Wisdom Teeth Removal

Wisdom Teeth Extractions in Cape Coral, FL

Wisdom teeth are a set of molars in the back of your mouth that usually present in late teen years to early twenties. Often they can cause pain, grow in at incorrect angles, and alter your smile. Dr. Pette will perform an in-depth evaluation to assess positioning, alignment and even look for gum disease and cavities.

Do I Need to Have My Wisdom Teeth Removed?

Wisdom teeth are located in the very back of the mouth and can cause a variety of problems and pain not only currently but also can impact the future health of your mouth. Often, there is not enough room in our mouths for our jaw to accommodate a third set of molars. As the wisdom teeth push through the gums they can push on neighboring teeth causing a crooked smile and pain on your teeth. Also, due to their location back in the mouth, the wisdom teeth may have difficulty coming through the gum surface and become impacted or stuck in your jaw or gum tissue, causing pain.

Should Dr. Pette find through his evaluation of your mouth to not have enough room for proper growth or showing signs they are angled on your x-rays, generally speaking removal of the tooth is the best option. Removal of the wisdom teeth is best to do before the root of the tooth fully develops and binds deeper to the jaw

What Happens if I Do Not Remove My Wisdom Teeth?

The older we get, the stronger the connection the root of our tooth becomes to our jaw, making removal and healing of the tissue more difficult.  The healing response becomes more unpredictable than when you are younger.  The rate of infection and complications from the procedure also increases as we age.  Not having your wisdom teeth removed can lead to the following complications:

• Infection of the gums surrounding the tooth causing local discomfort, recurrent pain, swelling, and difficulty chewing and swallowing.
• Potential teeth crowding which can cause your teeth to shift and alter your smile and bite.
• Damage to neighboring teeth- if the tooth cannot be adequately cleaned, cavities and gum disease can form. You can even develop bone loss around the tooth.
• Cyst formation in the jaw – pressure from impacted teeth can cause cysts to develop and destroy the underlying jaw bone even tooth structure.
• Tumor growth – although rare, not removing wisdom teeth increases the chance of developing bone tumors in your jaw.

What Should I Expect on the Day of My Surgery?

When you arrive for your surgery, our staff will bring you back to the surgical suite. Dr.Pette will administer IV sedation and anesthesia so that you are relaxed and have no discomfort during treatment. We also offer blankets to keep you warm and comfortable during your procedure.  We ask that you have not had anything to eat or drink for 8 hours prior to surgery to minimize risk of nausea and vomiting post-surgery from the anesthesia.  You will need to have someone accompany you to the office on the day of your surgery as you will be sleepy after the procedure and unable to drive. On average, wisdom teeth removal takes about 45-60 minutes, and you may be in the office for about an hour and a half.

Before your procedure, Dr. Pette will write a prescription for pain medication to keep you comfortable at home. This will allow you to have necessary medications prior to your procedure.  You can expect your gums and mouth to be swollen, even bleed some. You may have dissolvable stitches to help your incision heal. We recommend you begin eating clear liquids such as broth and Jello and progress your diet as you feel you can tolerate. Be mindful of consuming dairy products such as milkshakes or yogurt as dairy can up set your stomach after anesthesia.

Oral Examination

With an oral examination and x-rays of the mouth, Dr. Gregory A. Pette 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 or orthodontist

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?

If you do not have enough room in your mouth for your third molars to fully erupt, a number of problems can happen.  Generally speaking, 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:

Infection: The most frequent clinical problem we see is pericoronitis, which is a painful 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.

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.

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.

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 becomes more dense. When it is necessary to remove 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. Our office staff has 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 and a well-trained experienced staff. The Surgical Care Team, the office facilities, and the doctors are inspected on behalf of the Board of Dental Examiners on a regular basis.

On the day of your procedure, you will take medications to help minimize post-operative pain and swelling. We ask that a parent or responsible adult accompanies you to the office and plans to stay with you the rest of the day. The procedure will take about 30 to 60 minutes and you will probably be in the office for 90 minutes. Recent advances in medicine and technology allow patients to undergo wisdom tooth removal in a manner, which promotes rapid healing and minimal post-operative 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). This does not mean you should try to fit in one “last meal” exactly six hours before your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications, including nausea and vomiting. Your procedure will be rescheduled if you have not heeded these guidelines. We may provide you with a prescription for pain medication at your consultation appointment, which for your convenience, can be filled in advance. When you are seated in the surgical room, we will make every effort to make you as comfortable as possible. If you are going to be sedated, we usually will place an IV in your left arm. This is a quick and nearly painless procedure that ensures optimal delivery of your medication. Local anesthesia is given to you afterwards to ensure comfort, and allow adequate time to travel home and rest. You will be sleepy for a significant portion of the day.

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. Please try non-narcotic anti-inflammatory medications such as ibuprofen (Advil®) first, to see if that adequately treats your pain. If not, begin your other prescription pain medication. 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.

We do not recommend using dairy products such as yogurt, ice cream or milkshakes on the day of surgery, as nausea and vomiting may develop in conjunction with the anesthetic and pain medication. 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 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 (239) 610-6200 and ask to speak to one of our patient care coordinators.