What Are Wisdom Teeth
Most people have four wisdom teeth, but some may have none or even more. These are the last teeth to develop and are located on each side of the mouth. Most of the time these molars erupt in your mouth in your late teens or early twenties and are often extracted around the same time. Many people eventually have some type of problem with their wisdom teeth. The most common problems evaluated are pain, pressure, cavities, infection, bone loss around the tooth, or potential tooth movement. Long term studies have shown that early intervention with wisdom teeth removal can have better outcomes and less surgical risk. It is good to go converse with your oral surgeon and evaluate so you can formulate the best decision possible.
Oral and Maxillofacial surgeons have years of advanced oral and facial surgical training beyond dental school. This training allows them to comfortably discuss wisdom tooth extraction options with you and review the reasons you may want to consider the procedure.
What Is An Impacted Tooth?
Many people develop wisdom teeth without adequate space in the jaw to accommodate them. The space in the back of the jaw does not allow the wisdom tooth to erupt naturally in order to properly clean them. When this occurs, typically the tooth is below the gum or bone in the back of the jaw. Our doctors can determine how deep an impacted tooth may be present the day of your consultation.
Oral and X-ray Examination Oral Examination
After an oral and x-ray examination, our doctors can determine the likelihood of current or future problems.
The majority of patients who come to our office to discuss wisdom teeth removal usually have some type of problem, however some do not. The most common problems evaluated are pain, pressure, cavities, infection, bone loss around the teeth, or potential tooth movement. Long-term studies have shown that early intervention with wisdom teeth removal can have better outcomes and less surgical risk.
When And Why Should I Have My Wisdom Teeth Removed?
Many people eventually have some type of problem with their wisdom teeth. Over time, the risk for cavities, infection, bone loss around the adjacent teeth, and potential shifting of other teeth increase. We prefer to extract wisdom teeth before the roots are fully developed. We can determine root development by evaluating the x-ray. Typically, we prefer to extract wisdom teeth when the roots are 1/2-3/4 of the way developed. This can range anywhere from the age of 11 to early 20’s.
What If I Don’t Have My Wisdom Teeth Removed As A Teenager Or Young Adult?
Generally speaking, after the age of twenty-five, as wisdom teeth develop, the roots become longer and the jaw bone becomes more dense. As age increases, it becomes more challenging to have a predictable post operative course. In the thirties, forties, fifties, and beyond, complications from wisdom teeth removal increase exponentially. Managing these challenges is more difficult with an older patient versus a younger patient. Occasionally we see and treat patients in their eighties and even nineties with impacted painful wisdom teeth.
Types Of Impactions
In order to determine the type of impactions you may have, a clinical examination and an x-ray examination must be performed. During this visit, Dr. Holm or Dr. Cordova will review your options and give recommendations based on what they find. Wisdom teeth impactions are classified based on how deep they are in the jaw bone.
• Soft Tissue Impaction: Gum tissue still covers part of the top of the tooth, making it impossible to clean the entire tooth.
• Partial Bony Impaction: The tooth has only been able to erupt partially into the mouth. Most of the tooth is under the gum and jaw bone.
• Complete Bony Impaction: The tooth is completely submerged under the jaw bone. There is NO space for the tooth to come into the mouth.
Can I Go To Sleep?
During your consultation, Dr. Holm or Dr. Cordova will discuss your options for anesthesia. Most people choose to have some type of sedation. As Board Certified Oral and Maxillofacial surgeons, Dr. Holm and Dr. Cordova have undergone years of rigorous training in dentistry, medicine, and anesthesia in order to provide you with a safe, comfortable, and predictable anesthetic experience. Dr. Holm and Dr. Cordova have been licensed in multiple states to not only provide oral surgery services, but to also offer different types of anesthesia.
Our office staff have consistent, up to date, and ongoing training in appropriate anesthetic care. Our anesthetic services are performed using modern equipment and a well-trained surgical team. Our surgical team is trained in advanced oral surgical anesthesia techniques. Continuing education also includes BLS, ACLS, PALS, DAANCE, OSHA, and infection control. Our main priorities are our patient’s safety as well as their comfort.
What are Dental Implants?
Dental implants represent one of the greatest advances in Dentistry for the replacement of missing teeth. A dental implant is a specially fabricated titanium screw that replaces the root of a missing tooth or teeth. Dental implants have been used predictably since the early 1980’s for this purpose. Over the years, techniques and materials have continued to be improved upon in order to provide a highly successful prosthesis for a person who is in need of teeth replacement. Since the early 1980’s Oral and Maxillofacial surgeons have been at the forefront of dental implant surgery and dental implant placement.
What is The Doctors Experience with Dental Implants?
Dr. Holm and Dr. Cordova have trained for many years, working with patients from many different backgrounds. Their surgical experiences include complex head and neck trauma or cancer reconstruction. They have also spent years working with patients with birth defects including cleft lip and palate or cosmetic needs, including orthognathic surgery to correct unfavorably positioned jaws. These experiences set them apart as specialists working in and around the mouth, especially in the treatment planning and surgical placement of dental implants.
Dr. Holm and Dr. Cordova have placed thousands of dental implants. They consistently receive up to date knowledge on advances in dental implant surgery, and lecture the surrounding dental community on ways to improve dental implant outcomes. They will bring this experience to you to offer the most up to date techniques and recommendations.
How Are Dental Implants Placed?
Dental implants are generally placed after teeth have been extracted. Traditionally, most patients were forced to have teeth extracted, then wait a period of around 6 months before implant placement. Implants were then placed and the patient had to wait an additional 6 months before getting teeth placed on the implants. Though this technique yielded high degrees of success, most patients don’t want to wait an entire year for new teeth! Dr. Holm and Dr. Cordova use up to date techniques, including immediate implant placement the same day the teeth are removed. This can be done in most cases. Generally speaking, most patients can be back to the dentist for a new tooth between 8 weeks and 3 months!
Why do I need a consultation?
During a consultation Dr. Holm or Dr. Cordova will examine your mouth and x-rays. At that time, a thorough discussion will be held regarding your dental implant options and what techniques are best suited for your needs.
A first appointment, known as a consultation, will take place with our doctors before a procedure is performed. At time, our doctors will do a visual examinations as well as a more in-depth imaging exam, such as an x-ray. It is important you bring your medication list and any health information we need to know. Your health history is very important to us and needs to be viewed and talked about so we can prevent any negative interactions with medications used in our office. You should also have your insurance card and referral from your dentist. At that time we will discuss the right procedure for you and go over any post-surgery prescriptions or instructions, along with the financial part.
Additional Dental Implant Procedures
Dental implants are used to replace a tooth or teeth that have been extracted. Many times, these teeth are removed due to infection, trauma, or other reasons. Sometimes when this happens, the bone and gums around the implants are also lost or recede. Occasionally, additional bone or gum needs to be added to the area to help it to heal and rebuild what has been lost. During your consultation, Dr. Holm and Dr. Cordova will discuss your needs and offer any additional procedures as needed.
Sedation / Anesthesia
As board Certified Oral and Maxillofacial Surgeons, Dr. Holm and Dr. Cordova have undergone many years of training in dentistry, medicine and anesthesia in order to offer safe, comfortable, and affordable sedation techniques to their patients. Due to their training, our doctors are certified to offer anesthesia services from very light or “twilight” anesthesia to deep or general anesthesia. The anesthetic training of an Oral and Maxillofacial Surgeon is rigorous and challenging. Our surgical assistants are well-trained in advanced anesthesia training alongside our doctors. Together we have created a safe environment to experience safe anesthetic services customized just for you.
What type of Anesthesia is Available?
Our office provides several options for anesthesia for our patients. Those options, include:
- Local anesthesia: This technique is similar to the general dentist, wherein the patients is anesthetized through carefully injected medication into the mouth or surrounding areas.
- Nitrous Oxide : Nitrous Oxide or “laughing gas” has been used in dentistry for almost 200 years. It is a breathable gas that gives a feeling “floating in the air”. Nitrous oxide is considered very safe and is often used with younger patients due to its rapid on and off effects. Oftentimes, nitrous oxide is used in combination with other techniques.
- Sedation: Sedation can be defined by how “deep asleep” a patient may become. In our office this ranges from lightly sedated or “twilight” anesthesia to deeply sedated, or even general anesthesia. What type of anesthesia you may benefit from the most will be discussed thoroughly during your consultation appoint with the doctor. Using their experience in all ranges of anesthesia, Dr. Holm or Dr. Cordova will give recommendations to keep you safe, and comfortable.
What kind of Anesthesia should I choose?
Dr. Holm and Cordova will review your surgical needs and anesthetic concerns at your consultation. During that time, anesthetic options will be discussed in detail and a plan that is right for you will be created. Most patients can be treated in our office setting. However, some patients needs are best met by going to an outpatient surgical center or hospital. These options will be discussed in detail with you, and your physician if needed. Our office will help you reach your anesthetic goals.
Our office staff has consistent, up to date, and ongoing training in appropriate anesthetic care. Our anesthetic services are performed using modern equipment and a well-trained surgical team. Our surgical team is trained in advanced oral surgical anesthesia techniques. Continuing education also includes BLS, ACLS, PALS, DAANCE, OSHA, and infection control. Your safety is our first priority, your comfort comes next.