Wisdom Teeth Extractions

Visiting your dentist twice a year for regular checkups will help your dentist follow the progress of your teeth. If they see something that concerns them about your wisdom teeth, they’ll examine your teeth further, take X-rays, and together you can discuss treatment. Wisdom teeth are typically extracted (removed) there’s evidence of:

  • Risk of infection
  • Cysts or tumors
  • Risk of impacted teeth
  • Healthy teeth adjacent to wisdom teeth could be damaged

Removing wisdom teeth helps reduce the risk of future problems, leaving your mouth healthier in the long run.

Wisdom Teeth FAQs

Impacted Wisdom Tooth Third molars are commonly referred to as wisdom teeth. They are usually the last teeth to develop and are located in the back of your mouth, behind your second molars. Their development is usually completed between the middle teenage years and early twenties, a time traditionally associated with the onset of maturity and the attainment of wisdom.

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 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:

InfectionInfection

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

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.

Wisdom Tooth Causing Crowding

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 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.

Wisdom Tooth Causing Crowding

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.

No, not all wisdom teeth should be removed. Healthy wisdom teeth that fit in the mouth are usually not extracted. Wisdom teeth that have not erupted and are in a good position can also be left in the mouth. However, wisdom teeth should be removed if they cause repeated symptoms or show signs of disease on examination, or if removal is required by some other dental or general condition. 

The best age to remove wisdom teeth is usually between 12-18 years of age.  The timing will depend on root development.  During this age range, the root is shorter and less developed, making the recovery time faster and more predictable.

As wisdom teeth develop, the roots become longer and the jaw bone denser. Removing impacted wisdom teeth in your thirties, forties or beyond, the post-operative course can be prolonged and have 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.

tooth acheWe recommend having your wisdom teeth removed before symptoms are present.  After examining your x-ray our doctor will determine if wisdom teeth extractions are necessary.

However possible symptoms of impacted or erupting wisdom teeth  that have been neglected include:

  • Ear Ache
  • Pain & Swelling Around the Wisdom Tooth
  • Ulcers & Pain on the Cheek
  • Pus from Swollen Gums
  • Swollen Glands
  • Pain & Difficulty Opening Mouth
  • Bad Breath & Taste

Intravenous Sedation (“Twilight Sedation”)

Our office offers our patients the option of Intravenous Sedation also referred to as “Twilight Sedation” for their dental treatment. Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed under intravenous sedation. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”.

If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by the doctor, therefore, eliminating the costly expense of having your treatment carried out in an operating room or same day surgical facility.

Nitrous Oxide (Laughing Gas)

Nitrous Oxide is a sweet smelling, non-irritating, colorless gas which you can breathe. It has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe; the patient receives 50-70% oxygen with no less than 30% nitrous oxide. Patients are able to breathe on their own and remain in control of all bodily functions.

There are many advantages to using Nitrous Oxide

  • The depth of sedation can be altered at any time to increase or decrease sedation.
  • There is no after effect such as a “hangover”.
  • Inhalation sedation is safe with no side effects on your heart and lungs, etc.
  • Inhalation sedation is very effective in minimizing gagging.
  • It works rapidly as it reaches the brain within 20 seconds. In as few as 2-3 minutes its relaxation and pain killing properties develop.

The use of sedation and anesthesia in dentistry has a commendable record of safety. This is due to the advanced training Doctor Shahzad has and his commitment to your overall health. It is important to advise Dr. Shahzad of all medications that you take as well as any changes in your health since your last visit.

Anesthesia

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, 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.

Before Your Surgery

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. 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.

On the day 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 6 hours prior (preferably longer). This does not mean you should try to fit in one “last meal” exactly six hours before your surgery. 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 followed these guidelines. We may provide you with a prescription for pain medication at your consultation appointment, which for your convenience, can be filled in advance.

During Surgery

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 arm. 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.

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.

After Surgery

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.

Once the local anesthesia wears off, you may require prescription pain medication. Please try non-narcotic anti-inflammatory medications such as ibuprofen (Advil®) first, to see if that adequately treats your pain. If not, begin your other prescription pain medication. 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 clear liquids such as jello and broths.  Then you can gradually increase in substance as your body permits.

We do not recommend using dairy products such as yogurt, ice cream or milkshakes on the day of surgery, as nausea and vomiting may develop in conjunction with the anesthetic and pain medication. 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.

Most procedures take up to an hour and half, and you should expect two to three days of discomfort and swelling. Your post-operative healing time will vary, usually ranging from a couple of days to a week.

On the first day after wisdom teeth removal surgery, you may experience some minor bleeding and pain. You should cover your pillowcase with something so that you don’t get any blood on it. Each individual’s reaction to surgery varies. The sensation of pain can range from mild discomfort to severe pain. A variable amount of swelling can be expected following the surgery. This swelling usually peaks on the second day and should begin resolving on the third day. You can limit the amount of swelling by using ice for the entire first day. The more ice you use the first day, the less swelling you are likely to have on the second day. Please remember to put ice on the first day even if the cold is somewhat uncomfortable to your skin.

On the third day, you will notice that your jaw muscles are stiff, and it is difficult to open your mouth normally. You can apply moist heat to your face on the second and third day to allow your muscles to relax more and open wider. Most of the time you will want to limit your activities for a few days. We ask that you follow your post-operative instructions closely. Doing so will make you as comfortable as possible during the first few days following your procedure. Please allow time for your body to begin healing before resuming an active social, academic, or athletic schedule. Most patients feel like they are over the hump and on their way to recovery in 3 to 5 days.

Depends. Unless the patient develops post-operative complications, most people can return to work (sedentary jobs) or school within 2-3 days of the extraction.