Wisdom Teeth Removal

Oral Examination

Office-stuff-001With an oral examination and x-rays of the mouth, the surgeons of Fountain View Oral Facial and Implant Surgery 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 by an oral and maxillofacial surgeon.

smiling 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.

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

Why Should I Have My Wisdom Teeth Removed?

It is common not to have adequate space in your mouth for wisdom teeth to fully erupt into a healthy and functional position. Common problems resulting from this include dental crowding of adjacent teeth and infection. Impacted wisdom teeth are ideally removed before their root structure is fully developed. This age varies considerably from the early teens to the early twenties. Problems related to the wisdom teeth tend to occur with increasing frequency after the age of 30. Some problems associated with retained, impacted wisdom teeth include:

A representation of a pericoronitis infection on a 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.

An example of a cyst formation on a wisdom tooth

Cyst Formation:

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.

An illustration of teeth crowding causes by a 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.

A visual of a wisdom tooth damaging an adjacent tooth

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 patients have wisdom tooth removal performed under deep intravenous sedation or general anaesthesia. All out-patient surgery is performed under appropriate anaesthesia to maximize your comfort. The medical, surgical and nursing staff at Fountain View Oral Facial and Implant Surgery have advanced training, certification and experience to provide all forms of anaesthesia. These services are provided in an environment of optimum safety utilizing modern monitoring equipment and surgical and anaesthesia equipment. The surgical care team, the office facilities and the doctors are inspected regularly by the Royal College of Dental Surgeons of Ontario. Our facility is fully certified and licensed to provide these treatments.

On the day of your procedure you will be given medication to help minimize postoperative pain and swelling. A parent or responsible adult must accompany the patient to the office and plan to stay with the patient the rest of the day. The office visit is typically two hours or so, with the surgery lasting about 40 minutes. Recovery time is about 30 minutes. Ongoing advances in medicine and technology allow patients to undergo wisdom tooth 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 for eight hours prior to surgery; this includes water. If you take medications, your surgeon will advise you regarding their use on the day of surgery.

It is important that you come with an empty stomach as directed. Having food or fluid in your stomach can increase the risk for serious anaesthetic complications, including nausea or vomiting. Your procedure will be rescheduled if you have not heeded these guidelines.

When you are seated in the surgical suite, you will meet your surgical team, including your surgeon. Treatment will be confirmed and you will be asked to sign a surgical consent form. We will make every effort to make you as comfortable as possible. With sedation or general anaesthesia, an intravenous will be placed in your arm. Medical monitors like electrocardiogram and blood pressure cuff will also be placed. Local anaesthesia is given after you are asleep to ensure comfort postoperatively. You will be sleepy for a significant portion of the remaining day and should plan to rest at home.

smiling teenage son with his mother

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 next 24 hours after surgery, following wisdom tooth removal.

If your surgery requires sutures, these are usually dissolvable and fall out in three to seven days. Some suture materials last up to two weeks or longer. You may also notice a sensation of your gums feeling swollen. This is all part of the normal recovery and will subside in several days.

You may require medication to control postoperative discomfort. These could include non-narcotic anti-inflammatory drugs like Ibuprofen or Advil or Tylenol. Your surgeon may well also prescribe more potent pain medication, which contains a narcotic.

Local anaesthetic in the lower jaw can last several hours postoperatively.

You should start your postoperative diet with clear liquids such as jello and broths. This can gradually be increased in substance as your body and chewing comfort permits. It is not recommended that you use dairy products such as yogurt, ice cream or milkshakes on the day of surgery as nausea and vomiting may develop in conjunction with the anaesthetic and pain medication.

If you are given antibiotics and you take birth control pills, please be aware that the birth control pills may become ineffective during that current cycle.

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 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 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 Fountain View Oral, Facial & Implant Surgery Centre Phone Number 905-275-0058 to speak to one of our patient care coordinators.