Procedures

Wisdom Teeth

Here at Blum-Nico Oral-Facial Surgery Associates, we are proud to offer wisdom teeth extraction for our patients.

Wisdom teeth are the last set of molars. Most people start to get their wisdom teeth when they are teenagers, though some teeth don’t come in until you are in your early twenties.

Wisdom teeth have a purpose. They are another set of molars, but more often than not they cause more problems than they are worth. Wisdom teeth can come in misaligned, facing any direction. They can even try to come in horizontally, growing into your other teeth. This can damage your nerves and even your jawbone.

There are also times when your wisdom teeth can become impacted and are not able to come through the gums. They can also come in partially, allowing food to catch in the area and cause plaque to build up. This can lead to bacteria and infection, which will only get worse.

Since wisdom teeth are often harmful, most doctors recommend their removal. The surgery goes much better if you get the teeth removed before any signs of problem. The recovery is easier also. Surgery and recovery are also easier when you are younger.

What Are Wisdom Teeth?

Wisdom teeth are the last set of molars to develop. Most people start to get their wisdom teeth when they are teenagers, though some teeth don’t come in until you are in your early twenties. They are called wisdom teeth because they appear so late – much later than the other teeth, at an age where people are presumably “wiser.”
Wisdom teeth do serve a purpose as another set of molars, but more often than not they cause more problems than they are worth. Wisdom teeth can come in misaligned (facing any direction), horizontally, and even growing into your other teeth. This can damage your nerves, your jawbone, other teeth, and can cause severe discomfort. If your wisdom teeth come in placing pressure on other teeth, they can cause your other teeth to shift and become misaligned. If you’ve had dental braces, wisdom teeth eruption can cause your teeth to shift. This can also lead to bite problems and problems of the jaw joint.
There are also times when your wisdom teeth can become impacted and are not able to come through the gums. They can also come in partially, allowing food to catch in the area and cause plaque to build up. This can lead to bacteria and infection that can eat away at the jaw bone and may even create cysts in your jaw.
Since wisdom teeth can cause problems, most doctors recommend their removal. If indicated, the surgery and recovery are much easier if you get the teeth removed before any signs of problems. Both the surgery and recovery are also easier when you are younger.

What to Expect After Your Wisdom Teeth Extraction

After your surgery you will likely be numb for several hours. However, since everyone is different, we do not know exactly when the local anesthesia will wear off for you. This is why we recommend that you take your pain medication before the local anesthesia wears off. We will also provide you with an ice pack right away to help combat any swelling.

For detailed post-operative instructions, click here. Remember, we are also here for you after you go home. Our doctors are always on-call. We are just a phone call away at (305) 936-5974 (Aventura) or (305) 538-

WISDOM TEETH FAQS

Wisdom teeth or third molars are the last set of molars to come in. They are located in the back of your mouth. They usually are the last teeth to develop.

Most people get their wisdom teeth in their late teens or early twenties, but it is also possible to develop wisdom teeth as a pre-teen or as an older adult.

Not everyone gets wisdom teeth. While many people get all four of their wisdom teeth, some people may only develop three, two or even just one. Some lucky individuals never develop any.

There are many symptoms that can be indicative of wisdom teeth issues. Some symptoms of wisdom teeth issues are pain in your jaw, tenderness, swelling around the gums, discharge if an abscess or infection is present.  There are some individuals that don’t have any visible or noticeable symptoms of wisdom teeth issues.

If your wisdom teeth are causing you discomfort or if they are causing your other teeth to shift, then your wisdom teeth should be removed. This way you can avoid damaging the surrounding teeth. If they grow in the right position, are healthy, and function properly, it may not be necessary to have them removed.

A wisdom tooth is considered impacted if there is not enough room after the second molar for the tooth to emerge or develop normally. Some wisdom teeth can be partially impacted. This means that only part of the tooth has come through the gum. Partially impacted wisdom usually teeth need to come out most of the time to prevent infection and pain.

Wisdom teeth that do not grow in properly can cause many dental problems. These include damage to surrounding teeth, cysts of the jaw, inflamed or infected gums, cavities, sinus problems, dental alignment issues.

Yes, wisdom teeth do not often grow in like regular teeth. They may be impacted and grow at angled position. Usually these teeth will need to be sectioned into pieces when extracted. If the tooth is not erupted and stuck under the gum, it will require a small incision in the gum tissue to access the tooth. Part of what makes wisdom tooth extraction more difficult is that the wisdom teeth’s root anatomy varies from regular teeth.  Wisdom teeth typically have multiple roots as well and these roots can grow separately or fused together. Teeth with irregularly shaped roots or root curvature can be more difficult to remove. This is especially true on the lower jaw because of denser bone and because of its proximity to the nerve.

Every case varies because the treatment is dependent on the position and complexity of each tooth. We also take into consideration dental insurance. For more information on wisdom teeth costs, please contact our office.

Depending on the local anesthesia our doctors use, the numbing effects can last from a few hours to the better part of the day. Long-lasting local anesthetics are beneficial because they give the patient some time to take pain medications on a full stomach.

IV Sedation is a great option for wisdom teeth removal. In fact, most of our patients have their wisdom teeth removed with the comfort of IV sedation. In order to have IV sedation our doctors will need to review your health history, allergies and medications before proceeding with his treatment recommendation.

Sedation is administered through an intravenous (IV) line in your arm. Most patients don’t feel anything when we use IV sedation. Instead, they wake up from their procedure very relaxed and comfortable. They usually don’t have any memory of the treatment. In other words, your oral surgery procedure becomes a non-event.

Medications most commonly used are Fentanyl, Versed, and Toradol. For more information on anesthesia and Sedation, please visit our Anesthesia Page.

On occasion, we may have an anesthesiologist present in your case, but most of the time our doctors handle the anesthesia themselves. Our doctors are fully certified and trained in IV sedation and general anesthesia. Furthermore, they are ACLS Certified and have yearly trainings and updates on anesthesia, emergency training, and anesthesia updates.  In addition to that our surgical assistants are also certified as sedation anesthesia assistants for OMS and are CPR certified. Our patients are monitored throughout the entire procedure using the latest equipment for monitoring vital signs.

No, you should not experience pain during your procedure. There are different anesthetic options that could be administered during the procedure to minimize any discomfort during the extraction. Please note that local anesthesia cannot take away the sensation of pressure, so you will feel our doctors working in the area, but you should not experience pain.

Typical recovery can be anywhere from 5-10 days, however some people may experience shorter or longer recovery times. This is all dependent on the patient’s recuperative capabilities.

During your consult we will prescribe pain medication for after your procedure. We recommend that you fill these prescriptions before your procedure and start taking your pain medication immediately after your procedure. Following the after-care instructions given to you by our assistants will help make the recovery process easier. We recommend icing 20 minutes on, 20 minutes off as much as possible for the first two days.

Not necessarily, not everyone gets sutures placed, but if you do, they will dissolve on their own within a week to ten days. If, after a few weeks, your stitches are still present and need to be removed, you contact our office to have them taken out.

There is no need for concern. After surgical extractions, some patients may discover pieces of the bone working their way to the surface of the extraction site. These are known as a “bone spurs”. This is common. When the tooth is being extracted, pieces of the tooth’s bony socket may also break off during the process. These slivers cannot be integrated into the healing tissues and your body will naturally begin to eliminate them, causing them to penetrate through the gum tissue. These spicules or bone spurs will usually fall out on their own, but if they are causing discomfort you can call our office to have these removed.

Nerve damage is a potential complication associated with wisdom teeth removal, however, the probability of nerve damage is very low. Oral surgeons are specially trained to extract teeth with as little trauma as possible. This is why we take special 3-D x-rays that help our doctors evaluate the wisdom teeth position and their relation to the nerves. If the root is close to the nerve, our doctors may opt to perform a Coronectomy. This is where the crown of the tooth is removed, but the roots are left intact. In doing this, the roots will heal over with the bone

A dry socket is a possible complication of wisdom tooth removal. Once the tooth is removed, there is a hole in the bone called a socket. A blood clot forms in that area to protect the bone and nerves underneath. If that clot becomes dislodged, it will cause the bone and nerve to be exposed to air, fluids, and food. This may cause a low-grade infection – or a dry socket.

Dry sockets typically occur three to four days after wisdom teeth removal. Some symptoms include pain that radiates to your ear and is not alleviated after taking pain medication, bad breath or an unpleasant taste/smell in your mouth. If you develop a dry socket contact our office immediately. Our doctors will treat your dry socket with special medication to promote the healing and stop the pain.

It is normal to experience swelling and bruising after your wisdom tooth surgery. The swelling usually improves after a few days while the bruising may take a few more to clear up. Please note that the third day is usually the worst for the swelling. Use ice packs immediately after your surgery as directed by our office in order to help reduce swelling.

We suggest that you avoid brushing your teeth for the first 24 hours after your procedure. After that, you may brush your teeth, but be sure to be gentle around the extraction sites or avoid them as much as possible.

We suggest that you avoid gargling or rinsing for the first 24 hours following your procedure. After that you can rinse lightly with warm salt water or mouth wash. We do not want you to rinse vigorously until you are cleared to do so at your post-op appointment.

Yes, we recommend you start with clear liquids like sprite, apple juice and water. If you are able to handle the clear liquids well, then we recommend drinking a protein based liquid before taking any pain medications. This can include ice cream, milkshakes, yogurt, pudding and cottage cheese. Do not drink these through a straw as this will create suction and dislodge the clot that is forming. This can also cause additional bleeding as well. Instead try drinking straight from the cup.

From there, we recommend trying soft, cooler foods including for the rest of the day. These may include apple sauce, mashed potatoes, mac ‘n cheese, steamed vegetables, well-cooked pasta, cream of wheat, soft fish, smooth soups, pancakes, canned fruit, beans, scrambled eggs, and any other soft foods.

There are some foods we would like you to avoid. These include spicy foods, anything with seeds, hard or chewy foods (like chips, crackers, or nuts), acidic foods and drinks, carbonated drinks, and anything with small particles like broccoli.

No, we need you to rest. We recommend waiting three-four days following wisdom teeth removal to exercise or participate in any vigorous activity. Exercising too early may cause the blood clot to dislodge and cause bleeding. Unfortunately this will increase your recovery time as well as cause discomfort.

Yes, but we recommend waiting at least a day or two following wisdom teeth removal to travel. Remember, that the third or fourth day is the peak of discomfort and swelling. However, it is safe to fly after or travel after surgery as it will not affect your ability to heal or cause additional bleeding.

No, smoking impairs the healing process in the mouth. If you must smoke, we recommend waiting at least 48 hours to smoke. Remember clot formation on the extraction site is crucial for the extraction site to heal properly. Smoking and inhaling can cause the clot to get dislodged or dissolve resulting in a dry socket. This could negatively affect the healing process and cause delays in healing or complications like dry sockets, bleeding, and poor healing of the gum tissues. Though surgery can be scary, our skilled doctors and entire staff at Blum-Nico Oral-Facial Surgery Associates will be glad to help you throughout the process. We will explain the whole procedure step by step until you are comfortable. We are also here for you after you go home. We are just a phone call away at (305) 936-5974 (Aventura) or (305) 538-4556 (Miami Beach).

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