several days.

Once the local anesthesia wears off, you may require prescription pain medication. Please thoroughly follow the pain medication instructions that the nurse discusses while you are in recovery. You will be given prescriptions for pain control. It is important that you bring an escort who will be able to help you get prescriptions filled and that will ensure you are following the instructions. Take your prescriptions as directed, at the proper times. This will ensure you have optimal pain control through the healing stage. The local anesthesia may last until the following day, and should not be confused with an injury to your nerve.

We recommend starting your post-operative diet with cool, soft foods such as jello, soup, pudding, yogurt, scrambled eggs, etc. and gradually increasing in substance as your body permits.

If you are given antibiotics and you take birth control pills, please be aware that the birth control pills might become ineffective and take appropriate precautions.

What does wisdom tooth removal cost and is it covered by insurance?

The fee for your treatment is determined by a number of factors. These may include the difficulty involved in removing your teeth and which type of anesthesia is best for you. We are able to provide you an estimate of fees, however, the cost may slightly be adjusted once the surgery is complete. Every insurance company has a different policy regarding the extent of coverage for a given surgical procedure. The oral surgeon’s office staff will provide you with an insurance claim that you can send to your insurance company for reimbursement.  

What if I have questions before surgery?

At the time of your consultation/surgery appointment, your oral surgeon will explain in great detail all risks and reasons of the surgery. You are required to read and sign a consent form on the day of surgery. Your oral surgeon will also explain your specific situation and you will be able to express any concerns or ask any questions regarding your treatment prior to surgery.

A smiling woman

The Day of Treatment

Please do not eat or drink anything prior to your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications.