Wisdom Teeth Removal
Oral Examination for Extraction of Wisdom Teeth
Wisdom Teeth Presentation
To provide you with a better understanding of wisdom teeth, we have provided the following multimedia presentation. Many common questions pertaining to wisdom teeth are discussed.
With an oral examination and x-rays of the mouth, Dr. Ying 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. Dr. Ying is trained, licensed, and highly experienced in providing various types of anesthesia for our 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 fully developed to minimize the risk of nerve injury. 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:
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.
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.
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?
You will be provided with the various anesthesia options at your consultation for you to decide which anesthetic option will provide the greatest comfort for you during the procedure. Our 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 and experienced staff. The Surgical Care Team, the office facilities, and the doctor are inspected and certified by the California Dental Board.
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 procedures on average will take about 45 to 60 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.
Prior to your surgical appointment, it is essential that you have nothing to eat or drink (excluding prescription medications with a sip of water) for at least 6 hours (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 during anesthesia, which may result in aspiration and possible death. Your procedure will be rescheduled if you have not followed these guidelines. 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 arm. This will allow the delivery of your medication to sedate you. Local anesthesia is given after you are sedated in order to ensure your comfort after the procedure 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.
If your surgery requires stitches, these are usually the type that dissolve in 5 to 7 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.
The local anesthesia may last for several hours. Once the local anesthesia wears off, you will have achiness and throbbing. Please try non-narcotic anti-inflammatory medications such as ibuprofen (Advil®or Motrin) first, to see if that adequately treats your pain. If not, you may also take acetaminophen (Tylenol) in conjunction with the ibuprofen. We recommend starting your post-operative diet with clear liquids such as jello and broths, gradually increasing 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. 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 type of impaction of your teeth and which type of anesthesia is best for you. During your consultation appointment, Dr. Ying will 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 administrative staff will review the fees and your insurance coverage for the 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 additional questions arise after your consultation, please call our office at Manhattan Beach Oral and Maxillofacial Surgery Phone Number 310-372-7575 to speak to one of our patient care coordinators.
The Day of Treatment
Please do not eat or drink anything at least 6 hours prior to your surgery if you are having sedation. Having anything in your stomach can increase the risk for serious anesthetic complications.