Wisdom (third molar) 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, Drs. Yamada and Zeidan can evaluate the position of the wisdom teeth (third molar teeth) and predict if there are present or future potential problems from them. 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. Drs. Yamada and Zeidan 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 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:
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. Additionally, the jaw bone will begin to fuse to the root of the tooth progressively with age. Therefore, 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 is advisable to have a consultation so that an appropriate risk/benefit analysis can be performed. 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 have general anesthesia. 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 Drs. Yamada and Zeidan are inspected on behalf of the Board of Dental Examiners on a regular basis.
On the day of your procedure, you will be given medications through your I.V. to help minimize post-operative pain and swelling and you will be instructed to take oral medications at home to maintain this during your recovery. 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 typically take about 30 to 60 minutes and you will probably be in the office for about 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 morning 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 (longer if possible) if you are having general anesthesia. This does not mean you should try to fit in one “last meal” exactly eight hours before your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications, including nausea, vomiting and aspiration. Your procedure will be rescheduled if you have not heeded these guidelines. We may provide you with a prescription for a post-operative pain medication at your consultation appointment, which for your convenience, can be filled in advance. When you are brought to the surgical suite, we will make every effort to make you as comfortable as possible. If you are going to have general anesthesia, we usually will place an IV in your right arm. This is a quick and nearly painless procedure that ensures optimal delivery of your medications. Local anesthesia is given to you after you are asleep to keep you comfortable for about 4-6 hours after you leave the office. You may be sleepy for a portion of that 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 sutures, these are usually the type that dissolve in 5 to 9 days and do not require removal. Afterwards, we anticipate swelling of the cheeks and gums, stiffness of the jaws and discomfort at the extraction sites.. These are 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. You will a given a post-operative pain management guide that discusses the options and use of over-the-counter (OTC) vs prescription pain medications (opioids). The local anesthesia occasionally may last until the following day, and should not be confused with an injury to your nerve.
You will be given detailed written instructions to follow for your home care as well as dietary recommendations. When all the instructions are followed, your recovery will be optimized. If you are given antibiotics and you take birth control pills, please be aware that the birth control pills might become ineffective and you should 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 difficulty involved in removing your teeth and which type of anesthesia is best for you. During your consultation appointment, Drs. Yamada and Zeidan 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 La Jolla Office Phone Number 858-452-8606 to speak to one of our staff members.
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.