Wisdom Teeth Extractions
Why Should I Remove My Wisdom Teeth?
Wisdom teeth are the last teeth to erupt within the mouth, at approximately 18 years of age. Some adults get their wisdom teeth earlier or later. If they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are unable to properly erupt within the mouth.
Often times the wisdom teeth may grow sideways, or only partially emerge from the gum. It is very common that they remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.
Poorly positioned impacted teeth can cause many problems, especially if they are left untreated for many years.
Partially erupted wisdom teeth create an opening around the tooth which can allow bacteria to grow. This bacteria growth will ultimately cause infection. This result will manifest itself into swelling, stiffness, pain and illness.
The erupting wisdom teeth may cause the other teeth to shift and disrupt the occlusion, requiring orthodontic care and realignment of teeth. This orthodontic care may have been avoided by simply removing the wisdom teeth at the early stages.
The most serious problems occur when tumors or cysts form around the impacted wisdom tooth. This may result in the deterioration or destruction of the jaw bone and healthy teeth. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.
When should I remove my wisdom teeth?
The ideal time to remove wisdom teeth is in the mid-teenage years. At this age the root development is not yet complete and the wisdom teeth are more easily removed. Over time, your wisdom teeth become more firmly anchored as their roots lengthen and the jawbone becomes more dense. There is much less risk of complications during the teenage years. Teenagers as a whole tend to tolerate the procedure much better than adults. This is not only due to the fact that healing is better at this age, but also from a standpoint of recovery. It is much easier to recover from getting your wisdom teeth removed when you have a caretaker such as a parent catering to your every need. Adults, on the other hand, frequently have jobs,children and other responsibilities that do not stay on hold for very long; and thus can make recovery a bit more challenging.
Are my wisdom teeth impacted? What does that mean anyway?
In dental terminology, an "impacted" tooth refers to a tooth that has failed to emerge fully into its expected position. This failure to erupt properly might occur because there is not enough room in the person's jaw to accommodate the tooth, the tooth's eruption path is obstructed by other teeth or because the angulation of the impacted tooth is improper.
There are degrees of impaction in which we classify your teeth, so one impacted tooth is usually different from another in position or degree. If you are a teenager, your teeth are most likely to be impacted. A simple panoramic x-ray is required to determine the presence and degree of impaction. Do not be alarmed if your teeth are impacted. Many times it is easier to remove an impacted wisdom tooth than it is to remove a fully erupted wisdom tooth.
I am an adult. Should I get my wisdom teeth removed?
Possibly. First of all, if they are causing pain or have caused pain in the past, then yes, they should be removed. The reason for this is clear: you cannot live in pain, and they will not get any better on a permanent basis. If you have any of the problems listed above detected by your dentist on exam and x-ray (even if they have not bothered you yet) then yes, they should be removed. The reason for this is clear: the disease process even in the absence of pain needs to be corrected to prevent progression. If you have no evidence of disease associated with your wisdom teeth on exam and x-ray (which is rare), then your age plays a role.
If you are under 25, then with only a few exceptions yes, they should be removed. The reason for this is clear: we know that the likelihood of these teeth causing problems in the future is very high, and the risks of removing them are extremely low. Even if they have never bothered you, the chances are extremely high that they will, and it is much better to get them out at this age, than to wait even just a few years.
If you are between the ages of 25 and 35, the risk of complications starts to increase a bit and there may be a few more patients for whom it is recommended to observe only, and not surgically intervene. However for most patients the answer is still yes, they should be removed. The reason for this is clear: we know that the likelihood of these teeth causing problems in the future is very high, and the risks of removing them are still low. Even if they have never bothered you, the chances are high that they will, and it is much better to get them out at this age, than to wait until they do cause problems.
For those patients over the age of 35, prophylactic removal is generally not recommended. This means that we do not remove wisdom teeth above this age just to prevent problems that may occur in the future. The reason for this is clear: at this age complications of surgery begin to outweigh the benefits of removal. As we age, the risks and complications of surgery increase, and our ability to tolerate the surgery decreases. So if you don’t have your wisdom teeth out by the age of 35, they are merely observed unless a problem occurs. We do of course remove them if there is an associated disease process or pain.
It must be emphasized here again the EXTREME BENEFITS of wisdom teeth removal in the teenage years. The risks are low, the benefits are high, the body is healthy, the surgery is tolerated well, and THE PATIENT NO LONGER HAS TO WORRY ABOUT THEIR WISDOM TEETH EVER AGAIN. MOM AND DAD TOOK CARE OF IT WHEN YOU WERE A TEENAGER!!!
I had braces. Should I get my wisdom teeth removed?
Absolutely yes. Most orthodontists consider the removal of wisdom teeth a part of getting braces. Having had braces is in-and-of-itself enough reason to get wisdom teeth removed. In people who needed braces, there was not enough room for the other 28 teeth to come in straight, much less wisdom teeth. If the wisdom teeth are allowed to develop and begin to erupt and push, a crowding effect can and does occur. This crowding effect is exactly what all that time, effort, and money put into the braces was spent to correct!! Yes most orthodontists will refer for wisdom teeth removal in order to protect the investment of the patient: a beautiful smile! If your orthodontist did not make arrangements for removal of your wisdom teeth, don’t worry! Just call the Oklahoma Wisdom Teeth Center for an evaluation.
My dentist told me I have enough room for my wisdom teeth; should I consider getting them removed anyway?
Yes. An evaluation by a specialist is always recommended when in doubt. As a fully trained oral and maxillofacial surgeon, Dr. Hudson is available to consult with patients contemplating wisdom teeth removal.
I heard that getting wisdom teeth removed is painful. Is that true?
There is no pain in the procedure itself, because of our advances in anesthesia. At the Oklahoma Wisdom Teeth Center all wisdom teeth cases are performed under some advanced form of intravenous anesthesia (sleeping through the anesthesia) so that there is no pain during the procedure. After the surgery, the discomfort is VERY manageable with the pain medication that is prescribed.
Is the anesthesia safe?
Absolutely yes. Studies have shown that the risk of an adverse event from intravenous anesthesia in the office of an oral and maxillofacial surgeon is much lower than that of hospital operating rooms. The reason for this is the intensive training an oral surgeon receives in the administration of office-based intravenous anesthesia. Oral surgery patients are also generally healthier than those in a hospital setting. Our facility and monitoring equipment actually EXCEEDS the requirements of the state of Oklahoma. Our safety record as a specialty and as a center speaks for itself.
How long will the wisdom teeth extraction take?
It generally takes about 45-60 minutes to remove 4 wisdom teeth. The recovery, or wake-up process can take another 30-45 minutes. We generally tell patients and parents/family to expect to be in the office about 1 ½ -2 hours.
Should I get all 4 wisdom teeth removed at the same time?
In the vast majority of cases, yes. One surgery, with one recovery, and one time of missed school or work is better than two. The concept of wanting to chew on one side that has not been operated on is not valid. Removing 2 wisdom teeth on one side produces the same amount of restrictions in diet and other functions as removing all 4. Unless there is an extenuating circumstance or a financial roadblock, we highly recommend the removal of all 4 wisdom teeth at once.
Can my parent or spouse watch the surgery?
Unfortunately, no. The patient will be brought back by himself/herself, however we will have the parent or family member in the recovery room while the patient is waking up. This is the same procedure used in hospitals and it is a good one. Family is not invited in to observe the surgery for a variety of reasons. The observation of a loved one undergoing surgery of any sort is simply not a good idea.
What if I am fearful of the IV?
For those patients that have anxiety associated with the starting of an IV, there are several measures taken at the Oklahoma Wisdom Teeth Center to accommodate them. First, after a pre-operative consultation, a prescription for an anti-anxiety medication can be given so that you will be relaxed on arrival to your surgery appointment. Second, a numbing spray can usually be used before the placement of the IV. Third, our friendly and understanding staff will help you through the procedure.
How long will I be out of work or school?
Most people will need the day of surgery off and one more day after that. About half of our patients will need a third day, and the other half are ready to go back after two. There is always the occasional patient who is able to get back to school or work after just one day; and a few others will want a fourth or even a fifth day. Regardless, the vast majority of patients (90%) will only need two or three days.
When can I play athletics again?
After anesthesia it is not recommended to undergo strenuous activity for 1-2 days, and this can vary with the patient. Just let the coach know you will need two days off, and possibly three. In our experience most high school and college coaches are very understanding and patient regarding this matter. In our experience, most athletes are back in action after two days.
When can I play my musical instrument again?
It is recommended to wait 5-7 days for woodwinds, and 7-10 days for brass. Tell the band director it will be about a week. Band directors are sometimes less understanding than coaches, and it is probably because more time is required. A note regarding your time off can be provided upon request.
What does a pre-operative evaluation and consultation involve? Must I have one?
A brief oral exam is conducted, and a panoramic x-ray (one that shows your jaws and teeth in one view) is taken. Diagnosis of the presence and/or degree of impaction is made, and a discussion of your individual case is then carried out. Any questions are also answered at this time. A great benefit is that you will be able to meet Dr. Hudson in person and see the care, attention, and compassion that he gives to his patients. This often brings a great amount of anxiety relief for many of our patients. If you would like and circumstances permit, you may simply schedule for surgery and meet Dr. Hudson at that time. This is preferred by many of our patients due to busy family schedules and we accomodate this option whenever possible. The staff is highly competent and can answer most questions you may have over the phone.
At Oklahoma Wisdom Teeth Center, the focal point of our practice is the removal of wisdom teeth in a comfortable, safe, and pain-free environment..