Wisdom Tooth Removal

WISDOM TEETH – A GUIDE FOR PARENTS AND PATIENTS

A GUIDE to wisdom teeth FOR PARENTS AND PATIENTS

YOU’VE BEEN ADVISED YOU NEED YOUR WISDOM TEETH OUT. WHAT COMES NEXT?

For many, the thought of having wisdom teeth removed can seem terrifying. Just the mention of the words “surgery” or “extraction” can conjure up fear. In truth, wisdom tooth extraction is a fast, safe, and effective means of improving your long-term oral health. The journey begins when you schedule an appointment to first assess your case specifics and then formulate a plan tailored to your unique needs. Each step in the procedure will be discussed and details such as sedation – anaesthesia, your drop-off and pick-up arrangements along with your post-operative regime will be reviewed. Our office offers a range of sedation – aenesthesia options coupled with advanced vital sign monitoring. Your health and safety remain our priority. The focus of our practice is to ensure your entire experience is positive and stress free.

WHAT ARE WISDOM TEETH?

Generally, we each possess three sets of molars that erupt at different times. The first molars erupt at approximately age six, the second molars around age 12, and the third molars develop during our late teenage years. As third molars tend to erupt during the transition into adulthood, classically they were referred to as wisdom teeth.

WHY SHOULD WISDOM TEETH BE REMOVED?

Anthropologists have determined that the coarse diet early humans consumed caused significant tooth wear. Compensatory drifting of the teeth due to this wear provided the space necessary for most wisdom teeth to erupt by the late teenage years. Our modern diet however is much softer. As a result, our teeth no longer experience such extreme wear. In addition, orthodontic treatment tends to establish a fuller and thus more cosmetic dental arch form. There is typically insufficient room for the wisdom teeth to properly erupt.
A constellation of potential issues tend to develop surrounding impacted or malposed wisdom teeth. Even if fully erupted, wisdom teeth due to their hard to reach locations at the back of our mouth can easily become infected. Further, impacted (unerupted) wisdom teeth can develop cysts or tumors (refer to “The Trouble with Wisdom Teeth”, below).

IN LIFE, EVERYTHING HINGES ON TIMING.
SO TOO WITH WISDOM TEETH!

Wisdom Tooth Development

Wisdom teeth development at 12 years of age

12 Years

Wisdom teeth development at 14 years of age

14 Years

Wisdom teeth development at 17 years of age

17 Years

Wisdom teeth development at 25 years of age

25 Years

You are likely aware that many of your friends are also having their wisdom teeth removed? There is harm in waiting until wisdom teeth start to bother you! The optimal (yet fleeting) window for wisdom tooth extraction is between ages 17-21 before the roots are fully formed. Ideally, this is when parents should consider their children be evaluated. During this time, the risk of damage to nearby nerves, teeth and/or bone is markedly reduced.
As a counterpoint, waiting to remove wisdom teeth once the roots have fully formed (potentially closer to the nerve) places you at greater risk. Even if wisdom teeth were to erupt, studies dating back over 50 years determined that in the average individual, there is typically insufficient room for wisdom teeth to erupt fully and thereafter be predictably cleansable. In such instances, as bacterial plaque and periodontal disease take hold, infection (jawbone death) begins around wisdom teeth and spreads to involve the adjacent second molars. Dr. Novack views such complications as entirely preventable. Non functional wisdom teeth should be extracted rather than permitted to jeopardize and in many instances, cause the loss of your critically important adjacent molars. By our 30‘s and 40’s, the literature has shown a partial hole (defect) in the jaw will remain following tooth extraction. As one likely would expect, by age 60 our bodies lack a robust regenerative capacity. Should a wisdom tooth be removed later in life, typically there is a requirement for extensive bone regenerative surgery to reconstruct the lost periodontal (gum and bone) support. Further, as we age our jawbone tends to become more brittle, the literature notes that older patients are at greater risk of developing gum and jawbone infection (periodontitis) in the region surrounding the wisdom teeth and adjacent molars. Finally, chronic gum – periodontal infections do affect our general health!

THE TROUBLE WITH WISDOM TEETH

Are you still feeling unsure? To assist you in better understanding the issues surrounding wisdom teeth, we have provided the following computer animations. Many common questions and concerns pertaining to wisdom teeth are visually explained.

A representation of a pericoronitis infection on a wisdom tooth

Infection:

Your gums may become infected, a condition known as “pericoronitis”, when wisdom teeth fail to successfully erupt. Pericoronitis infection causes pain, swelling, difficulty swallowing and if left untreated, these symptoms tend to worsen.

An example of a cyst formation on a wisdom tooth

CYSTS AND BENIGN TUMORS:

Cysts are fluid-filled sacs that can form within the jawbone when impacted wisdom teeth are not removed. As cysts continue to grow, they can damage your jawbone and neighboring teeth. The larger cysts become, the more difficult they are to treat.

An illustration of teeth crowding causes by a wisdom tooth

CROWDING AND ALIGNMENT ISSUES:

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 jaw bone.

A visual of a wisdom tooth damaging an adjacent tooth

DAMAGE TO NEARBY TEETH:

It is difficult to perform effective oral hygiene (brushing and flossing) so far back in the mouth where wisdom teeth are situated. Overtime, ineffective oral hygiene in the area surrounding wisdom teeth can result in tooth decay and jawbone loss (periodontal disease).

If you have been procrastinating about removing your wisdom teeth, take the first step and call. We are committed to providing you with the calm, safe and comfortable experience you are looking for!

WISDOM TEETH REMOVAL CO$TS

The cost of wisdom teeth removal varies depending on several factors (position, degree of impaction, number of teeth) unique to your case. We will review all costs at your consultation appointment. You will be reassured to know that Dr. Novack’s professional fees remain at or below the Ontario Dental Association Fee Guide for Periodontal Specialists. Our office staff will assist in determining your level of insurance benefits for the required procedures.

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Must Wisdom Teeth Be Removed Even If They Haven’t Yet Caused Pain?

In many respects, we tend to measure our health by the absence of pain. Unfortunately, whether it be cancer, heart disease or wisdom teeth, the absence of pain at least early on does not confirm health. Irreversible damage to the adjacent jawbone, nerves and teeth can continue even in the absence of symptoms until permanent harm has occurred.

In truth, no one can predict if or when wisdom tooth issues will occur. Nevertheless, complications later in life are typically more serious, painful, challenging and costly to treat.

Take the First Step

At your consultation, Dr. Novack will assess your specific situation and then in a comprehensive and transparent manner advise you on what to expect. Time will be set aside to ensure all your questions and concerns are addressed. Please share your entire medical history with Dr. Novack along with any medications and supplements you currently take.

What To Expect After Wisdom Tooth Removal?

Following wisdom tooth removal, it is typical to experience transient swelling and discomfort. You will be provided with a cold compress prior to discharge to help minimize swelling. In addition, medication will be prescribed to effectively manage discomfort.

All patients are urged to refer to the Post Operative Instructions – Tooth Extraction Section on our website. Your compliance with these few simple precautions will help prevent possible complications during the recovery period.

Most important is that you are not alone. Dr. Novack is available after hours to assist.

Post Operative Instructions
Wisdom Tooth Dental Extraction

Antibacterial Rinse

  • An antibacterial mouth rinse is generally prescribed. Commence the antibacterial rinse the day following your surgery provided no bleeding is evident.
  • It is permissible to drink lukewarm or cool liquids immediately.

Prescriptions

  • Take all prescriptions as advised.
  • If antibiotics are prescribed, please remember to take the entire prescription at the defined times.

Smoking

Patients’ are strongly advised not to smoke ideally forever, but at least during the first 3 days following tooth extraction.

Diet – Nutrition

Please adhere to a soft yet nutritious diet over the first few days. Thereafter as your symptoms abate gradually ease into more solid food.
Avoid drinking through a straw to reduce potential complications (i.e. Dry Sockets).

Dry Socket Prevention Technology

The most common complication following wisdom tooth extraction is the development of a dry socket (alveolar osteitis). This condition tends to arise when the blood clot that forms naturally within the extraction socket becomes dislodged or dissolves prematurely. Loss of the blood clot can expose the socket bone and nerves, delay healing, increase pain and lead to infection. Dr. Novack’s training coupled with precision surgical care will ensure the gums surrounding your wisdom teeth are fully sealed (primary closure). Attention to each step in your treatment hastens healing while dramatically reducing pain and the development of a dry socket.
In specific cases, to reduce the potential for dry socket formation, Dr Novack employs advanced – platelet rich fibrin (APRF). Your own blood (platelets) is harvested to create a membrane which has been shown to improve tissue (gum and bone) regeneration by increasing the rate of healing.

BLEEDING

It is normal for the saliva to be lightly streaked with blood for the first couple days. If continuous bleeding is present, fold the provided gauze into a firm wad and place directly over the operative site. Remember to maintain steady pressure for 20 – 30 minutes. Do not expectorate vigorously or chew the gauze. Alternatively, a tea bag may be substituted for the gauze pad.

SWELLING

Swelling is to be expected following any surgical procedure and tends to reach a maximum on days 3-5. Swelling should then disappear spontaneously over the following two or three weeks. To reduce swelling, an ice pack should be applied 20 minutes on and 20 minutes off for the first 3 days. Thereafter, ice packs can be continued if you find they help relieve discomfort. There is no need to remain indoors, “avoid drafts” or cover the area of swelling.

DISCOLORATION

Bruising of the skin occasionally occurs but will disappear spontaneously in approximately a week to ten days. Discoloration is not a cause for concern and no treatment is indicated.

EMERGENCIES

Do not hesitate to contact the Dr. Novack at any time if in doubt regarding instructions or should concerns arise.

CHOOSING THE RIGHT DENTAL SPECIALIST

It was following Dental School during Dr. Novack’s Hospital Residency and thereafter, Periodontal Specialty Program that he received extensive training and experience to best manage wisdom tooth removal. We will be with you every step of the way while paying extra attention to all critical elements of your care including;
Anaesthesia- A variety of options are available to accommodate all ages.

  • Compassion and Comfort – Our goal is to make your experience as pleasant as possible.
  • After Hours – Contact information and availability.
  • Patient Specific – Minimally Invasive Surgical Therapy.
  • Careful Consideration – Timing your treatment to ensure the easiest recovery possible.

WHO SHOULD REMOVE YOUR WISDOM TEETH?

Most of us turn to Google for information. Common searches include “Reasons for wisdom tooth removal?” and “How are wisdom teeth removed?.”The one question that all too often goes unasked may well be the most important; “the professional who will provide your care?”
Although all dental professionals are legally allowed to remove wisdom teeth (i.e. periodontists, oral surgeons or even general dentists), it is arguably more important to focus on the individual. We believe that a periodontist is particularly qualified to perform complex wisdom tooth removal procedures with the greatest degree of safety and comfort. Dr. Novack incorporates a holistic approach that promotes long term oral – periodontal health, not merely wisdom tooth extraction, are also considered.
Dr. Phil Novack performs all periodontal, implant and surgical procedures including tooth removal in our state-of-the-art centre in the Yonge – York Mills – 401 area of Toronto.
Dependent upon the specifics of your or your children’s teeth (erupted, partially erupted or impacted), Dr. Novack will perform either a simple, complicated or surgical extraction. For more complex surgical extractions, a small incision is made and the surrounding gum tissue released to permit visualization. Dr. Novack’s training and years of experience ensure that the safest and least traumatic approach will be employed to remove your wisdom teeth.
To ensure optimal treatment results and problem free recovery, Dr. Novack continually reevaluates protocols and technologies to minimize complications and discomfort while improving your long term oral health.
Contact Dr. Philip Novack in Toronto, Ontario today!
Safe and successful tooth and in particular, wisdom teeth extraction is dependent upon your selection of a periodontist with advanced training in the procedures you require. Don’t hesitate to contact Dr. Phil Novack in Toronto for a consultation today.