Oral Surgery

3rd Molar Surgery

Third molar surgery is recommended when you have impacted wisdom teeth. A digital panorex xray is the best way to view wisdom teeth and diagnose problems.

You will be prescribed medications for the surgery. We recommend headphones with music to further help to relax you during this procedure. You can bring your own music or we can provide you with an IPOD.

This appointment is usually about an hour and a half in length allowing ample time for the local anesthetic to become profound enabling you to be comfortably numb for the procedure. A small flap is made to gain access to the teeth. Frequently, wisdom teeth require bone reduction if the tooth does not yield easily to forceps or elevators. Lower wisdom teeth are often more impacted in the bone and require sectioning to allow easier removal which is better for healing and kinder to the surrounding bone.

Sutures are placed at each extraction site and we will see you again in a week to remove the stitches and check the healing.

Please view the patient education video below for Third molar surgery and refer to post surgery instructions for this procedure.

Impacted Teeth

Third molar teeth (commonly referred to as wisdom teeth) consist of the upper and lower third molars; they usually appear between the ages of 16 – 25 or older – old enough to have supposedly gained some wisdom.

Wisdom teeth are commonly extracted when they affect other teeth or when there is little or no room to accommodate them. Most adults have four wisdom teeth, but it is possible to have more or fewer.

Impacted wisdom teeth fall into one of several categories. Mesioangular impaction is the most common form. (44%) and means the tooth is angled forward, towards the front of the mouth. Vertical impaction (38%) occurs when the formed tooth does not erupt fully through the gum line. Distoangular impaction (6%) means the tooth is angled backward, towards the rear of the mouth. And finally, horizontal impaction (3%) is the least common form, which occurs when the tooth is angled fully ninety degrees forward, growing into the roots of the second molar.

Impacted wisdom teeth may also be categorized on whether they are still completely encased in the jawbone. If it is completely encased in the jawbone it is a bony impaction. If the wisdom tooth has erupted out of the jawbone but not through the gumline, it is called a soft tissue impaction.

Sometimes the back of the wisdom tooth extends over the biting surface, forming a soft tissue flap around the tooth. Debris and bacteria can easily accumulate under the tissue flap which may cause pericoronitis, a common infection problem with partial impactions that is often worsened by occlusion with opposing third and second molars. Common symptoms include swelling and redness of the gum around the eruption site, difficulty opening the mouth, and pain.

Other reasons for removing wisdom teeth include pressure on the lower teeth causing movement and overlapping of lower anterior teeth. Impacted wisdom teeth can also develop cysts around them destroying bone around them which in extreme cases can cause jaw fracture.

Please view the patient education videos titled “Wisdom teeth consequence – Crowding” and “Wisdom teeth consequence – Cyst and jaw fracture” by clicking the link below. Refer to post surgery instructions for this procedure.

Click below to view educational video; select ‘Surgery’:

 

Oral Sedation

Oral sedation is prescribed for relieving anxiety in the hours immediately before a dental appointment. In dentistry, the most commonly prescribed drugs for anxiety belong to the “benzodiazepine” family. You’ve probably heard of them by their tradenames – for example, Halcion, Valium or Ativan.

Benzos directly and efficiently decrease anxiety by binding with receptors in the brain which tone down activity in those parts of the brain responsible for fear allowing you to have your dental work done comfortably. Oral sedation is a great alternative to IV sedation.

Should you choose to have an oral sedative prescribed for you, you must have an adult drive you to and from the office and you must not drive or engage in potentially dangerous activites for 24 hours.

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