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.

A representation of a wisdom tooth impacted by soft tissueSoft Tissue
An example of a wisdom tooth with a partial bony impactionPartial Bony
An illustration of a wisdom tooth completely impacted by boneComplete 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.

A diagram depicting an infection that occurs after wisdom teeth removal

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.

An illustration of teeth crowding causes by a wisdom tooth

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.

A visual of a wisdom tooth damaging an adjacent tooth

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.

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My experience here was perfect. I felt completely comfortable, and the entire staff was friendly and informative.

- Marc L

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Dr. Pulver and his staff are the best. I would highly recommend this office for your oral surgery needs.

- mia l

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great expierence

- samantha m

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Everyone was very kind and helpful. I will definitely recommend to friends and family.

- Aaron H

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EVERYTHING WENT GREAT

- JESSICA S

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Dr. Pulver and staff are the greatest! They go over everything with you and make sure you're comfortable before he starts any work on you. I would definitely recommend him.

- Carri G

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100 percent satisfied, thank you guys so much.

- Earseline G

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Very great experience, very scared patient, all went well, thanks for the patience

- Audrey A

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The staff was really friendly thru it all

- Dianira A

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Awesome

- Kelly B

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This is my third child to have wisdom teeth removed with DR Pulver

- leesa h

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great service overall !!!!!

- jennifer s

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Dr. Pulver and his Staff are amazing.

- Shannon K

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Dr. Pulver is kind and highly skilled.

- Jeremy S

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Please note that I was not the patient; my husband was. I appreciated the wealth of information provided to me at the time of service. Dr. Pulver and his staff answered all of my questions to my satisfaction.

- Shelley W

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great office and staff they did everything to make the pt relaxed before the procedure

- quashaundra j

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great job

- jessica s

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Professional and thorough. Doctor spends time with patient and family. All procedures explained and questions answered.

- Janet B

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Very easy and complete satisfactory

- Miranda K L

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excellent!

- JENNIFER C

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