Wisdom Teeth Removal
Initial Consultation And Oral Examination
With an oral examination and x-rays of the mouth, Dr. Schwartz 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 general dentist, orthodontist, or by an oral and maxillofacial surgeon.
All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. Schwartz 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 third molars to fully erupt, a number of problems can happen. Impacted wisdom teeth should be removed before their root structure is fully developed. In some patients it is as early as 12 or 13, and in others it may not be until the early twenties. 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:
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 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 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 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.
Damage to Adjacent Teeth:
If there is inadequate room to clean around the 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 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 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, more predictably and have fewer complications if treated in your teens 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 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. Dr. Schwartz and his surgical staff have 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, as well as an experienced and well trained surgical staff. Our surgical staff members, our office facilities, and Dr. Schwartz are inspected and registered on behalf of the Board of Dental Examiners on a regular basis.
On the day of your procedure we ask that a parent or responsible adult accompany you to the office. Your responsible party must stay in our reception area at all times while you are in the office surgical suite, for this reason we ask that all errands, child care, shopping or filling prescriptions be taken care of before you and your responsible party arrive at our office for surgery. Due to the lingering effects of some anesthesia and oral pain medications we also would like you to have a responsible party plan to stay with you the rest of the day. The procedure will take about 30 to 45 minutes and you will probably be in the office for 60 minutes. Recent advances in medicine and technology allow patients to undergo wisdom tooth removal in a manner, which 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). Your surgical procedure will be rescheduled if these guidelines are not followed, for your own safety. If you find that you develop a cold, nasal congestion or allergies that affect nasal airways, please contact our office as soon as possible before your surgery. We do understand that illness can happen at inconvenient times and Dr. Schwartz will decide to proceed with the surgery, in the event of illness, on a case to case basis. Please don’t hesitate to call our office with any concerns before and after your surgery.
Once you are seated in the surgical room, we will make every effort to make you as comfortable as possible. Dr. Schwartz may determined at your initial consultation appointment that you would benefit from additional oral sedation and may provide you with medication to take prior to your surgery. Please take this medication as directed if prescribed by Dr. Schwartz. Depending on your needs, Dr. Schwartz may first have you breathe a mixture of oxygen and nitrous oxide (laughing gas) to make you start to feel comfortable. If you are having IV Sedation, Dr. Schwartz will administer an IV in your arm and begin to administer the sedation. He uses a technique that makes the IV placement virtually painless for most patients. This is a quick and nearly painless procedure that ensures optimal delivery of your medication. Local anesthesia will be administered in the area of extractions to ensure your comfort and pain free removal of the wisdom teeth.
After the procedure is completed you will be monitored by Dr. Schwartz and his trained staff members to ensure that you meet all criteria to be discharged from the office. Before you are discharged, your responsible party will be brought back to the surgical suite and all post-operative instructions will be given to them by Dr. Schwartz and the surgical staff.
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, these are usually the type that dissolve in 3 to 5 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. Dr. Schwartz and his surgical staff will go over all instructions regarding the pain medication after your surgery. We have also provided our post-operative instructions here on our website under “surgical instructions”, if you would like to familiarize yourself with them before your surgery date. The local anesthesia may last until the following day, and should not be confused with an injury to your nerve. We recommend starting your post-operative 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 Tooth 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, placement of the teeth and which type of anesthesia is best for you. During your consultation appointment, Dr. Schwartz will review your x-rays, complete an oral examination, determine the best option for anesthesia, discuss all option with you. Our staff will then be able to provide you with an estimate. Every insurance company has a different policy regarding the extent of coverage for a given surgical procedure. Our office staff will help you obtain maximum insurance coverage for your treatment. Please keep in mind that we can only provide an estimate of your insurance and out-of-pockets expenses, and only if we have received all the correct information from you regarding your insurance coverage. All costs not not covered by your insurance will be your responsibility.
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 use that opportunity to ask any questions you may have. If new questions arise after your consultation, please call our office at Daniel M. Schwartz DMD MD LLC Phone Number 216-464-1200 to speak to one of our staff members.
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.