Wisdom Teeth Extraction

Highland, IN

Wisdom Teeth Presentation

To provide you with a better understanding of wisdom teeth, we have provided the following multimedia presentation. Many common questions pertaining to wisdom teeth are discussed.

Wisdom Teeth Presentation

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

The average mouth is made to usually hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. During the course of evolution our diets have changed and our jaw bone has adapted more quickly than have our teeth. Our Jaw size has decreased at a faster rate than has the size of our teeth. We are left with a jaw size/tooth size mismatch, which often doesn’t allow our last 4 teeth to fit in our jaw. These four other teeth are your third molars, also known as “wisdom teeth.”

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Why do I need my wisdom teeth removed?

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.

We like to consider the removal of third molars on average between the ages of 15 and 25. More importantly than a patient’s age, the root development of the lower molars can be used to determine the best time for treatment. Between the ages of 15 and 25 the jaw bone is more expandable/bendable and healing occurs most readily. Tooth roots are not fully formed and the teeth are well-suited for removal. The root tips are therefore not as close to the sensory nerve running just beneath the teeth. Bone becomes more calcified and firm as we age and post-operative symptoms linger on longer as we get older. Alteration of the sensory nerve as a result of surgery can lead to altered sensation in the lower lip, chin, teeth, tongue and any branch of this nerve. Early intervention can help reduce this from occurring. Bone becomes more calcified and firm as we age leading to a more involved procedure. Post-operative symptoms linger on longer as we get older.

Soft Tissue
Partial Bony
Complete Bony

If your wisdom teeth have caused pain in the past, it is likely that this will occur again in the future. The second episode is often worse than the first.
Wisdom teeth that have not fully erupted into your mouth tend to place pressure upon the teeth directly in front of them (second molars). This can result in bone loss and loss of tooth structure. Decay may occur in these areas as well. The pressure from the erupting wisdom teeth may move other teeth and disrupt the orthodontic or natural alignment of teeth. If your third molars are only slightly poking through, a channel forms through which saliva, bacteria and food debris can pass resulting in decay, foul odor and infection. Food debris suspended within your saliva may get trapped between the tooth surface and the gums as this area is not easily cleaned. This often results in swelling of the tissue and the upper molar pressing down on this inflamed painful tissue.

If your third molars are fully erupted in your mouth, they may be very difficult to keep clean. If the gum tissue and the top of the tooth are at the same level, you may be prone to infections. Some wisdom teeth may interfere with chewing & biting. They may impinge upon the surrounding gum tissue and cause pain and swelling. The removal of wisdom teeth will often alleviate these problems if they have already occurred.

Third molars are often very difficult teeth to restore with fillings, root canals and crowns due to lack of accessibility.

Third molars can be associated with pathology, such as cysts, resulting in the destruction of the jawbone and healthy teeth. Although this is not very common it requires more extensive surgery. Removal of your wisdom teeth can prevent this from occurring and thus early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.

Wisdom teeth are classified based upon the degree of gum tissue and bone that they are surrounded within.

Infection:

Occasionally, post-operative infections occur. This usually requires an office visit and clinical examination. Many times, just placing you on an antibiotic for one week will take care of the infection. If it persists, the area will have to be drained and cleaned. Other temporary problems you may experience in the post-operative period include stiffness of the jaws, chafing around the corners of your lips, facial bruising, and blood oozing from the extraction sites. The post-operative instruction sheet we will provide should answer many of the questions related to these more common concerns. If not, don’t hesitate to call the office.

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 jawbone.

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.

The American Association of Oral & Maxillofacial Surgery funded an intensive review of the philosophy and concept of wisdom tooth removal. It has been referred to as the White Paper after the name of the lead investigator. This paper can be located on line for those of you who are interested in reading a long dissertation on the Risks Indications and Benefits of Wisdom Tooth removal. Some of the more pertinent points are as follows:

  • Periodontal pocketing
  • Bone fill of extraction site
  • Missed work
  • Altered sensation

Over the years techniques have been developed to predictably and safely remove wisdom teeth in a comfortable environment to make for a pleasant experience. We constantly review and improve our skill, technique; care and judgment to assure you are treated in a safe efficient and pleasant environment. We are happy to answer any further questions you may have when you visit with us at our office.

Oral Examination

With an oral examination and x-rays of the mouth, Dr. Pulver can evaluate the position and number of the wisdom teeth. He can predict if they will erupt properly or may perhaps lead to future problems. Studies have shown that early evaluation and treatment result in a superior more predictable outcome for the patient. (See Third Molar Surgery information at AAOMS) AAOMS white paper on wisdom teeth for further reading). Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon. Wisdom teeth are best addressed between the ages of 18 – 25 on an elective basis. As you get older the bone holding your wisdom teeth becomes denser and less expandable. The roots of your teeth will continue to grow down towards the nerve that gives sensation to your lip, chin and tongue. These changes with age can lead to a more prolonged recovery, infection and postoperative difficulties.

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. Pulver has the training, license, Board Certification and experience to provide various options of anesthesia for his patients to select on an individual basis based upon patient preference.

Removal

In most cases, the removal of wisdom teeth is performed under general anesthesia in our office. Some patients elect to have the procedure done with laughing gas (nitrous oxide/oxygen analgesia) or local anesthesia. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. Once the teeth are removed, the gum is sutured. To help control bleeding, bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home. We will review your post-operative information with you in our recovery area. Upon discharge, your post-operative kit will include postoperative instructions and extra gauze. As a convenience, your prescription for pain medication and antibiotics will be called in to the pharmacy of your choice. If you have any questions, please do not hesitate to call us at Pulver Oral Surgery Phone Number 219-934-0404.

Our services are provided in an environment of optimum safety that utilizes modern monitoring equipment and staff who are experienced in anesthesia techniques.

Request an Appointment
The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Pulver Oral Surgery

5 out of 5 stars based on 55 Wisdom Teeth reviews.

Our Latest Testimonial

Overall satisfied.

- Don N

4 out of 5 stars on

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Everyone was very nice.

- Erianna S

5 out of 5 stars on

Our Latest Testimonial

I've been waiting for so long for someone to have the confidence to remove all four of my wisdom teeth without breaking the right side of my jaw or cause me to lose feeling.. I am beyond greatful for Dr. L. Eric Pulver and His super amazing staff.. I don't want to leave anyone out however I do want to Recognize one of the friendly voices over the phone who I got to meet at the end.. her name is Andrea... Andrea I just want to thank you for your patience.. I thank you so much for explaining to me from the finance standpoint and also the procedure.. you and the rest of the front office staff are the faces of Dr. Pulver and I'm glad he has you guys.. Dr. L. Eric Pulver... Thank you .. Thank you.. Thank you!!!!!!!!! I have been trying for so long to get my wisdom teeth pulled.. but others would take one look at my X-rays and refer me to the next for only the next to refer me to the next to the point I was seriously ready to give up on ever having a chance to one day having normal smile.. Being let down so many times is so frustrating and discouraging..I felt relieved after you looked in my mouth and afterwards explained what you were about to do next.... I've never got that far in the past ... after we kept talking it made me feel even more lucky to know you were from one of the best hospitals in Chicago and was familiar with Dr McKay McKinnon and his work... today was much bigger to me then just getting my wisdom teeth pulled. And no General Anastasia will make me not remember one of the best days of my life that took place in your office today 4/24/2017

- Anndrea S

5 out of 5 stars on

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Staff is very friendly and helpful. Waited a little long to have procedure done. I had came in early due to a cancellation and still waited over an hour. Other than that, everything was fine.

- Sherisse R

5 out of 5 stars on

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GREAT

- Stephen V

5 out of 5 stars on

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Fast and Efficient

- LeClere S

5 out of 5 stars on

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Dr. Pulver and all of his staff were excellent. From the first appointment where we had an initial evaluation to the procedure itself. The financials were clearly explained and there were no surprises, the procedure went well, the explanations and literature provided for postop care was excellent. I highly recommend this office for any dental procedure one may need to have.

- Max G

5 out of 5 stars on

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thank you for doing such a great job!

- Sally B

5 out of 5 stars on

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Great staff, very friendly , procedure went smoothly.

- Ali M

5 out of 5 stars on

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Very nice

- Elva Lopez

5 out of 5 stars on

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Great staff, clear instructions and quick procedure.

- Sydney P

5 out of 5 stars on

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best doctor and staff that i have ever ssen.

- joanniem m

4 out of 5 stars on

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I will be referring every one that have any dental issues to Dr. Pulver. I thank you and your staff for being so pleasant.

- Kiara P

5 out of 5 stars on

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Great experience. I didn't feel anything.

- Gail B

5 out of 5 stars on

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The staff was very professional and procedure was quick. I would recommen Dr. Pulver to anyone. he was very friendly.

- Waynenasha C

5 out of 5 stars on

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I noticed on my initial phone call to the office the customer service was really good. Front office staff and all the rest of the staff was very pleasant and put me at ease. The dentist is one of my GREATEST fears and after my oral surgery today I am convinced I will be taking care of my teeth on a more regular basis! Dr. Pulver is pleasant and personable. He has a light touch and very fast!

- Latrice G

5 out of 5 stars on

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They were very nice and extremely fast. everyone here is awesome, especially megan

- marissa m

5 out of 5 stars on

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Everyone was very nice and polite. Dr. Pulver was quick and made everything painless.

- Madison S

5 out of 5 stars on

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Everyone was very nice and welcoming I would greatly recommend coming here.

- Berenice H

5 out of 5 stars on

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They did GREAT JOB handling my anxiety and apprehension

- Franco K

5 out of 5 stars on