If it is recognized that you do not have enough room in your mouth for your third molars to erupt, it is advisable to have them removed as soon as it is recognized. In some patients it is as early as 14 whereas in others it may not be until 17 or 18 years of age. Younger patients will heal faster, with more predictable final healing and have fewer complications than older patients.

Many people, especially in years past, were told to take a “wait and see” approach to wisdom teeth.  Many who did not have adequate room developed localized problems previously mentioned.  The problem with this approach is that if it is necessary to remove impacted wisdom teeth in your thirties, forties, fifties, or beyond, it will be much more difficult for you as the patient.  The post-operative course is usually prolonged and there is a higher complication rate. Treating these complications is more difficult than with a younger patient. If you do not have your impacted wisdom teeth removed in your teenage years or in your early twenties, it may be advisable to wait until a localized problem (such as cyst formation or localized gum disease and bone loss) develops and then treat the affected area only. This is because the predictability of healing decreases with age and the likelihood of infection and delayed healing increases.

There is probably never a good time to undergo an elective procedure such as wisdom teeth removal. The most “popular” times for wisdom teeth removal is during the summer and school vacations. The bottom line is that with adequate preparation, any time will work for most people if they have planned accordingly in advance.

Nearly all wisdom teeth extractions are done under sedation “going to sleep”.  Most people clearly prefer to be unaware of the experience when they have their wisdom teeth removed. You will be provided with appropriate anesthesia options for you at your consultation.

 We ask that a parent or responsible adult accompanies you to the office and they must remain at the office during the entire procedure. They should plan on staying with you the rest of the day.  Your procedure will take about an hour and you will probably be in the office for 1 1/2 -2 hours.  Our registered nurses will review your post-operative instructions.  When you leave the office you will be comfortable and drowsy.  Most patients prefer to go home and rest with no other physical or scholastic activities planned for a few days.

 All outpatient surgery is performed under appropriate anesthesia to maximize your comfort. We have the training, license, and experience to provide various types of anesthesia to allow patients to select the most appropriate option. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment and staff experienced in anesthesia techniques.

Most of the times you will want to maintain a low profile for a few days. We ask that you follow your post-operative instructions closely as they will make you most comfortable during the first few days following your procedure. Please allow the time to let your body begin healing before resuming an active social, academic, or athletic schedule. Most patients feel like they are over “the hump” in 3-5 days.

As with any medical procedure, there can be complications or an unanticipated result that you should be aware of:

 There is a nerve, which supplies feeling to the lower lip, chin, and tongue which is frequently very close to the roots of the lower wisdom teeth. Having these teeth out between the ages of 14 and 18 usually provides shorter roots so that the nerve is not so close to the roots of these teeth.  Occasionally, when the teeth are removed, especially in older patients, the roots have grown longer and become closer to the nerve itself.  This nerve can become irritated in the process of removing the tooth.  When local anesthesia wears off, you may experience a tingling or numb sensation in the lower lip, chin, or tongue.  Should this occur, it is usually temporary and will resolve gradually over a period of weeks or months.  RARELY, it can result in a permanent alteration of sensation similar to the feeling of Novocaine, although to a much lesser degree.  We feel that you should be aware of this before consenting to surgery.

 The upper wisdom teeth are situated close to your sinuses and their removal can result in a communication between your mouth and the sinus.  Once again, if the teeth are removed at an early age, the root formation is minimal and this complication is very unlikely to occur.  Should this occur, it will usually close spontaneously. We may give you special instructions to follow if this is apparent at the time of surgery. We prefer that you don’t blow your nose for two or three days following the surgery.  You can wipe your nose, but don’t blow your nose.  If you have to sneeze, you should sneeze with an open mouth into a tissue.  You should not create any pressure in the sinus area, which may dislodge the healing blood clot.  If you sense a communication occurring after the surgery, please contact the office.  RARELY, an additional procedure may be necessary to close the communication.

 The most common problem encountered following surgery of any kind is infection.  This usually requires an office visit and clinical examination. Many times, just placing you on an antibiotic for one week will take care of the infection.  It will occasionally require drainage of the infected area, which may have accumulated near the surgical site, and even more rarely do the patients need to be admitted to the hospital for intravenous antibiotics and further surgical drainage.

 Other temporary problems you may experience in the postoperative period include stiffness of the jaws, chafing around the corners of your lips, facial bruising, and blood oozing from the extraction sites. The postoperative instruction sheet we will provide should answer many of the questions related to these more common concerns. If not, don’t hesitate to call the office.

Dry sockets continue to be the most common problem people experience following wisdom tooth surgery.  They arise due to premature loss of a blood clot in the empty tooth socket and affect approximately one out of five patients.  This seems to occur with greater frequency in people who smoke or are taking birth control pills.  While both jaws can be affected, they usually occur in the lower jaw on the third to fifth day.  They cause a deep, dull, continuous aching on the affected side(s).  Patients may first notice the pain starting in the ear radiating down towards the chin.  It frequently begins in the middle of the night, and the Ibuprofen medication usually doesn’t help.  Treatment involves placing a medicated dressing in the “empty” tooth socket.  This will help decrease the pain and protect the socket from food particles.  The effectiveness in alleviating the pain lasts for 24-48 hours and usually will require dressing changes every two or three days for approximately one week.  Dressings are usually removed when you have been pain free for 2-3 days.  The dressing doesn’t aid in healing.  The only reason to place a dressing is for pain control.  If ibuprofen is controlling the pain, the socket will heal without a dressing.  An irrigation device can be given to you to help keep food particles from lodging in the extraction site following removal of the dressing.

Because of the different types of impacted wisdom teeth, along with different anesthesia options, it is impossible to give you a realistic estimate of what our services will cost until we have reviewed your x-rays. Every insurance company has a different policy regarding the extent of coverage for a given surgical procedure. We will provide you with an estimate and obtain a predetermination of your coverage prior to the procedure. We do however, encourage you to check your dental insurance carrier to determine your coverage and out of pocket liability.

We recognize that having your Wisdom teeth out is not something you really want to do.  We also realize that with an active schedule there is never a really good time to have this done.  If this information, combined with information you receive at your consultation appointment doesn’t answer all of your questions, please call our offices to speak to one of our Patient Care Coordinators.