Without treatment, wisdom teeth may become impacted and cause severe problems like pain, overcrowding of teeth, and negative effects to your oral health and other teeth. However, many general dentists do not offer advanced treatment for wisdom teeth extraction.
Our expert surgeons have performed over 100,000 of teeth extractions in Charleston, SC and are committed to your complete relaxation and a virtually pain-free procedure.
We are committed to your complete relaxation and a virtually pain-free procedure during tooth extraction in Charleston.
Wisdom teeth are how people commonly refer to ‘3rd molars’. As you age, your baby teeth are replaced with a set of adult teeth that come in slowly between the ages of 7-21, depending on a number of factors. Typically, molars begin to erupt starting with the 1st molar around age 7, followed by 2nd molar eruption between ages 11-13. Wisdom teeth begin making their way down in early adolescence with a wide age range between 15 to early 20s. All of these permanent molars are intended to make chewing easy – and since chewing plays an important role in healthy eating and digestion, it’s important we chew well. Sometimes, though, our wisdom teeth which long ago were helpful in processing a tougher diet can cause problems now that mouths tend to be smaller than they once were, making accommodating those large teeth more difficult. When the mouth doesn’t have enough space to allow for those wisdom teeth to erupt, often the solution is to have them surgically removed. Wisdom tooth surgery, or extraction, is a very common procedure that 80-95% of American adults have completed at some point in their lives.
Wisdom tooth extraction is a fairly standard and straightforward, outpatient dental procedure. Unless the teeth are erupting and causing discomfort, it is common to first hear about wisdom teeth removal surgery from your general dentist or orthodontist during routine visits. The timeline on having your wisdom teeth removed can be up to you based on your comfort as they begin to erupt, or they can be part of an orthodontic treatment plan to ensure that all other permanent teeth are positioned correctly before, during, and after braces. Often if you are recommended to have those molars removed, you will be referred to an oral surgeon.
There may be a number of reasons for you to be searching Google for “wisdom teeth removal” for yourself or for your child. Some reasons to seek wisdom tooth extraction with your general dentist or an oral surgeon include:
“Malposition” – wisdom teeth can be what dentists refer to as ‘malposed’, meaning that the tooth is positioned in such a way that isn’t upright. It may be that it is erupting at an angle into the roots or crown of an adjacent tooth. When wisdom teeth are malposed and erupting, it can cause discomfort and damage to the neighboring molar. Being that wisdom teeth are impacted (see below) before they erupt, it isn’t possible for an orthodontist to fix the position of these teeth so that they aren’t affecting other healthy teeth.
“Impaction” – before any tooth erupts it is covered by gum tissue and jaw bone. For wisdom teeth this can lead to trouble when the teeth begin to push themselves through that tissue into your smile line. Often, the mouth is too small to accommodate our third set of molars. Not having enough space to erupt will result in either a ‘partial bony impaction’ or a ‘full bony impaction’ of any or all of the wisdom teeth. Impacted wisdom teeth without room to move can lead to jaw pain, toothaches, pain when eating or brushing, swelling, and infection.
Decay and/or Caries – For some, wisdom teeth erupt perfectly well and can be relied upon to act as healthy teeth for any number of years; however, erupted wisdom teeth are susceptible to decay and caries. Those third molars reside in the farthest corners of your mouth making them difficult to clean with even the best regular brushing habits. Lack of routine oral hygiene is the top cause of caries – cavities – followed secondly by diet. When you combine an adulthood of acidic coffees, office breakroom birthday cakes, and snackfoods that like to cling to your enamel, like potato chips, it makes sense that adults find their way to the dental chair for wisdom tooth extractions even after decades of faithful service by those extra molars.
The process of wisdom tooth removal is generally very straightforward and is outlined below.
There are three ways you might come to realize your wisdom teeth need to be removed.
1.You’re advised by your general dentist or dental specialist
2.You’re experiencing pain associated with eruption
3.You know that most people have their wisdom teeth removed at some point
If you’re unfamiliar with wisdom tooth removal treatment, i.e. surgical extraction, you should start with discussing your case with an oral surgeon. Every patient is just a little bit different when it comes to wisdom teeth. Factors like the number of wisdom teeth you have, the stage of eruption of each tooth, the position of each tooth, etc. will contribute to your treatment plan. These factors will also play a role in possible complications, though serious complications are rare.
Your oral surgeon will evaluate these factors using a panoramic radiograph, or PAN. Panoramic x-rays are two-dimensional images of the full upper and lower jaws. These images capture all of the detail of each tooth from crown to root tip, their position relative to one another, bone density, and proximity to important structures like facial nerves and arteries. Having an accurate picture of your mouth allows your surgeon to most carefully plan the extraction of each wisdom tooth in the least risky and traumatic method possible.
After reviewing your x-ray with you, your surgeon will diagnose each third molar as erupted, partially impacted or fully impacted. These diagnosis codes are used to generate a treatment plan that outlines your recommended procedure.
Depending on the reason you consulted to have your wisdom teeth removed, you may be eager to schedule surgery or you may be inclined to wait until a time that is better suited to you financially, medically, or otherwise. In most cases, surgery isn’t urgent so unless directed expressly by your surgeon you should feel comfortable taking your time deciding when you’re ready for surgery.
The extraction of each tooth will depend on the level of impaction, but to keep things simple, the following explanation details extraction of fully impacted molars.
1. You arrive the morning of surgery with a licensed driver and an empty stomach.
2. You are escorted to a surgical suite where you will be placed in a semi-reclined position, have an IV placed, and given the opportunity to ask any outstanding questions.
3. The oral surgeon will confirm your treatment with the clinical team prior to surgery, this is called a time out. Following the time out, the surgeon will administer a cocktail of intravenous sedative and analgesic medications that will cause you to drift into a comfortable sleep state. Once asleep, the surgeon will administer a numbing medication, injected at the gumline of each extraction site.
4. Typically beginning with the upper wisdom teeth, the surgeon will use a scalpel to cut cleanly along the gumline of your backmost molar, exposing the jaw bone covering your wisdom tooth. The surgeon will then use a dental drill to uncover the crown of the wisdom tooth, separating it from the jaw bone. Using special dental pliers, the tooth will be wiggled free of the remaining jaw bone. Some surgeons may elect to place dissolvable stitches at some or all extraction sites while some opt not to.
5. Once all wisdom teeth have been extracted in this same fashion, the surgery is complete and you are allowed to wake up. You’re going to be groggy but you should not be experiencing any pain. If there is any immediate discomfort it is due to the bite block that is placed between your teeth to keep your mouth open during surgery. This discomfort will fade.
6. Between waking up and the effect of both sedation and numbing medications wearing off, you will typically be prescribed pain medication to pick up from the pharmacy on your way home. These post-operative medications and dosing instructions, along with other care instructions, will be provided to your driver at the time you are released to them (normally 15-20min after surgery is completed).
Serious wisdom tooth extraction complications are rare, but there are some common post-operative issues to look out for:
Dry Socket – Once a tooth is extracted, the jaw bone it was seated in would be otherwise exposed to the conditions of the mouth if not for the blood clot that forms in that site in the hours following surgery. It is critical for the prevention of dry socket to apply considerable pressure on the extraction sites using sterile gauze for the first 30 minutes following surgery to halt active bleeding and allow a blood clot to form. If the blood clot is dislodged through any sort of change in pressure like sucking, forceful spitting, drawing on a cigarette or vape pen, vigorous swishing or oral rinses, etc., you may be at risk for dry socket. This post-operative condition is characterized by excruciating pain that may radiate into the ear or face, foul taste and/or smell in the mouth, visible bone in the extraction site, among other symptoms. Dry socket tends to occur in the third or fourth day after surgery for those who have not followed proper post-operative instructions; it is very unlikely to occur greater than a week from surgery. There is no absolute fix for dry socket. The symptoms can be managed with a return visit to your oral surgeon who may pack the extraction site with medicated gauze intended to last no greater than 24 hours. Dry socket will resolve within a day or two of experiencing symptoms as the site begins to heal from the inside out.
Excessive Bleeding – It is important that prior to surgery you review all of your medical history with your surgeon. Some health conditions and medications can put you at risk for prolonged or excess bleeding following extraction. For a healthy individual, bleeding should slow to an ooze or cease entirely within an hour of surgery if proper pressure is applied. For individuals with greater risk of bleeding or who do not apply enough pressure to the extraction sites, bleeding may be moderate to severe. If bleeding remains steady greater than 2 hours following surgery, contact the office for further guidance.
Impacted Food, Debris – For extraction sites without sutures there is the likelihood that food and debris can be lodged in the lower extraction sites if proper diet and rinsing instructions are not adhered to. When the sites are packed with food or debris, the sites may begin to swell, redden, smell badly, or emit discharge. If there is concern that something has become lodged in the extraction site, contact the office to schedule a post-operative appointment to have the sites flushed. At this visit you may also receive a syringe for at-home use to keep the sites clean throughout the healing process.
Generalized Discomfort – Dental extractions are an irreversible, surgical procedure. As with any surgery there is the potential for general discomfort during healing. For wisdom tooth extractions that may mean unusual sensation in adjacent teeth, neighboring teeth feeling loose, jaw soreness or pain, facial pain, facial numbness, periods of inflammation, taste of blood in the mouth, and throbbing or pulsing at the extraction sites.
To lessen your risk for these complications, follow all post-operative instructions provided by your oral surgeon and their clinical team. The most common cause for these complications is non-adherence to these directions because you’re “feeling fine.” Ensure that all instructions and medications are followed throughout the time period they are prescribed.
Searching something like “wisdom tooth extraction near me” is going to bring up far too many results for you to fairly consider. Consider, though, that wisdom tooth removal is one of the procedures that oral surgeons are specifically trained to complete. That isn’t to say that general dentists aren’t capable of extracting third molars – they can be. Oral surgeons are skilled in those extractions that are considered more complex due to impaction or another structural complexity, which is why a general dentist may even refer patients to a surgeon.
Charleston Oral and Facial Surgery has 5 board-certified oral surgeons on staff offering the most advanced surgical techniques and integrative medical procedures, providing the ultimate patient experience. Outside of the surgical suite, the COAFS team focuses on the following pillars of care:
Our Administrative team supports our surgeons in ensuring that you understand your treatment options prior to considering surgery. This begins with capturing the best x-ray imaging to diagnose and plan your surgical care. Your surgeon and patient care coordinator are experts, so be sure to use your consultation as an opportunity to ask any questions you may have after the surgeon completes his exam. Successful surgeries start with understanding your case.
From the diagnosis, your patient care coordinator will develop a treatment plan estimate to outline the cost of all treatment options you discussed with your surgeon. Prior to your visit, our team verified any dental insurance policy you provided when you scheduled. Those benefits will be carefully applied to your treatment plan to give you an estimated out-of-pocket obligation for those services not covered in part or in full by your insurance provider.
If the out-of-pocket cost of your treatment plan is prohibitive, your patient care coordinator is able to discuss a number of financing options that may work for you. There may also be opportunity to adjust the timeline of your treatment to “phase” care in more financially feasible increments.
Since payment is due at time of service, our team does everything possible to ensure all foreseeable costs are detailed up front. We are proud that we can be among the few medical providers with whom you don’t have to blindly commit to recommended treatment only to be surprised with bills 2-4 weeks later. Our team takes the up front approach to discussing a financially comfortable treatment plan.
If successful surgeries start with understanding your case, then they certainly conclude with understanding your post-operative care. Our Clinical team works with your surgeon to provide the most detailed pre- and post-operative care instructions so that healing from surgery isn’t holding you back from returning to daily life. Dental treatment, especially oral surgery, can unexpectedly put a stop to your routines and comfort. Completing surgery with Charleston Oral and Facial Surgery means that you’ll be back to smiling again in no time.
“I was so impressed with Dr. Strauss and the staff at COAFS! I was extremely nervous since all four of my wisdom teeth were impacted, but I surprisingly feel fantastic!”
“This is the best dental/oral surgery practice I have ever gone to. The facility is immaculate and has all state-of-the-art equipment. The staff was caring and efficient. Dr. Lee. and his assistant Nicki extracted my wisdom tooth without any pain.”
“Thankfully I don’t have to get my wisdom teeth removed again, but if I did, I would absolutely go here.”