Category Archives: Oral Surgery & Tooth Extractions

Removing Wisdom Teeth: How to Decide

How to Decide?

Answer the following questions:

  1. Are you planning on being put to sleep?
  2. Can you take up to a week off if needed?
  3. Are you in your teens or twenties?
  4. You DON’T suffer from any serious breathing problems, very high blood pressure, or any other bleeding or heart related conditions?
  5. Do you have dental insurance and enough benefits to cover removal of all your wisdom teeth?
  6. Can you afford the copays for removing all four wisdom teeth? Whether cash or if need be through financing.

If you answered “yes” to most of the above questions then you are probably better off removing all the wisdom at once. If you are planning on being put to sleep then you should only consider removing them all as it makes no sense to go under anesthesia twice. But even if you are planning on using anti-anxiety pills or nitrous gas it is still worth considering removing them all and getting it over with.

If you  answered “no” to most of the above questions then you might want to pace yourself and consider removing the wisdom teeth one or two at a time.

If you have high blood pressure, a serious heart condition or some type of blood clotting issue you should avoid getting all of your wisdom teeth out in one setting.

Severe asthmatics or those who have serious breathing problems may feel their breathing becoming hindered when their entire jaw is numbed up and should consider removing the wisdom teeth over two or more sessions.

Patients with severe anxiety and certain nerve conditions may also be better off avoiding having their whole jaw numbed up. In these cases it is best to do the left side and the right side separately to allow you to function on the opposite side during recovery periods.

Final Thought

We prefer to have all our wisdom teeth removed at once since delaying the inevitable will only complicate matters. This will mean you only need one time off, one recovery period, one surgery and one round of medications. Has it been 6 hours since your last dose of Penicillin yet?

Typically only one of your four wisdom teeth should be hard to remove and will be responsible for most of the swelling and pain afterwards. But when you have two or more wisdom teeth which are going to be very difficult to remove then chances are you will swell up and be in lots of pain all over your face. If this is the case then you may not be able to eat or breathe properly for days or weeks after your surgery. Some even end up being admitted to the emergency room due to the pain, breathing problems or other complications. If your extractions are expected to be very complicated then it might not be a bad idea to work on one side at a time, left or right, to allow you to chew and function on the one side while the opposing side is recovering.

Helpful hint – If you have dental insurance then start planning your surgery well in advance to be able to set aside one year of your dental benefits exclusively for the wisdom teeth and get it over and done with. It is best that you pay for the cleaning if you have to and reserve all of your insurance benefits for the wisdom removal surgery.

NEXT >> Removing All Wisdom Teeth at Once

Removing Wisdom Teeth: Removing Wisdom Teeth One or Two at a Time

Removing Wisdom Teeth: Removing Wisdom Teeth One or Two at a Time

1. You can chew and function on the opposite side as the surgery side continues to heal. Spreading out your tooth removals over a few visit will make it easier for you to function while you are recovering. If you can’t afford to take a few days off form school or work then you might be better off doing one or two extractions at a time to allow yourself to recover quicker after each procedure. Since the post-op swelling can really affect what your eating and breathing it is recommended that your dentist or oral surgeon work on either the right side or the left side to allow you to use the other side of your mouth during the recovery period.

2. You can stretch out the expenses. Getting four wisdom teeth removed all at once is quiet expensive typically running between one to two thousand without dental insurance. If you need to budget yourself you can always start off with the one that is hurting you most and work your way through them one at a time. Keep in mind that being put to sleep will no longer make any sense and you have to be awake if you are going to remove them one at a time.

3. It is less risky to remove the wisdom teeth one or two at a time. To have all four wisdoms removed at once you need close to a dozen shots. Getting these many shots can seriously raise your blood pressure, possibly to dangerously high levels.

  • If you have hypertension or a history of heart problems then you should consider removing your wisdoms one or two at a time to avoid getting so many shots in one setting
  • If you have bleeding issues such as if you are on blood thinners then you should probably avoid removing so many teeth all at once
  • Severe asthmatic or those with serious breathing problems may feel asphyxiation symptoms if their entire mouth is numbed up and might want to consider doing their surgery over the course of a few visits to avoid this
  • And finally those with  high anxiety levels should pace themselves, unless they are being placed under sedation

helpful hint – If you simply have a very long list of various medical problems, which can happen as you get older, then getting all four wisdom teeth out at once may be too risky and not worth it. Complications from wisdom teeth removal go up with age, suck as ending up with nerve damage or ankylosis where your tooth is fused to the bone and you lose a large chunk of your jaw bone along with the tooth. And since recovery times will also increase with age it might be better to consider spreading out your extractions over several visits a few weeks apart.

NEXT >> How to Decide

Removing Wisdom Teeth: Removing All Wisdom Teeth at Once

Deciding to Keep or Remove Wisdom Teeth

10 Questions to help you decide whether to keep or remove wisdom teeth

Once you’ve understood the pros and cons of removing versus keeping wisdom teeth, then it’s time to make a decision. Here is a list of question to better help you decide whether to keep or remove wisdom teeth in your mouth. Please answer each question with either a “yes” or “no”:

  1. Do you have pain and swelling on your wisdom teeth?
  2. Have you experienced repeated episodes of pain and swelling where your wisdom are located, lasting about a week at a time?
  3. Do you suffer from unexplained headaches or jaw (TMJ) problems?
  4. Is there insufficient space for your wisdom teeth to fully come out within your jaws?
  5. Have you worn braces before?
  6. Have people in your immediate family had to remove their wisdom teeth?
  7. Are you under the age of 40?
  8. Is your wisdom tooth removal considered a low-risk or medium-risk surgery?
  9. Can you afford to pay for wisdom removal surgery? Generally a few hundred bucks a tooth?
  10. Do you have dental insurance which covers wisdom teeth removal surgery?

Good candidate for removing wisdom teeth

The decision to keep or remove wisdom teeth depends on numerous factors. If you answered “yes” to most of the above questions then you probably should consider removing your third molars:

Questions 1 through 3: Pain and discomfort

The most obvious reason for removing wisdom teeth is pain and discomfort. If you’re actively experiencing pain then you should remove your wisdom teeth. However, most experienced dentists and oral surgeons can correctly predict if you will be facing pain sooner or later. Removing wisdom teeth before they start to actually cause pain is always a wise idea and will spare you tremendous pain and headaches.

Questions 4 and 5: Teeth crowding

If you’ve had orthodontic treatment before then you’ve suffered from teeth crowding issues. It’s unlikely that there’s sufficient room for four more teeth in your mouth. This generally means that it’s more likely that you need to remove your wisdom teeth as well. The sooner you remove wisdom teeth, the lesser damage they do to your bite and remaining teeth. You may have to consult your dentist or oral surgeon see if not removing your wisdom teeth is going to cause teeth crowding or not.

Question 6: Familial traits

This is not a major determining factor, but we do see a trend run in families. If your parents or siblings had to remove their wisdom teeth, then odds are you will too. This is usually because teeth size compared to jaw size is a familial trait. However if you are much taller or larger than the rest of your family members, or if you have disproportionately smaller teeth, then you may be just lucky enough to get to keep your wisdom teeth.

Question 7: Your age

Ideally you want to remove your wisdom teeth early on in your teens or twenties. By the time you are in your forties and beyond, the negative impact of having wisdom teeth is starting to diminish. Additionally, risks and complications of wisdom removal surgery increases significantly with age.

If you’re middle-aged and still have a couple of wisdom teeth left, it might not be a bad idea to only remove them if it becomes necessary. For instance, should they develop infection or start causing pain. Otherwise consider leaving your wisdom teeth alone since removing them is probably not worth the trouble any longer!

Question 8: Surgery risk levels

If your tooth is seated very deeply, then the odds of it actually trying to come out and cause problems in the future is very slim. This also means your tooth is sitting very close to your nerves or sinuses. Removing deeply embedded wisdom teeth can be quite risky and dangerous. It could lead to nerve damage or sinus tear, both which are serious complications.

Nerve damage may go away after a few weeks or months. However occasionally it remains there indefinitely. This means that you will feel numb in that region permanently which is not a good feeling at all. A sinus tear is also very serious and causes a stuffy feeling. Smaller sinus tears heal on their own but larger ones may require a subsequent surgery to treat.

If you’ve been told your wisdom surgery is high risk, you should consult an oral surgeon about it. Often times your oral surgeon will wisely advise you to consider leaving such a wisdom teeth alone. This is typically sound advice and you should follow it!

Question 8: Paying for the procedure

Affording the surgery is a big part of deciding to keep or remove wisdom teeth. Wisdom tooth removal surgery is expensive. Removing each tooth typically costs a few hundred dollars. That means that if you have four of them you’re probably looking at a few thousand to have them all removed. If you can’t afford it you can consider financing options. If that still doesn’t work, then just remove the one that is hurting your the most. 9 out of 10 times the lower wisdom teeth hurt more than top ones so you should focus on removing them first.

If you have dental insurance then seriously consider removing your wisdom teeth. Plan on dedicating one calendar year of your dental insurance benefits to cover your wisdom teeth removal surgery. Also try to perform the surgery when you’re off from work or school. Summer breaks and holidays are the best times to allow yourself sufficient time to recover afterwards.

Good candidate for keeping your wisdom teeth

If you answered “no” to most of the above questions, then consider holding off on removing your wisdom teeth. Of course things can always change in the future. Keep in mind that so long as you keep your wisdom teeth, you must keep a close eye on them. Go to your regular dental checkups so your dentist has a chance to monitor them as well. Also make sure not to forget to get your toothbrush and floss all the way back there as well to keep them nice and clean!

Final thought on deciding whether to keep or remove wisdom teeth

The sooner you decided whether to keep or remove wisdom teeth, the better your outcome. Waiting until you’re older and your teeth start to hurt causes unnecessary pain and discomfort. Additionally, you run the risk of having your other teeth become crooked. You could also sustain damage to the neighboring teeth which sit right next to your wisdom teeth.

Essentially, a single bad wisdom tooth can affect your entire oral and overall well-being. It can cause toothache, gum problems, headaches and all sorts of pain and discomfort which you may not even attribute to the wisdom tooth. So talk to your dentist and oral surgeon and make the right decision when it comes to whether or not you should retain your wisdom tooth or not.

NEXT >> When should I remove wisdom teeth?

When should I keep wisdom teeth?