Wisdom Teeth Removal

Oral Exam and Consult

With an oral examination and x-rays of the mouth, Dr. Parmer and Dr. Macholl 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 or orthodontist.

All surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. Parmer and Dr. Macholl are  trained, licensed, and highly experienced in providing various types of anesthesia for patients.

Wisdom Tooth Removal Overview

For a brief narrated overview of the wisdom tooth removal process, please click the image below. It will launch our flash educational MiniModule in a separate window that may answer some of your questions about wisdom teeth.

Wisdom Tooth Removal Overview

Having trouble? Please make sure you have the Adobe Flash Player plugin installed in order to correctly view this presentation. This software is available as a free download.

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 roots are fully developed. In most patients, this is around 16 to 17 years old. 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:

graphic showing infected gum tissue around partially erupted wisdom tooth

Infection:

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.

graphic showing cyst formation around partially erupted wisdom tooth

Cyst Formation:

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 also be associated with impacted wisdom teeth.

graphic showing teeth crowding from an impacted wisdom tooth

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 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.

graphic showing adjacent teeth damage from an impacted wisdom tooth

Damage to Adjacent Teeth:

The tooth directly in front of the wisdom tooth, the second molar, can be damaged, resulting in erosion of the root, 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. If 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 and more painful.  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 They Are Removed?

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 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 office facilities and the doctors are inspected on a regular basis.

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 45 to 60 minutes and you will probably be in the office for 2 hours. Recent advances in medicine and technology allow patients to undergo wisdom tooth removal in a manner that 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 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 (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 heeded these guidelines. We will provide you with a prescription for pain medication at your consultation appointment, which for your convenience can be filled in advance. 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 will place an IV.  This is a quick and nearly painless procedure that ensures optimal delivery of your sedation. Local anesthesia is administered after you go to sleep to ensure your comfort. You will be sleepy for a significant portion of the day.

photo showing smiling adult female and young adult male

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, your oral surgeon will use the type that dissolves 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 prescription pain medication. You can try non-narcotic anti-inflammatory medications such as ibuprofen (Advil, Motrin®) first if you are not allergic, 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. We recommend starting your post-operative diet with clear liquids such as Jello and broths, gradually increasing in substance as your body permits.

What Does The Procedure 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 used. During your consultation appointment, the surgeon 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. The oral surgeon’s 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 the doctor’s office at Keller Office Phone Number 817-741-2200 to speak to one of the patient care coordinators.

photo of relaxed smiling young woman

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.