Wisdom Teeth Removal
Oral Examination for Extraction of Wisdom Teeth
With an oral examination and x-rays of the mouth, Dr. Gulati 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, orthodontist, or oral and maxillofacial surgeon.
All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. Gulati is 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 wisdom teeth to fully erupt, a number of problems can happen. Impacted wisdom teeth should be removed before their root structure is fully developed. For some patients this is as early as 12 or 13, but for others it may not be until their early 20s. Problems tend to occur more frequently 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. These cysts 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. Also, 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 ones, 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, such as retained, impacted wisdom teeth. 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 a 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. When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the removal may be more difficult or have a higher complication rate, and the postoperative course may be prolonged. 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 and more predictably and have fewer complications if treated in your teenage years 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 they usually decide to be sedated. 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 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, office facility, and doctor are inspected on behalf of the Board of Dental Examiners on a regular basis.
On the day of your procedure, you will take medications to help minimize postoperative pain and swelling. 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 30–60 minutes, and you will probably be in the office for 90 minutes. Recent advances in medicine and technology allow patients to undergo wisdom teeth removal in a manner that promotes rapid healing and minimal postoperative 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) prior to the surgery. 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 followed these guidelines. For your convenience, we may provide you with a prescription for pain medication at your consultation appointment to fill 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 usually will place an IV in the back of your right hand. This is a quick and nearly painless procedure that ensures optimal delivery of your medication. Local anesthesia is given to you while you are sedated to ensure comfort and allow adequate time to travel home and rest. You will be sleepy for a significant portion of the 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 the wisdom tooth removal.
If your surgery requires stitches, these are usually the type that dissolve in two weeks 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 after a few days.
Once the local anesthesia wears off, you may require prescription pain medication. Please start your prescribed medication before your local anesthesia wears off. This will ease the discomfort. In most cases, you can supplement the prescribed medication by using a non-narcotic, anti-inflammatory medication, such as ibuprofen (Motrin or Advil). Prior to supplementing your prescribed medication, please contact the office so we can direct you appropriately. The local anesthesia may last for up to 6–8 hours and should not be confused with an injury to your nerve. We recommend starting your postoperative diet with clear liquids such as jello and broths, gradually increasing in substance as your body permits.
If you are given antibiotics and you take birth control pills, please be aware that the birth control pills might become ineffective and take appropriate precautions.
What does wisdom teeth 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, 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 and individual plan 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 our office at Novi Office Phone Number 248-348-2115 to speak to one of our patient care coordinators.
The Day of Treatment
Please do not eat or drink anything for six hours prior to your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications.