Impacted Wisdom Teeth

Impacted Wisdom Teeth are no fun
Posted on 21 Mar 2014
By Dr. Mark Baker

A big part of our practice at Facial & Oral Surgery Associates includes the removal of impacted wisdom teeth. These teeth begin to develop at the age of fourteen to fifteen. When wisdom teeth are impacted, it means that they are still covered with gum tissue and bone. Oftentimes four impacted wisdom teeth, at Facial & Oral Surgery Associates, can be removed in less than half an hour with IV sedation, where the patient is relaxed, asleep, and comfortable.

There are complications that can occur when wisdom teeth are removed. The inferior alveolar nerve is always a big consideration and can present itself very close to the roots of the wisdom teeth. Great care must be taken to avoid injury to the inferior alveolar nerve as an injury can result in numbness of the lower lip and chin. This is a very disturbing complication in the removal of wisdom teeth. Typically this numbness, or paresthesia, is temporary, but it can be a permanent lifelong numbness. It is also possible to have numbness of the tongue, but this is an extremely rare complication. With attention to detail and vast surgical experience, many of these complications can be avoided. Dr. Baker and Dr. Jepsen have thirty-seven years of combined surgical experience in the removal of impacted wisdom teeth.

Most patients have heard of dry sockets. These occur when a blood clot does not form after the wisdom teeth are removed. This leaves the socket empty or void of a clot, and hence the term dry socket is utilized. The bone becomes inflamed and can cause a lot of pain to the patient in his or her recovery from surgery. One telling sign of a dry socket is increasing pain on about day five. Pain and swelling from surgery will typically peak on day three, after which the symptoms should begin to subside. If on day five the pain continues escalating, it might be an indication that the patient is developing a dry socket.

The greatest concern with the removal of upper wisdom teeth is the maxillary sinus. On occasion the roots of the upper wisdom teeth extend into the sinus, and upon removal of these teeth, an opening is left into the maxillary sinus. When a sinus opening is recognized, the site must be closed in a primary tension-free manner, and the patient must be given antibiotics as well as sinus precautions. For the most part, if these precautions are followed, no further surgery will, in all likelihood, be necessary. The key is astute attention to detail.

At Facial & Oral Surgery Associates, the majority of patients are sedated to have their impacted wisdom teeth removed. This provides amnesia to the patient and a comfortable surgery. The patient is relaxed, asleep, and comfortable, and wakes up when the surgery is completed.

Patients can expect to have some swelling of the gums and cheek following the removal of their impacted wisdom teeth. Our patients are instructed to use ice packs for forty-eight hours to help reduce swelling and to maintain a soft diet for several days.

When complicated wisdom teeth present to our office, we might elect to obtain an ICAT scan, or a cone beam scan. This allows us to look at the bone in a three-dimensional manner and to identify the position of the nerve with respect to the roots of the wisdom teeth. This will allow us to map out our surgery in an effort to avoid injury to the inferior alveolar nerve.

The best way to avoid complications is to have your wisdom teeth removed by an Oral Surgery Specialist who has vast training and experience in the removal of impacted wisdom teeth. Dr. Baker and Dr. Jepsen have over thirty-seven years of combined surgical experience in the removal of impacted wisdom teeth. At Facial & Oral Surgery Associates we pride ourselves in avoiding complications and in making the surgery as pleasant as possible for the patient.

We would love to be of service to you and your family. Please do not hesitate to visit with us if you have questions regarding impacted wisdom teeth or other oral surgery needs.

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American Association of Oral and Maxillofacial Surgeons (AAOMS) Idaho State Dental Association (ISDA) American Society of Implant and Reconstructive Dentistry (ASIRD) Institute for Dental Implant Awareness (IDIA) Western Society of Oral and Maxillofacial Surgeons (WSOMS)