Wisdom Teeth Removal
Oral Examination for Extraction of Wisdom Teeth
With an oral examination and x-rays of the mouth, Dr. Peoples, Dr. Oghalai and Dr. Krutoy can evaluate the position of the wisdom teeth and discuss with you 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. Ideally, impacted wisdom teeth should be removed before their root structure 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 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 patients choose to be comfortably sedated for wisdom tooth removal. During your consultation, we’ll discuss anesthesia options and answer any questions. Our experienced surgical team provides care in a safe, fully monitored environment that meets or exceeds Board of Dental Examiners standards.
Before Surgery
Do not eat or drink (except for prescription medications with a small sip of water) for at least 8 hours before your appointment. Eating or drinking too close to your surgery increases the risk of complications and may require rescheduling. Please arrange for a parent or responsible adult to drive you home and stay with you for the rest of the day.
During Surgery
The procedure usually takes 30–60 minutes, and you’ll be in the office for about 90 minutes total. If you are being sedated, we’ll place a small IV in your arm to deliver medication. Local anesthesia is also used to keep you comfortable during and after the procedure. Dissolvable stitches may be placed if needed.
After Surgery
You’ll be sleepy for much of the day. As the anesthesia wears off, you may have mild discomfort or swelling. If you are able, we recommend taking ibuprofen 600 mg (either one prescription tablet or three regular Advil®) and one regular Tylenol® at the same time for pain and inflammation relief. Start taking these medications BEFORE the local anesthetic wears off for the best effect.
For diet, start with clear liquids such as broth or gelatin, then gradually return to soft foods as tolerated. Avoid dairy products (milk, yogurt, ice cream) on the day of surgery, as they may cause nausea.
If antibiotics are prescribed and you use birth control pills, please note that antibiotics may reduce their effectiveness.
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.
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. Our 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 at Winston-Salem Phone Number 336-765-5374 to speak to one of our patient care coordinators.
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.