Wisdom Teeth Extractions

By the age of 18 to 25 years, the average adult has 32 teeth: 16 teeth on both the top and the bottom jaw. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canines, and bicuspid teeth) are ideal for biting into and cutting food into smaller pieces. The back teeth (molar teeth) are used to grind food up into a consistency suitable for swallowing.

Unfortunately, the average mouth usually only has space for 28 teeth. No one is exactly sure why. Problems can arise when these last four teeth try to fit in a mouth that only holds 28 teeth. These last four teeth are commonly known as “wisdom teeth” or “third molars”.

In some cases, an individual’s jaw is large enough to allow room for the wisdom teeth to come in and be cleaned. However, more often than not, one or more of these wisdom teeth fails to properly emerge or is unable to push through the gums, resulting in an impacted tooth.

FAQs

What is an Impacted Tooth?

It’s a tooth that hasn’t erupted normally into the mouth. It may be blocked by another tooth or simply not have enough space. Any tooth can be impacted but most commonly impacted teeth are the wisdom teeth.

What does this mean for my Health?

Impacted teeth can grow in any direction and most often grow forward and push against other teeth. This may result in the development of gum disease, decay or damage to the adjacent tooth. Removal of your wisdom teeth at an early age can help ensure the long-term health of your neighboring teeth.
An impacted tooth can become cystic. A cyst is a fluid-filled sac within the bone that enlarges over time. As it enlarges it damages other teeth and can weaken the jaw itself.
An impacted tooth does not lend itself to be easily cleaned. Food and bacteria get trapped around the wisdom teeth. This can lead to decay, infection and abscess.

When should I remove my Wisdom Teeth?

In your young adult years before your wisdom teeth start causing damage to other teeth. Unfortunately, as you age, the bone surrounding the teeth gets stiffer. This makes the teeth harder to remove and can result in more potential complications and longer healing times. We recommend patient come in for a consultation to establish the best time to remove impacted wisdom teeth.

What is the Procedure?

A patient may select to be awake or asleep for the procedure but local anesthetic/freezing is always given prior to the start of the extraction(s). If a patient elects to be asleep for the procedure then the local anesthetic/freezing would be given after the patient is asleep. The procedure typically involves making an incision and exposing the impacted wisdom tooth. The impacted wisdom tooth is removed by either lifting it out or by sectioning the tooth prior to removal of the tooth. After the tooth is removed, the area will be thoroughly washed and the gums may be closed with dissolvable stitches.

Am I asleep during the Procedure?

We offer various forms of anesthesia to ensure you are comfortable throughout the procedure. The medical health of the patient and the extent of the procedure may influence what forms of anesthesia are appropriate for each patient.

Anesthetic Options:

Local anesthesia – Commonly known as “freezing”. It’s the simplest form of anesthesia and should be considered for patients who are not anxious about their procedure.
Nitrous Oxide with Local anesthesia – This is commonly known as “laughing gas”. This a very mild form of anesthesia as patients remain completely awake. This should be considered for patients who are very minimally anxious.
IV Sedation with Local anesthesia – This type of anesthesia is appropriate for patients who are moderately anxious about their surgery or undergoing moderately extensive surgery. A patient may drift in and out of consciousness with this level of anesthesia.
IV General anesthesia with Local anesthesia – This type of anesthesia is appropriate for patients who are highly anxious about their surgery or undergoing more complicated forms of surgery. Patients with this level of anesthesia are asleep.

What happens after the Surgery?

Once the surgery is complete, you will spend a short time recovering prior to leaving the office. During this recovery time, written home care instructions will be reviewed and you will be prescribed appropriate medications for your healing period. You will be prescribed appropriate pain medication(s) and an antibiotic when required.

You should expect some swelling which will increase for the first 2-3 days before decreasing. Icing for the first 24 hours will significantly reduce the amount of swelling but will not eliminate it. In addition, you may develop some bruising or discoloration of the skin in the cheek or neck area. Your jaw may also feel quite stiff which can be exacerbated if you clench or grind your teeth at night. All of these are normal reactions and side effects to oral surgery in the mouth and will improve.

Are there any Risks?

With any surgery, there is the risk of complications. During your pre-surgery consultation, we will review the possible risks associated with your surgery and answer any questions that you may have.

The various options for anesthesia include:

Local anesthesia – Commonly known as “freezing”. It’s the simplest form of anesthesia and should be considered for patients who are not anxious about their procedure.
Nitrous Oxide with Local anesthesia – This is commonly known as “laughing gas”. This a very mild form of anesthesia as patients remain completely awake. This should be considered for patients who are very minimally anxious.
IV Sedation with Local anesthesia – This type of anesthesia is appropriate for patients who are moderately anxious about their surgery or undergoing moderately extensive surgery. A patient may drift in and out of consciousness with this level of anesthesia.
IV General anesthesia with Local anesthesia – This type of anesthesia is appropriate for patients who are highly anxious about their surgery or undergoing more complicated forms of surgery. Patients with this level of anesthesia are asleep.

How much does it Cost?

Once you are assessed at your consultation appointment, you will be provided with a predetermination estimate upon request which can be submitted to your insurance company. Our fees are based on the standard Ontario Dental Association fee guide for Oral & Maxillofacial Surgeons.

Exposure and Bonding of Impacted Teeth / Uncovering Buried Teeth

Tooth exposure is the process by which we first uncover a tooth that is either fully or partially buried beneath the gum line, and then we bond an attachment so that your Orthodontist can direct the tooth into position.

Root Resection and Retrograde Fillings

Retrograde filling is a restoration placed in the apical part of a tooth root to seal the apex of a previously treated root canal. An incision is made through the tissue over the root of the tooth so the underlying area can be cleaned and the end of the root smoothed off.