Wisdom Teeth Removal

Oral Examination

2 teenage girls sitting back to backWith an oral examination and x-rays of the mouth, Dr. Crago, Dr. Chahal, Dr. Deatherage, Dr. Gray, Dr. Gomez, Dr. Bui, Dr. Knoll or Dr. Miller can evaluate the position of the wisdom teeth and predict if there are present or future potential problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist, or by an oral and maxillofacial surgeon.

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Our doctors are trained, licensed, and highly experienced in providing various types of anesthesia for patients.

Why Should Wisdom Teeth Be Removed?

If there is not enough room in the mouth for the third molars to fully erupt, a number of problems can happen. Impacted Wisdom Teeth should be removed before their root structure is fully developed. In some patients it is as early as age 12 or 13, and for others it may not be until their early twenties. Problems tend to occur with increasing frequency after the age of 30. Some of the possible problems related to not removing wisdom teeth include:

A representation of a pericoronitis infection on a wisdom tooth

Infection:

The most frequent clinical problem we see is pericoronitis, which is a localized gum infection. Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.

An example of a cyst formation on a wisdom tooth

Cyst Formation:

Non-infectious diseases may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jaw bone that develop as a result of impacted teeth and slowly expand destroying adjacent jaw bone and occasionally teeth. They can be very difficult to treat if the wisdom teeth are not removed during the teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.

An illustration of teeth crowding caused by a wisdom tooth

Possible Crowding:

Impacted wisdom teeth may contribute to  the crowding of 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 a patient has an active problem when they see the oral surgeon, the reason for removal is primarily to prevent long-term damage to their teeth, gums and jaw bone.

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, called the second molar, can be adversely affected resulting in gum disease, bone loss around the tooth, and/or decay.

What If A Patient Doesn’t Have Their Wisdom Teeth Removed As A Teenager Or Young Adult?

As wisdom teeth develop, the roots become longer and the jaw bone becomes more dense.  When it is necessary to remove impacted wisdom teeth when a patient is in their thirties, forties or beyond, the post-operative course can be prolonged and there is a higher complication rate. Treating these complications is often more difficult and less predictable than with a younger patient. Healing may be slower and the chance of infection can be increased. If impacted wisdom teeth are not removed during the teenage years or early twenties and they are completely impacted in bone, it may be advisable to wait until a localized problem, such as cyst formation, localized gum disease, or bone loss, develops. In general, patients will heal faster, have more predictable complications,  and have fewer complications if treated as a teen or in their early twenties.

What Happens On The Day Wisdom Teeth Are Removed?

Most people prefer to be unaware of the experience when they have their wisdom teeth removed and usually decide to be sedated. Patients will be provided with appropriate anesthesia options at their consultation. All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Our office staff has the training, licensing, and experience to provide the various types of anesthesia. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment and a well trained experienced staff. The Surgical Care Team, the office facilities, and the doctors are inspected on behalf of the Board of Dental Examiners on a regular basis.

On the day of the procedure, we ask that a parent or responsible adult accompany the patient to the office and plan to stay with them the rest of the day. The procedure will take about 30 to 60 minutes, however patients will probably be in the office for 90 minutes. Recent advances in medicine and technology allow patients to undergo wisdom tooth removal in a manner, which promotes rapid healing and minimal post-operative discomfort. State of the art sterilization and infection control techniques are used at all times.

On the morning or afternoon of the scheduled surgery, it is essential that patients have nothing to eat or drink with the exception of prescription medications and a sip of water for at least 6 hours before surgery. This does not mean a patient should try to fit in one “last meal” exactly six hours before their surgery. Having anything in the stomach increases the risk for serious anesthetic complications, including nausea, vomiting, and lung infection. The  procedure will be rescheduled if a patient has not followed these guidelines. When the patient is seated in the surgical room, we will make every effort to make them as comfortable as possible. If a patient is going to be sedated, an IV is usually placed in the left arm. This is a quick and nearly painless procedure that ensures optimal delivery of medication during the procedure. Local anesthesia is given to afterwards to ensure comfort. Patients will be sleepy for a significant portion of the day.

smiling teenage son with his mother

The Day of Treatment

An adult must accompany the patient at the time of surgery. Plans should be made to have a parent or responsible adult stay with the patient for the rest of the day, following wisdom tooth removal.

If surgery requires stitches, these are usually the type that dissolve in three to five days and do not require removal. Patients may also notice a sensation of their gums feeling swollen and pulling away from their teeth. This is all part of the normal recovery, and will subside in several days.

Once the local anesthesia wears off, a prescription for pain medications may be needed. Please try non-narcotic anti-inflammatory medications such as ibuprofen (Advil®) first, to see if that adequately treats the pain. If not, other prescription pain medication may be started. The local anesthesia may last until the following day and should not be confused with an injury to the nerve. We recommend starting the post-operative diet with clear liquids such as jello and broths, and gradually increase in substance as the body permits.

We do not recommend consuming dairy products such as yogurt, ice cream, or milkshakes on the day of surgery, as nausea and vomiting may develop in conjunction with the anesthetic and pain medication. If prescribed antibiotics are taken along with birth control pills, please be aware that the birth control pills may become ineffective and appropriate precautions must be taken by the patient.

What Does Wisdom Tooth Removal Cost And Is It Covered By Insurance?

The fee for treatment is determined by a number of factors. This may include the difficulty involved in removing the teeth and which type of anesthesia is best to use. The surgeon will need to review  x-rays, complete an examination, and determine the best option for anesthesia before an accurate estimate can be provided. Every insurance company has a different policy regarding the extent of coverage for a given surgical procedure. The oral surgeon’s office staff will help each patient obtain maximum insurance coverage for their treatment.

What If I Have Questions Before Surgery?

At the scheduled consultation, the patient’s specific case will be discussed in greater detail. We encourage patients to ask any questions they may have. Patients may also call our offices to speak to one of our patient care coordinators.

A smiling woman

The Day of Treatment

Patients should not eat or drink anything prior to their surgery. Having anything in the stomach increases the risk for serious anesthetic complications.

Face & Jaw Surgery Center

4.5 out of 5 stars based on 38 Wisdom Teeth reviews.

Patient Review

They did a great job And caring about there Patience

- Brian G

5 out of 5 stars on

Patient Review

If I need anymore teeth pulled or dental work that requires me to be put under I will definitely be back! 10/10 for patient care.

- Shelby C

5 out of 5 stars on

Patient Review

Everyone was great and caring. It’s hard to go into a situation that tends to come with high anxiety and then let them sedate you and still be made to feel comfortable. Even with all the Covid protocols it was good.

- Lauren N

5 out of 5 stars on

Patient Review

I had a pleasant experience on a not so pleasant task. I thank all of you for a totally professional and pleasant experience.

- Wayne P

5 out of 5 stars on

Patient Review

I had been trying to get my last two wisdom teeth out for the past 3 years. I 've always been extremely anxious and somewhat terrified about doing the surgery all over again. I'll admit I cancelled a few times. I was very nervous that morning, but as soon as I walked in at the Bismarck location, I became less tense. The lobby was calm & relaxing. I loved the fireplace and there was a good view from the 3rd floor windows. The staff was welcoming, friendly and professional. The nurses knew what they were doing. Dr. Knoll was also friendly and professional. He explained eveything clearly and answered my questions. I was hooked up to machines with ease and put to sleep right away. He told me my wisdom teeth were like regular teeth, so he pulled them out and there was no need for stitches or medication. I can't believe the procedure only took 30 minutes. I arrived 7am (mountain time) and left by 8am. A couple of days have gone by and I am just so relieved that Face & Jaw was available in Bismarck. I would certainly go back...the whole experience was great. Thank you!

- Ann R

5 out of 5 stars on

Patient Review

I went to the Fargo location for wisdom teeth extraction, and I am sorry to say I have no memory for names so I can't give the credit I wish I could to the individuals. I do not like needles and have never been put under anesthesia prior. I'm also prone to fainting symptoms with medical procedures. The receptionists were friendly and patient. When I was taken to the back (10 minutes early even since I arrived early) the woman was kind and listened to my concerns. The anesthesiologist listened to my concerns about needles since my veins tend to disappear and I had to fast (including water) before the surgery and she even got the IV in the first time and I dare say it was the least painful one I've ever had done. The doctor took good care of me even when I started feeling faint and had to lie back and cool down. After the surgery, the ones monitoring me were kind and helpful even after I threw up the medicine they tried to give me and gave me plenty of time to recover. I am very happy with the service I received. It was well worth the cost!

- Samantha D

5 out of 5 stars on

Patient Review

There is not one thing I would have changed to make my visit any more pleasant. The many assistants that prepped me were all very attentive to my needs. Each wanted me to understand completely what would be happening. They all repeatedly checked with me to see if I had questions. The doctor also took time to explain what he would be doing and told me to let him know if there was pain and when there would be pressure. It was overall a much more positive experience than I ever anticipated. I would be happy to recommend this office highly to anyone needed to have oral surgery. Excellent treatment and care. Thank you. Josie

- Josie P

5 out of 5 stars on

Patient Review

The service is great, the staff is very friendly. I would definitely recommend Face and Jaw Surgery Center.

- Madison D

5 out of 5 stars on

Patient Review

I saw dr. crago years and years ago in 2002 and i really couldn’t afford my bill but you all were so awesome and said even if i paid $5 a month that would help. even after i moved to alaska and didn’t always pay on time you all were awesome and understanding. dr. crago did an amazing job that i was talking and eating like normal and had very little pain.

- kristin c

5 out of 5 stars on

Patient Review

every staff member I encountered was kind professional and I honestly felt like I was being treated like family. I know its a big cliché to say that but truly was a great experience.. i 100% recommend this company.

- joshua c

5 out of 5 stars on

Patient Review

My dental assistant was the BOMB.COM! I'm not talking about the nurse. I'm talking about the dental assistant actually I guess she was a surgical assistant. She was very friendly and cool. Going into this I thought I was going to be nervous, but I wasn't! I felt very comfortable and safe and had no worries! I just hope that I was polite afterwards when they woke me up. I don't remember, but my mom says I was so I hope she was right! I'm so sorry if I made anything difficult because you guys sure didn't make anything difficult for me. You guys were AWESOME!!!!!!!!! (MIC DROPPPP)

- Destiny D

5 out of 5 stars on

Patient Review

They did an excellet job, I only had the most pain on the first day of recovery otherwise the staff was friendly and very helpful.

- Gunnar P

5 out of 5 stars on

Patient Review

Dr. Chahal was very reassuring, all staff were very friendly, knowledgeable and caring.

- Carter O

5 out of 5 stars on

Patient Review

I was treated with respect by all. Procedure was done quickly with very little pain. I must say it was a very good experience in what professional courtesy ought to be, 1. explaining procedure and after care. 2. Doctor and Assistants spent time visiting with me in casual topics,Weather, Sports and Families etc. I was not left alone for any length of time. God bless all Mike Dorsher

- Mike D

5 out of 5 stars on

Patient Review

Going to the doctor is never a great experience but the folks at Face and Jaw went out of their way to make this tooth extraction as comfortable as possible.

- William G

5 out of 5 stars on

Patient Review

I have not had any issues since surgery other than some undetermined reaction on the left side of my face (emergency room doctor was perplexed but an iv of steroids and an antibiotic solved it). The doctor was great at explaining everything that was going on. The procedure was very quick and I was on my way home in less than an hour. I am on the mend and happy with my procedures. Would go there again if needed!

- KATHERINE S

5 out of 5 stars on

Patient Review

Great experience under the circumstances

- Kevin H

5 out of 5 stars on

Patient Review

Very pleased with everything. They called to check on Things the following day.

- Kristin F

5 out of 5 stars on

Patient Review

Dr. Gray and his staff are amazing. I have an irritional fear of sedation/anesthesia and when I went in to get my wisdom teeth out I was extremely terrified. Dr. Gray and his assistant were so understanding and accommodating to my hesitation they allowed me to just use local Novocain. They were so kind and let me feel like I was in control of the decision and didn't push me to do anything I wasn't willing to do but they also thoroughly explained everything so that I was at ease and made sure I was making the best decision. Dr. Gray is very approachable and so professional and kind my nerves subsided. I really appreciated the entire experience and I couldn't say enough good things about Dr. Gray and his assistant. I would 100% recommend! I will need to go back for implants later and I'm actually looking forward to it. Such a great place where everyone is helpful and kind. Thank you Face & Jaw!

- Jill K

5 out of 5 stars on

Patient Review

I was very pleased with my care! I've never had surgery before and was super nervous. Everyone-office staff, nurses, doctor-was so friendly and put me at ease!

- Lauren C

5 out of 5 stars on