Wisdom Teeth Removal (Extraction) Boulder CO

What Are Wisdom Teeth?

Wisdom teeth are the third and final set of molars most people get in their late teens or early twenties. For some people, these extra teeth come in without any problems. But for others, wisdom teeth can cause a lot of pain and irritation. 

They may crowd other adjacent teeth, causing them to shift out of place. If there is not enough space in the mouth for the wisdom teeth to come in they will become stuck or impacted in the jawbone. This is the situation for the vast majority of people. . 

Impacted wisdom teeth can be very painful and can lead to infection, damage to nearby teeth, the development of jaw cysts and tumor, and other problems. Wisdom teeth do not need to be removed in every situation. But, if they are causing you pain or other problems, your dentist or oral surgeon may recommend removing them.

Wisdom Teeth Removal Consultation

If you are experiencing pain or other problems with your wisdom teeth, the first step is to schedule a consultation with one of our oral surgeons. Our surgeon will assess your situation during the consultation and recommend the best treatment plan. This may include leaving the teeth alone, removing them surgically, or a combination of both. 

During your consultation with Dr.Foley or Dr.Le, x-rays will be taken of your mouth. This will help your doctor to see the position of the wisdom teeth. It will also allow them to see if there are any problems with them or if future problems are likely to occur. 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.

Wisdom teeth extraction is a relatively common procedure, and our surgeons have the experience and expertise to ensure that your surgery is performed safely and effectively. At your consultation, it is important that you let us know about your medical history and any medications you are taking, such as aspirin, blood thinners (Coumadin), platelet inhibitors (Plavix), or any herbal supplements. 

Sedation Methods

We offer various sedation options to help you relax and feel comfortable during your procedure. Removal can be performed with local anesthesia, nitrous oxide, intravenous (IV) moderate sedation, or intravenous (IV) deep sedation. Our surgeons will recommend the best type of sedation for you based on your situation.

• Local Anesthesia – May be used alone or with sedation to “numb” teeth to be removed.  Numbness may last up to 8 hours.  All patients receive local anesthesia whether fully awake or sedated.
• Nitrous Oxide (“laughing gas”) – Provides some relaxation and helps to decrease anxiety associated with surgery . You are aware of your surroundings, and you will remember the procedure.  Local anesthesia must always be used. 
• I.V. Moderate Sedation – An IV line is started for administration of sedative drugs.  You will be very relaxed but conscious.  You may remember some aspects of the procedure.  Most patients are comfortable with this level of anesthesia for the majority of  clinic procedures.
• I.V. Deep Sedation – This is similar to moderate sedation except that you will not be conscious and will not have any significant recall of the surgery. 

The Procedure

Wisdom teeth removal is typically performed as an outpatient procedure, which means you can go home the same day. The exact details of your surgery will depend on the type of sedation you receive and the number of teeth removed. 

In most cases, the surgeon will make a small incision in the gum tissue to access the teeth if they have not erupted. The teeth may then be removed whole or in pieces. In some cases, the surgeon may need to remove some bone around the tooth to safely access and remove it. Once the teeth have been removed, the incisions will be closed with stitches.

Recovery After Surgery

When your surgery is complete, you will rest in our office until we feel you are ready to be taken home. We will discharge you with a post-operative kit that includes instructions on post-operative care, a prescription for pain medications, medicated mouth wash and a plastic syringe to irrigate and keep your extraction sites clean. In most cases, a follow-up appointment is not necessary unless you are experiencing complications or simply have a desire to be seen by the doctor. It is important to take the medication as prescribed and to follow all post-operative instructions given to you by our staff.

The recovery process is different for everyone. It will depend on the type of sedation you receive, the number of teeth removed, and your healing process. Generally, the first two days after surgery will be the most uncomfortable. It is normal to experience some swelling, bruising, and discomfort following the procedure.  By the third day, you should notice improvement and be more comfortable. If you still have swelling by the third day, don’t worry; this is normal. You should be able to tolerate a more substantial diet by day three. From day three, you should continue to see gradual, steady improvement.

A word of caution regarding prescription pain medication. Opioid/narcotic medication has the potential to be addictive. The medication should only be taken to control significant post-operative pain. Once your pain has resolved, please take any unused medication to the police station or pharmacy so that they can dispose of the medication responsibly. Never leave unused medication in your medicine cabinet. 

Non-Narcotic Pain Medication Options

If you are concerned about your child taking narcotic pain medication to manage your pain after wisdom tooth removal, we offer a long-lasting local anesthetic medication called Exparel. The medication is injected into the surgical area and is released into the body over a long period of time for lasting pain relief, eliminating or diminishing the need for prescription opioid medication. 

Some patients may still need narcotic pain medication even with the use of Exparel. However, less pain medication is usually required to relieve discomfort. If you want to know more about this option, please discuss this with your doctor during the consultation and visit the Exparel website for more information. 

Do’s and Don’ts After Removal

The following are important dos and don’ts to remember during your recovery.

Do:

• Take your prescribed pain medication as needed.
• Rest and avoid strenuous activity for the first few days following surgery. 
• You will not be able to return to work or school on the day of surgery. Allow one to three days to recover before returning to work or school. 
• Ice the area for 20 minutes at a time, several times a day. (Note: never apply ice packs directly to the skin, use a cloth barrier)
• Eat soft foods and gradually introduce solid foods back into your diet as you are able.
• Brush your teeth and tongue gently, avoiding brushing extraction sites directly. 
• Keep your head elevated when lying down to help reduce swelling.  
• Clean the surgical areas as directed by our staff.

Don’t:

• Drink through a straw for at least one week following surgery.
• Smoke for a minimum of four weeks following surgery.
• Drink alcohol for at least 48 hours following surgery or while you are still taking the narcotic pain medication. 
• Eat hard, crunchy, sticky, or spicy foods for at least one week following surgery.
• Engage in strenuous physical activity for 2-3 days after surgery.

What is a Dry Socket?

Dry socket is a common complication following wisdom teeth removal. It occurs when the blood clot that forms in the empty socket after surgery becomes dislodged, exposing the underlying bone and nerves. This can cause pain, swelling, and bad breath. 

There are several steps that the patient can take following surgery to prevent the development of dry sockets. 

• Do not smoke for 4 weeks following surgery
• Do not use a straw for two weeks following surgery 
• Do not drink alcohol for one week following surgery. 
• Perform good oral hygiene following surgery:
  • Brush and floss your teeth twice daily
  • Following meals, rinse with a 50% mixture of salt water and 50% hydrogen peroxide
  • Following tooth brushing, gently rinse with an antibacterial mouth rinse for 1 minute and do not eat food or drink fluids for 30 minutes after using the mouth rinse

If you think you may have developed a dry socket, please call our office so that we can evaluate and treat the condition. The pain associated with dry sockets can be treated with a medicated dressing by your surgeon. 

When To Call the Office

After surgery, it is normal to experience some swelling, bruising, bleeding, and discomfort. However, if you experience any of the following symptoms, please call our office immediately:

• Fever over 101.5 degrees Fahrenheit
• Increasing pain that is not relieved by medication
• Swelling that continues to worsen
• Prolonged bleeding or oozing from the surgical sites
• Redness, warmth, or pus around the surgical sites 
• Numbness, tingling, or weakness in your arms or legs
• Difficulty breathing or swallowing 
• Numbness to your tongue, lips and cheeks which does not resolve after 24 hours following surgery

Risks of Wisdom Tooth Removal

Generally, tooth removal is considered a very safe procedure; however, every surgery has expected consequences and associated risks. Many of the side effects of having teeth removed are common and expected (pain, swelling, bleeding and jaw stiffness).  Other, less common events are not generally expected and are complications of tooth removal (infection, sinus problems, tooth displacement or damage, nerve injury, and jaw fracture).  

Part of being a patient and making an informed decision requires that we discuss the risks and consequences of surgery with you before your treatment at the consultation appointment. This information is not intended to scare you or to be a complete list of all possible side effects and complications resulting from oral surgery.  However, it does include what we believe to be the most important considerations. 

We will discuss these risks and consequences with you in greater detail at your consultation. While the risk of complications following wisdom teeth removal is rare, it is important to be aware of the potential risks and side effects associated with the procedure. 

These include:

• Pain
• Swelling
• Bleeding 
• Jaw stiffness
• Infection
• Nerve injury
• Sinus problems
• Displacement or damage of teeth/tooth parts
• Jaw fracture

If you have any questions or concerns about wisdom teeth removal, our experienced and caring staff will be happy to answer them.

Frequently Asked Questions