Wisdom Teeth

CONDITION: Wisdom Teeth

Wisdom teeth removal is necessary to protect mouths from crowding, infection, and tooth damage. It’s best to have them removed between the ages of 14-21 when the bone is still soft, and recovery is quicker.

We need a pano or CBCT within 6 months in order for the doctor to review the placement of the teeth to ensure the best surgical results.

Why would you choose to get your wisdom teeth completed here vs an oral surgeon office? 

• It’s simple. We know you. We support you through all stages of your dental care.  
• We do as many cases of wisdom teeth as many of the surgeons. Our doctors are proficient in the procedure as well as the sedation process.

This embodies what our message is to patients:

In the absence of pain and/or infection, wisdom tooth removal is always elective. However, when electing to have them out while you are young, the roots are not fully formed, the bone is not as dense, which means overall, a less complicated procedure and easier recovery. This also gives your family the opportunity to schedule the extractions at a time that is convenient. Many elect to have wisdom teeth out over school breaks, or in an off season from sports- ideally a time when the young person has several days without commitments. Delaying this treatment is up to you but the likelihood of having complications with retained wisdom teeth during a person’s lifetime is high.

For adults with retained wisdom teeth (over 30) as a general rule, if they are not problematic ie: no decay, not a perio issue, no pain or infection- they do not need to be removed. The risks associated with removing fully formed wisdom teeth remain the same throughout adulthood. Therefore, should be removed only if and when there is a problem. With that said, once there is a sign of an issue, such as bleeding, increased probing depths, etc, we want to evaluate and remove. We almost always want to remove prior to ortho treatment.

Procedure Codes

In this office we will treatment plan everything as a D7240 – completely bony.  Meaning most or all the top of the tooth is covered by bone.  During surgery the doctor can make the judgment to change the code to a lesser charge, based on what is physically in the mouth. This goes back to our “worst case scenario” philosophy and reduces the instances of surprises.

Post Care for Wisdom Teeth Removal 

• Use ice packs – each patient is given 2 ice packs at the end of their appointment.
• Do not drink through a straw or anything that may complicate the healing of the surgical sites.
• Recommend a soft food diet for the next several days.  Nothing that 
• The site will swell post surgery, this is normal and will start to get better in the next 2-3 days.
• Recovery will take 2-3 days but then the patient should start to feeling like normal.  If surgery is on a Thursday, they should be able to return to school/work on Monday.  Patients should monitor themselves to make sure they are able to complete their daily activities – again the meds we offer in the office will ware off fairly quickly.
• We typically do not send patients home with a prescription for drugs, instead we recommend 650mg Tylenol and 600mg Advil. Take at the pills together, every 6 hours. This will be a super important conversation with parents as statistics show the most common time to become addicted to narcotics is when you have your wisdom teeth removed.

Office Organization around Wisdom Teeth

• All of our doctors are comfortable giving a wisdom tooth consult. A CBCT is taken and reviewed.
• The treatment planners are happy to call patients or parents and explain the procedure and answer any questions about cost of the procedure or cost of sedation element.
• Patients must have a driver the day of their surgery and we will ask the person to stay in the office throughout the process. 

Basic Principles:

• Easier to extract mandibular wisdom up to age 14-20.  Once curved root tips on mandibular wisdom teeth have developed fully, the extractions can become complicated and risk go up immensely
• When is too early?
  • Mandibular – if it can bee seen on x-ray we are probably wanting to remove it. Often around 13-15 years of age.
  • Maxillary – It’s easiest when the crown of the wisdom tooth has reached the CEJ of the 2nd molars. Often we will remove the lower teeth first and wait for the upper teeth to come down. They often never cause a problem and are extremely easy to remove later in life. So patients want to do it all at once and we can do that as well.
• Risks?
  • Main risks are numbness in the lower lip, nerve runs right under the lower teeth.  Well, only about 1-2% of patients, and 99% of these patients have feeling comes back within 6 months.  It’s rare but possible.  Even those that are a little numb, get used to it over time and function normally. They must be informed of this risk! 
  • Sinus perforation
  • Trismus and/or TMJ problems

Our Wisdom Tooth Pamphlet For Patients: