The average adult has thirty-two teeth by age eighteen, however; the average mouth is made to hold only 28 teeth. It can be painful and costly when 32 teeth try to fit in a mouth only designed to hold 28. These four "extra" teeth are known as third molars or "wisdom teeth." Third molars are the last teeth to erupt. If they align properly, and gum tissue is healthy, it is not necessary to remove them, however; this generally isn't the case.

Third molars are normally impacted (a tooth that fails to emerge or fully break through the gum tissue). Occasionally, impacted teeth do not present problems, but in most circumstances, patients will develop one of a number of problems associated with impacted third molars. Infection is the most common condition related to impacted teeth. It may range from a localized gum infection to an acute, extensive, life threatening infection of the head or neck. Untreatable root decay can form in adjacent teeth. Tumors or cysts can form in conjunction with impacted third molars resulting in jawbone loss or loss of adjacent teeth. In addition to infection and bone loss, wisdom teeth can damage expensive orthodontic work.

You can rely on the expertise of your general dentist, orthodontist or oral surgeon to diagnose existing or potential problems associated with your wisdom teeth. Early evaluation and treatment result in a favorable outcome for the patient. Typically, patients are initially evaluated in the mid-teenage years. At this age, the roots of the third molars are not fully formed which makes removal easier and post-operative recovery simpler.

It is important to schedule a consultation before the actual surgery is done. During the consultation, panoramic x-ray and medical history is reviewed. Prescriptions for antibiotics, pain control and an anti-inflammatory medication will be given as well as pre-operative instructions. Patients are encouraged to ask questions concerning their treatment.

Oral surgery is performed on an out-patient basis in an in-office setting. "Twilight" sedation or local anesthetic is administered according to patient preference and doctor recommendation. Under careful monitoring, it normally takes 20 - 30 minutes to remove wisdom teeth. After surgery, patients are observed for at least 30 minutes or until discharge criteria have been met. Accompanying care giver will be given complete post-operative instructions.

Q: What determines the cost of removing wisdom teeth?
A: It is based on the degree of impaction, the difficulty of removal, and the type of anesthesia used (local or intravenous sedation).

Q: Are there any post-operative surgery complications?
A: The most common complication of wisdom tooth removal is a dry socket. It occurs when an impacted tooth has been removed if the blood clot in the socket sloughs off before the healing process occurs. This exposes the area causing great discomfort. Symptoms such as a dull, throbbing pain may present within three days of extraction. If this occurs, the patient will be seen immediately. Following post-operative instructions will lessen the chance a dry socket occurring.