Image focus on doctor with patient opening mouth for wisdom tooth removal in the background.

Wisdom Teeth Removal

Wisdom teeth, also called third molars, are the last set of molars to develop in the mouth. Wisdom teeth are often partially or fully impacted, meaning they remain trapped beneath the gum or bone and are unable to erupt properly. Such malpositioning may also cause pain, swelling, bone loss and damage to adjacent teeth, among other concerns.

Problematic wisdom teeth are a common oral problem for many teens and young adults. Wisdom teeth typically begin the eruption phase in the mid-teen to early adult years. This is the most ideal time to perform wisdom teeth extractions, as patients in this age group tend to experience faster healing and recovery.

Impacted Wisdom Teeth

When there’s insufficient space for teeth to emerge in the jaw, it indicates their inability to erupt into the correct position for chewing and cleaning. These teeth are termed impacted.

There are three types of impactions, these include:

  • Soft Tissue Impaction: When there isn’t adequate room for the gum tissue to retract, hindering proper cleaning of the tooth. Teeth that are soft tissue impacted have not erupted and are covered by gum tissue.
  • Partial Bony Impaction: When there’s sufficient space for the wisdom tooth to partly emerge. However, it cannot function effectively in chewing and poses challenges for cleaning. Teeth that are partial bony impacted can either be partially erupted or completely unerupted and not visible in the mouth.
  • Complete Bony Impaction: When there is no space for the tooth to emerge. The tooth remains lodged in the jawbone, requiring intricate surgical methods for extraction. The impacted tooth might also be positioned abnormally, complicating the removal process. Such situations can arise due to the jawbone’s shape or size, along with other facial structures, making the extraction notably more complex.

A panoramic x-ray of the mouth and jaws is taken to determine if wisdom teeth are impacted, if there’s adequate space for them to emerge, and the level of difficulty anticipated for their removal.

Dr. Mario Capuano

Dr. Mario Capuano

Oral & Maxillofacial Surgeon

“We specialize in wisdom teeth removal, it’s a very common procedure that we perform. Using the latest surgical techniques to ensure a smooth and comfortable experience, our focus is on providing exceptional care, leading to faster recovery for our patients.”

Wisdom Teeth Extraction Process

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.

At Leading Edge Oral Surgery, the extraction process begins with a consultation. With an oral examination and x-rays of the mouth, our experienced oral and maxillofacial surgeons can evaluate the position of the wisdom teeth and predict if there are any issues or future potential problems.

If extraction is necessary, 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.

Which type of anesthesia you get depends on how hard removing the wisdom teeth is expected to be and your comfort level.

When removing your wisdom tooth, your dentist or oral surgeon:

  • Makes an incision in the gum tissue to expose the tooth and bone.
  • Removes bone that blocks access to the tooth root.
  • Divides the tooth into sections if it’s easier to remove in pieces.
  • Removes the tooth.
  • Cleans the site of the removed tooth of any debris from the tooth or bone.
  • Stitches the wound closed to make it heal better, though this isn’t always needed.
  • Places gauze over the site where the wisdom tooth was removed to control bleeding and help a blood clot form.

You will be provided with appropriate anesthesia options at your consultation. All 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 procedure will take about 30 to 60 minutes and you will probably be in the office for 90 minutes. On the morning or afternoon 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 to surgery (preferably longer). 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 heeded 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 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.

Healing from Wisdom Teeth Extractions

After surgery, your surgeon will place gauze over the site of the extraction and ask you to keep pressure on it by biting your jaws together for up to an hour. This is to allow a blood clot to form in the empty tooth socket. In some cases, antibiotics may be prescribed if you have an ongoing infection.

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. Once the local anesthesia wears off, you may require pain medication. Please try non-narcotic anti-inflammatory medications such as ibuprofen (Advil®). 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, gradually increasing in substance as your body permits.

For the 24 hours after removing your wisdom tooth, you should avoid:

  • Rinsing your mouth out with liquid
  • Drinking alcohol and smoking
  • Drinking hot liquids such as tea or soup
  • Strenuous physical activity

When Are Wisdom Teeth Extractions Necessary?

Our surgeons recommend a clinical and radiographic examination of wisdom teeth in the early teen years, to evaluate positioning and determine if wisdom teeth extractions may be necessary. The mouth can comfortably hold 28 teeth, and by the time the wisdom teeth start to grow, those 28 slots are already filled, making it difficult for an additional 4 wisdom teeth to fit properly. As a result, 9 out of 10 people have at least one impacted wisdom tooth that requires extraction. Even if the wisdom teeth come in properly positioned, they could quite easily become infected, and would be at risk for cysts and tumors.

Many signs and symptoms may indicate the need for wisdom teeth extractions. These include:

  • Jaw pain or discomfort
  • Evidence of bone loss
  • Gum or facial swelling
  • Impacted teeth
  • Inflammation or redness
  • Difficulty opening
  • Cysts
  • Tumors Malpositioning
  • Insufficient space

Risks of Leaving Wisdom Teeth in the Mouth

Waiting to remove wisdom teeth can lead to many more procedures in the future, increasing the likelihood of problems and complications should they need to be removed down the road.

Leaving impacted or otherwise unproblematic wisdom teeth in the mouth increases the risk of experiencing several health concerns:

  • Pain and discomfort
  • Tooth decay
  • Gum disease
  • Bone loss
  • Crowding
  • Damage to neighboring teeth
  • Nerve damage
  • TMJ problems

As wisdom teeth develop, the roots become longer and the jaw bone becomes 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.

Why Choose Leading Edge Oral Surgery for Your Wisdom Teeth Removal?

Oral surgeons are highly trained in wisdom teeth removal, and experts in performing complex surgical procedures. At Leading Edge Oral Surgery, our oral and maxillofacial surgeons are dedicated to providing the highest standard of extraction care for patients of all ages. From our modern, well-appointed practice facilities, we offer IV sedation and other relaxing dental anesthesia options to provide comfortable, stress-free wisdom teeth extractions for you and your family.

Healthy teeth and wisdom tooth with mesial impaction . Medically accurate tooth 3D illustration.

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