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ORAL AND MAXILLOFACIAL PROCEDURES

WISDOM or 3rd MOLAR EXTRACTION

Wisdom teeth are the third and final set of molars. When they align properly, if gum tissue is healthy, and they can be easily reached to clean, wisdom teeth do not have to be removed. Unfortunately, this does very typically not the case. An x-ray or Dental CT scan will help the doctor determine when is the most appropriate time for extraction.

REASONS FOR WISDOM TEETH REMOVAL:

  • 1) Wisdom teeth that are misaligned can crowd or damage adjacent teeth, the jawbone, or nerves.
  • 2) The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth.
  • ​3) Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris.
  • 4) Wisdom teeth that are partially erupted (gum tissue covers back on 3rd molar) allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness.
  • 5) Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.
  • 6) Teeth that remain partially or completely entrapped within the soft tissue and /or the jawbone are termed “impacted.” impacted teeth can become infected and can crowd adjacent teeth.
  • 7) The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth.

WHEN IS THE BEST TIME FOR WISDOM TOOTH REMOVAL?

Your general dentist, orthodontist and surgeon may recommend extraction of your wisdom teeth to prevent the problems above. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure. With an oral examination and x-rays of the mouth, Dr. Casey can evaluate the position of the wisdom teeth and predict if there may be present or future problems and make recommendations on the best timing for removal of teeth.

Current research shows that early evaluation and treatment result in a superior outcome and recovery for the patient. Patients are generally first evaluated in the mid- teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.

If your child is in orthodontic treatment it is common for the orthodontist to refer to an oral and maxillofacial surgeon for an evaluation for wisdom tooth extraction as it is part of their reccommended protocol for completion of orthodontic treatment and long term stability of teeth.

TOOTH REMOVAL PROCEDURE

All procedures performed in the office are performed under appropriate anesthesia to maximize patient comfort. Dr. Casey is licensed and has excellent training and experience to provide various types of anesthesia for patients to select the best alternative.

​In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia) and/or I.V. anesthesia. Our services are provided in an environment of optimum safety that utilizes the most modern monitoring equipment and JCAHO accredited techniques to maximize your safety.

Once the teeth are removed, you will rest comfortably under our supervision in our recovery suite until you are comfortable and are ready to be taken home. Upon discharge, your post-operative kit will include postoperative instructions, a prescription for pain medication, antibiotics if needed and a follow-up appointment.

IMPLANT REPLACEMENT OF EXTRACTED TOOTH

In some situations, teeth can be extracted and implants can be positioned in their place. This is a great way to avoid cost of future anesthesia and additional surgical recovery time. An immediate implant is a great and easy way to replace the tooth that needs to be extracted. Please ask Dr. Casey if you are a candidate for this procedure.

HOW SERIOUS IS AN IMPACTED WISDOM TOOTH?

If left in the mouth, impacted wisdom teeth may damage neighboring teeth, or become infected. Because the third molar area of the mouth is difficult to clean, it is a site that invites the bacteria that leads to gum disease. Oral bacteria may travel from your mouth through the bloodstream, where it may lead to possible systemic infections and illnesses that affect the heart, kidneys and other organs. Research has shown that once periodontal disease is established in the third molar areas, the problem is persistent and progressive, but may improve following extraction of the teeth. In some cases a fluid-filled cyst or tumor may form around the base of the untreated wisdom tooth. As the Cyst grows it may lead to more serious problems as it hollows out the jaw and damages surrounding nerves, teeth and other structures.

Please schedule a consult to discuss any questions or concerns you may have at 239-947-6637.

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