Wisdom Teeth Removal

The removal of wisdom teeth is a highly common procedure. Early wisdom tooth removal (late teens- early 20’s) has proven to be easier with a more rapid and comfortable recovery.

Wisdom teeth are one of the most common problems handled at Dolman Oral Surgery. Choosing a board certified oral surgeon is a crucial factor in the care and outcome that you receive.

Wisdom teeth are one of the most common problems handled at Dolman Oral Surgery.

Wisdom Teeth 101

Usually, an adult will develop four wisdom teeth, one in each quadrant (corner) of the jaw. The first adult molar generally erupts (surfaces in the mouth) at or around the age of 6 years old and is often referred to as a “6 year molar”.

At or around the age of 12, the second molar will erupt directly behind the first molar and may be referred to as a “12 year molar”.

The expectation is for the 3rd molar to erupt directly behind the second molar around the age of 18 (17-25) or the time when an individual should be gaining wisdom, hence the term “wisdom tooth”.

Problems With Impacted Wisdom Teeth

When a wisdom tooth is unable to erupt or push through into the mouth, it is referred to as an impacted wisdom tooth. Impacted wisdom teeth may be fully embedded in the jawbone or may be partially exposed into the mouth.

Impacted wisdom teeth usually result from an inadequate amount of space in the jawbone and/or a misalignment of the tooth itself, meaning the wisdom tooth is tilted, angled or crooked.

These impacted wisdom teeth and their surrounding soft tissue may become inflamed, painful, infected, and/or decayed. Additionally, they may compromise the periodontal (gum) health of the adjacent second molar and/or contribute to decay in the second molar as well. Rarely, the tissue around wisdom teeth may develop into localized cysts which in turn may compromise the strength and integrity of the jawbone if not treated.

When To Remove Wisdom Teeth

At Dolman Oral Surgery, Dr. Robert M. Dolman is able to comprehensively evaluate the condition of your wisdom teeth and if wisdom tooth removal is needed, Dr. Dolman will completely customize your treatment.

In general, the need to remove wisdom teeth can be determined by the following categorizations:

1. Complaint group: Patients who present with a complaint of pain and/or swelling, or have bad breath (halitosis). Typically the patient will have a decayed wisdom tooth and/or infected soft tissue (pericoronitis) surrounding the wisdom tooth. They often have difficulty opening their mouth and their face and or neck may be swollen. The pain may increase when biting as well. In more advanced scenarios fever may be present along with difficulty swallowing.

2. Silent problem group: This group includes patients who have a situation that they are not aware of such as decay (cavities/caries) or periodontal disease (gum disease) that are silent or dormant. Possibly, although rarely, they may have a localized cyst or tumor. These patients are typically identified on a routine examination.

3. Preventative group: This group of patients is the classic group of 16- 25 year olds in whom impacted wisdom teeth during routine radiographic work up and specific exams. Often, but not always, they will have undergone orthodontic treatment. The removal of wisdom teeth is generally beneficial to prevent the onset of pain, infection, periodontal disease (periodontitis) and caries (decay, cavities). Surgical removal of impacted wisdom teeth in this group is often the easiest with the quickest recovery and least amount of risk.

Wisdom Teeth Evaluation and Removal

At Dolman Oral Surgery, Dr. Robert M. Dolman will thoroughly evaluate the condition of your wisdom teeth and determine the need for their removal. Dolman Oral Surgery is equipped with state of the art equipment including a panoramic unit and a CT scan (I-Cat unit) for selected cases where required.

As is the case with each patient, Dr. Dolman will listen carefully to your complaints, questions and concerns, examine you fully, and customize your treatment plan. He will determine if in fact your wisdom teeth need to be removed or if retention of the teeth is more appropriate.

Typical Wisdom Tooth Treatment

At the initial visit, Dr. Dolman will carefully listen to your concerns. He will compile a complete medical and dental history followed by a thorough physical oral and head and neck examination inclusive of the TMJ. This will be followed by detailed radiographic evaluation which is comprised of a panoramic radiograph and occasionally a 3-D image or I-Cat CT scan when required and as determined by the needs of the patient.

Once all of the information has been compiled and reviewed, Dr. Dolman will explain the nature of your situation, review all associated risks and benefits and recommend the appropriate treatment specifically for you. All of your questions will be answered carefully and to your satisfaction in an unhurried manner.

An appropriate surgical date and time will then be arranged to accommodate your schedule. If required and desired, surgery may be possible on the same day.

On the day of surgery, your treatment will be reviewed again together with you, and all of your questions will be answered. Informed consent will be reviewed and signed and treatment will be completed in an unhurried, uninterrupted, comfortable and calm setting.

When done, you will remain in the office for a short time for observation and you will then be able to go home. If required, a car will be called on your behalf and you will be escorted to the car as required. A follow up will be pre-arranged for the week(s) following your surgery.

Wisdom Teeth FAQ

Do all wisdom teeth need to be removed?
No. Every case is different. Occasionally, a wisdom tooth will fully erupt into a normal position. Provided it can be easily maintained and it remains free of periodontal disease and decay, it can usually be left in place.

Additionally, it is important to evaluate its effect on the neighboring teeth. Oftentimes, your dentist or hygienist will recognize that your wisdom teeth are interfering with your ability to properly clean and maintain the adjacent second molars. Even though the wisdom teeth are not problematic per se, it may be decided to remove them to help you maintain the teeth directly in front. Dr. Dolman will examine you carefully and determine if in fact your teeth need to be removed.

How long will it take?
Of course, every case is different, some taking longer than others. Recognizing that often all 4 wisdom teeth are removed in one visit, it will usually take less than 1 hour for treatment to be completed.

Do I have to remove all 4 wisdom teeth at one time?
No. Each treatment plan is specific to the patient and will be customized combining Dr. Dolman’s recommendations and the patients needs and wants.

Is the treatment painful?
No. Dr. Dolman will make your treatment fully comfortable. Should you desire, he will utilize intravenous sedation/general anesthesia as needed.

Do I have to go to sleep for the procedure?
No. Dr. Dolman can perform your procedure with complete comfort and absolutely no pain without the need to go to sleep.

How long is recovery?
Recovery time varies from patient to patient of course. Typically, the usual recovery varies from 1-4 days.

What happens if I have a problem after surgery?
Dr. Dolman is easily available after hours. He can be reached directly on his cell phone and/or email or text messaging. You can feel fully at ease with the understanding that Dr. Dolman is easily accessible for any questions you may have.

What is a dry socket and what do I do if I get one?
A dry socket is a situation when the blood clot in the extraction site dissolves too soon and leaves the area exposed. The site becomes very painful and will not typically respond to the use of analgesics (pain medication). This usually occurs on or around the 4th day after surgery. Should you have a problem at any time, you can easily reach Dr. Dolman on his cell phone, via texting or email.