Wisdom Teeth Removal

Oral Examination

With an oral examination and x-rays of the mouth, Dr. Tracy 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 are generally first 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 doctors are trained, licensed, and highly experienced in providing various types of anesthesia for patients.

Why Should I Have My Wisdom Teeth Removed?

If you do not have enough room in your mouth for your third molars to fully erupt, a number of problems can happen. Impacted wisdom teeth should be removed before their root structure is 1/2 to 2/3 formed, before it is fully developed. In some patients it is as early as 12 or 13, 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:

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.

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.

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.

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 healing 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. 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 and comfort, utilizing modern monitoring equipment and a well trained experienced staff. The Surgical Care Team, the office facilities, and the doctors are inspected on behalf of the Board of Dental Examiners on a regular basis.

On the day of your procedure, you will take 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 will probably be in the office for 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 in our facility.

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 prior to the surgery if we are doing sedation. Having anything in your stomach can increase the risk for serious anesthetic complications, including nausea and vomiting. Your procedure will be rescheduled if you have not heeded these guidelines. We will provide you with a prescription for  pain medication the day of your surgery to be picked up at your local pharmacy. 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 in your right or left arm. This is a quick and nearly painless procedure that ensures optimal delivery of your medication. Local anesthesia is given to you once you are sedated to ensure comfort, and allow adequate time to travel home and rest prior to taking your pain medications. You will be sleepy for a significant portion of the day.  All your pain medications should be taken with some food in your stomach to avoid nausea and possible vomiting.  Food recommended after surgery are soft cold foods.

If your surgery requires stitches, these are usually the type that dissolve in 3 to 5 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.  Peak days of swelling after a surgery are 3-4 days after.

Prior to the local anesthesia wearing off we recommend that you start taking your pain medicine as directed when you leave the office.  This will ensure that the pain medication will already be in your system prior to the local anesthesia wearing off.  In this way your discomfort will be minimized. The local anesthesia typically lasts 4-6 hours after surgery.  We recommend starting your post-operative diet with clear liquids such as jello and room temperature broths, gradually increasing in substance as your body permits.

If you are given antibiotics for any reason and you take birth control pills, please be aware that the birth control pills might become ineffective until your next cycle, therefore appropriate precautions should be taken.

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. During your consultation appointment, the surgeon will need to review your x-rays, complete an examination and determine the best option for anesthesia, before an accurate estimate can be provided. Every insurance company has a different policy regarding the extent of coverage for a given surgical procedure. The oral surgeon’s office staff will help you obtain maximum insurance coverage for your treatment.

What If I Have Questions Before Surgery?

At the time of your consultation, your specific situation will be discussed in greater detail. We encourage you to ask any questions you may have. If new questions arise after your consultation, please call our office to speak to one of our patient care coordinators.