Wisdom Teeth Removal
Oral Examination for assessment of the Wisdom Teeth
With an oral examination involving clinical and radiographic assessment, Dr. Özcan will evaluate the position of the wisdom teeth and diagnose any present concerns, as well as determine whether problems are likely to develop in future. Studies have revealed 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 by an Oral and Maxillofacial Surgeon.
All outpatient surgery is performed under effective anesthesia to maximize patient comfort. Dr. Özcan is trained, licensed, and highly experienced in providing various types of anesthesia for patients.
Why should wisdom teeth BE removed
If there is insufficient space for the third molars (wisdom teeth) to fully erupt, they are diagnosed as being impacted. Impacted wisdom teeth should ideally be removed before their roots are fully developed. As wisdom tooth development timelines vary widely, extractions may be indicated for some patients as early as 12 or 13 years of age, while for others, the latter teenage years may be the optimal time for removal of such teeth. If impacted teeth are not removed, problems tend to occur with increasing frequency beyond the age of 30. Some of the complications that may arise if problematic wisdom teeth are not removed include:
The most frequent clinical problem that develops is pericoronitis (a localized infection of the gum tissue). Without enough room for a wisdom tooth to fully erupt, it is very challenging to maintain proper oral hygiene. The gum tissue surrounding the wisdom tooth is therefore susceptible to becoming irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.
Non-infectious conditions may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” that may develop within the jaw bone due to the presence of an impacted tooth. Over time, a cyst may slowly expand, possibly causing destruction of the adjacent jaw bone and occasionally adjacent teeth. Although rare, tumors can be associated with the delayed removal of wisdom teeth. The development of pathology in association with impacted wisdom teeth, makes treatment of both conditions much more complex than removing wisdom teeth would be in one’s teenage years, before such problems have an opportunity to arise.
The presence of impacted wisdom teeth may contribute to eventual crowding of one’s other teeth. This is most noticeable with the front teeth, particularly the lower front teeth, and may occur whether or not a patient has had orthodontics (braces). Although noticeable problems may not be experienced with one’s wisdom teeth initially, removal will often prevent adverse consequences from developing with them in the future and/or from negatively affecting the other teeth, gum tissue and supporting jaw bones long-term.
Damage to Adjacent Teeth
If there is inadequate room to properly clean around the wisdom tooth, the second molar (the tooth directly in front of the wisdom tooth), may also be adversely affected by the gum disease, bone loss around the tooth, and/or decay that may develop when proper oral hygiene cannot be maintained.
What can be expected if the removal of problematic wisdom teeth is delayed?
As wisdom teeth develop, their roots become longer as they fully form. As a person becomes older, the jaw bone also becomes more dense (harder). Should it be necessary to remove impacted wisdom teeth in one’s thirties, forties or beyond, there is therefore a greater complication rate and the post-operative course may be prolonged. Treating complications is often more difficult and less predictable when wisdom teeth require removal in older patients, as the body’s ability to heal declines with age as well as requires more time to heal, while the possibility of infection developing increases for the same reasons. If the wisdom teeth are completely impacted within bone and not removed in one’s teenage years or early twenties, Dr. Özcan may advise leaving them in place unless a localized problem develops (such as cyst formation, localized gum disease and/or bone loss). In general, one will heal faster, more predictably and have fewer complications if problematic wisdom teeth are removed in one’s teenage years or early twenties.
What can be expected on the day wisdom teeth are removed?
In order to have the most comfortable experience when wisdom teeth are removed, intravenous sedation is generally recommended. There are various anesthesia options that will be presented at the consultation appointment, however, so that each patient can make the informed decision that is best for their individual circumstances. All outpatient surgery is performed under effective anesthesia to maximize one’s comfort. Treatment is provided by our well trained, licensed and experienced staff, utilizing state-of-the-art monitoring equipment in our annually inspected facilities, and in an environment where optimum safety is of utmost importance.
On the day of your procedure, you will take the medications that have been prescribed for you to help minimize post-operative pain and swelling. We ask that a parent or responsible adult accompanies you to and from the office and is also able to stay with you for the rest of the day. You can expect to be in the office for 90 minutes, with the procedure itself anticipated to take approximately 30 to 60 minutes. State-of-the-art sterilization and infection control techniques are utilized at all times, as are the latest advances in medicine and technology to enable wisdom tooth removal to be as comfortable as is possible.
On the morning or afternoon of your surgery, it is essential that you have had nothing to eat or drink (excluding prescription medications that are taken with only a sip of water) for at least 8 hours prior to your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications, including nausea and vomiting. For your well-being, your procedure will be rescheduled if you have not heeded these guidelines. We may have provided you with a prescription for pain medication at your consultation appointment, which, for your convenience, may 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 have chosen to have intravenous sedation, this will usually be administered in your left arm. This is a quick and nearly painless procedure that ensures optimal delivery of the medication that will be administered for your surgery. Local anesthesia is then given to ensure comfort at the surgical site(s). The local anesthesia will also help you remain comfortable while you are accompanied home to rest. Following your surgery, you will be sleepy for a significant portion of the day.
The Day of Treatment
Be sure to have a parent or another responsible adult accompany you to and from your surgical appointment as well as stay with you for the rest of the day following wisdom tooth removal.
Your surgery will likely require the placement of sutures (stitches). The type of sutures usually placed are those that dissolve in 7 to 10 days and therefore do not require removal. If another type of suture is indicated for your procedure, you will be scheduled for approximately one week following your surgery so that these sutures can be removed by Dr. Özcan. Regardless of the suture material placed, you may experience the sensation of your gums feeling swollen and “pulling away” from your teeth. These sensations are to be expected in the normal recovery process, and will subside in several days.
Before the local anesthesia (freezing) wears off, we recommend you begin taking pain medication to alleviate the anticipated discomfort. The non-narcotic anti-inflammatory medications such as Ibuprofen (Advil® or Motrin®) should be taken first. If Ibuprofen in the recommended dosage does not adequately treat your pain, one can take Tylenol® or Extra Strength Tylenol® as recommended at the next time interval. Should neither the Ibuprofen nor Tylenol® formulations be effective enough for your pain management, at the subsequent time interval you may begin taking the prescription pain medication as Dr. Özcan has directed. The effects of the local anesthesia may be experienced until the following day, and should not be confused with an injury to your nerve.
We recommend you begin your post-operative diet with clear liquids such as broths and jello, gradually introducing soft foods as your body permits. In subsequent days, comfort will dictate when you are able to introduce a broader variety of foods to your diet.
We do not recommend including dairy products such as yogurt, ice cream or milkshakes on the day of surgery, as nausea and vomiting may develop in conjunction with the anesthetic and pain medication.
If you are given a prescription for antibiotics and you take birth control pills, please be aware that the antibiotics may interfere with the effectiveness of birth control pills, and therefore take appropriate alternate precautions.
What does wisdom tooth removal cost and is it covered by insurance?
The fee for your treatment is determined by a number of parameters. These include the difficulty involved in removing your teeth as well as the type of anesthesia indicated for your individual circumstances. During your consultation appointment, Dr. Özcan will review your health/medical history, complete an oral examination and assess your x-rays, and will also recommend the best option for your anesthesia. Consideration of all of these factors will permit an accurate estimate to be provided. Although every insurance company has a different policy regarding the extent of coverage for a given surgical procedure, Dr. Özcan’s staff will help you obtain the maximum insurance coverage pertaining to your treatment.
What if I have questions before surgery?
At the time of your consultation, your specific circumstances will be discussed in greater detail. We encourage you to ask any questions you may have. If additional questions arise following your consultation, please feel free to contact our office at Prince George Phone Number (250) 614-1828.
The Day of
Please do not eat or drink anything prior to your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications.