Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally evaluated in their mid-teenage years by their restorative dentist or Orthodontist and referred to Precision Oral and Maxillofacial Surgery for consultation.

After an oral examination and review of the imaging, Dr. Pierse will evaluate the position of the wisdom teeth and determine if they require removal. Risks, benefits and alternatives are discussed in detail so that the patient has a thorough understanding of the anatomy as well as the overall procedure.

Why Should I Have My Wisdom Teeth Removed?

If you do not have enough room in your mouth for your third molars to fully erupt, a number of problems can occur. Impacted wisdom teeth should be removed before their root structure is fully developed. In some patients it is as early as 12 or 13, and in others it may not be until their early twenties. Problems tend to occur with increasing frequency after the age of 30. Some of the possible problems related to not removing your wisdom teeth include:

A representation of a pericoronitis infection on a wisdom tooth


The most frequent clinical problem we see is pericoronitis, (a localized gum infection). Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.

An example of a cyst formation on a wisdom tooth

Cyst Formation:

Non-infectious diseases may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jaw bone that develop as a result of impacted teeth and slowly expand destroying adjacent jaw bone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.

An illustration of teeth crowding caused by a wisdom tooth

Possible Crowding:

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 Adjacent Teeth:

If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the second molar, can be adversely affected resulting in gum disease, bone loss around the tooth, and/or decay.

What If I Do Not Have My Wisdom Teeth Removed As A Teenager Or Young Adult?

As wisdom teeth develop, the roots become longer and the jaw bone more dense. When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the post-operative course can be prolonged and there is a higher complication rate. Treating these complications is often more difficult and less predictable than with a younger patient. Healing may be slower and the chance of infection can be increased. If your impacted wisdom teeth are not removed in your teenage years or early in your twenties and they are completely impacted in bone, it may be advisable to wait until a localized problem, such as cyst formation or periodontitis develops. In general, you will heal faster, more predictably and have fewer complications if treated in your teens or early twenties.

What Happens On The Day Wisdom Teeth Are Removed?

Most people prefer to be unaware of the experience when they have their wisdom teeth removed and usually decide to be sedated. You will be provided with appropriate anesthesiaoptions at the time of your consultation. All outpatient surgery is performed under appropriate anesthesia to maximize your comfort. Our office staff has the training, licensing, and experience to provide various types of anesthesia. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment with a well-trained, experienced staff.

On the day of your procedure, we ask that a parent or responsible adult accompanies you to the office and plans to stay with you the rest of the day. The procedure usually takes about 30-60 minutes. Recent advances in medicine and technology allow patients to undergo wisdom tooth removal in a manner, which promotes rapid healing and minimal post-operative discomfort. State-of-the-art sterilization and infection control techniques are used at all times.

It is essential that you have nothing to eat or drink (excluding prescription medications with a sip of water) for at least 6-8 hours prior to surgery. Having anything in your stomach can increase the risk for serious anesthetic complications, including nausea, vomiting, potentially aspiration pneumonia and death. Your procedure will be rescheduled if you have not followed these guidelines. When you are seated in the surgical suite, we will make every effort to make you as comfortable as possible. If you are going to be sedated, medication will be administered through an IV in your arm or hand. This is a quick and nearly painless procedure that ensures optimal delivery of your medication. Profound local anesthesia is then given as you are falling asleep to ensure that you are numb throughout the entire procedure. You will be drowsy for a significant portion of the day and should rest under appropriate supervision.

If your surgery requires stitches, these are usually the type that dissolve in 5-7 days and do not require removal. You may also notice a sensation of your gums feeling swollen and pulling away from your teeth or cheek. This is all part of the normal recovery process, and will usually subside over a seven day period.

When you get home and the local anesthesia wears off, you may require prescription pain medication. Dr. Pierse usually prescribes both a non-narcotic anti-inflammatory medication for moderate pain alternating it with a more potent narcotic for breakthrough pain to ensure patient comfort throughout recovery. The local anesthesia may last until the following day, and should not be confused with an injury to your nerve. We recommend starting your post-operative diet with clear liquids and a very soft diet, gradually increasing in substance as your body permits after approximately 7 days.

If you are given antibiotics and you take birth control pills, please be aware that the birth control pills might become ineffective and take appropriate precautions.

What Does Wisdom Tooth Removal Cost And Is It Covered By Insurance?

The fee for your treatment is determined by a number of factors. These may include the difficulty involved in removing your teeth and which type of anesthesia is best for you. During your consultation appointment, Dr. Pierse will review your imaging, complete an examination and determine the best option for anesthesia, before an accurate estimate can be provided. Every insurance company has a different policy regarding the extent of coverage for a given surgical procedure. The staff at Precision Oral and Maxillofacial Surgery will help you obtain maximum insurance coverage for your treatment.

What If I Have Questions Before Surgery?

At the time of your consultation, Dr. Pierse will discuss the relevant anatomy and course of treatment in great detail. If you have any questions after your consultation, please call the office to speak to one of our patient care coordinators. Furthermore, Dr. Pierse will be happy to address any last minute questions on the day of the procedure.

Contact Precision Oral and Maxillofacial Surgery online or by phone at Phoenix Office Phone Number (623) 518-2325.