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Wisdom Teeth Extractions

First Coast Oral and Maxillofacial Surgery

Wisdom Teeth Removal

The removal of wisdom teeth is a routine procedure in our office, but it probably doesn’t feel that way to you. For many of our patients, just hearing the words “surgery” and “extraction” tends to bring up some fears. Dr. Skigen and Dr. Massaro want you to know that wisdom teeth extraction is safe, quick, and comfortable.

What are wisdom teeth, anyway?

We each get three sets of molars during our lifetime – the first molars arrive at age six, the second at age 12, and the third molars develop during the late teens and early twenties. Because it is during this age that children become wiser and transition into adulthood, we refer to the “third molars” as “wisdom teeth”.

Why is timing important?

You may have noticed that many of your friends are having their wisdom teeth pulled out too. Why? That’s because there is an optimal (yet fleeting) opportunity between the ages of 17-25 when the tooth roots haven’t fully formed yet. Thus, the risk of damaging nearby nerves, bones and teeth during this time is significantly less.

The Extraction Process

  • An incision is made in the gum tissue to expose the tooth and bone.

  • If any bone is blocking access to the tooth root, it is removed.

  • The tooth is divided into sections - if it's easier to remove in pieces.

  • The tooth is removed.

  • The site is cleaned of any debris from the tooth or bone.

  • The wound is stitched closed to promote healing, though this isn't always necessary.

  • Gauze is placed over the extraction site to control bleeding and to help a blood clot form.

Four Different Types of Impacted Wisdom Teeth:

Your mouth was designed to hold 28 teeth, not 32. By the time your wisdom teeth start to grow, those 28 slots are already filled, making it difficult for them to grow in properly. That’s why 9 out of 10 people find themselves with at least one impacted wisdom tooth that requires extraction. Even when properly positioned, wisdom teeth can easily become infected.

Vertical Impaction


This happens when the tooth is erupting and growing vertically. It’s very likely that this type of impaction will erupt normally and most cases don’t require surgery to remove them. However, sometimes the tooth may be too close to its neighboring molar and can damage the tooth by crowding or damaging it.

Distal Impaction


This happens when the tooth is angled towards the back of the mouth. This is the most uncommon impaction. The decision to remove it is mostly based on the angle and whether the tooth will eventually grow to impact the jaw bone.

Mesial Impaction


This is the opposite of Distal impaction, as the tooth is angled towards the front of the mouth. This is the most common type of tooth impaction and is commonly partially erupted. Typically the back of the tooth erupts and the front is pushed against the front molar. 

Horizontal Impaction


This is the most painful type of impaction as the tooth or teeth grow in sideways, fully beneath the gums, pushing forward on the molar in front of it. This type of impaction will likely cause damage to surrounding teeth and unbearable pain if it isn’t taken out. 

If you have been putting off wisdom teeth surgery, give us a call – we can give you the calm, safe, comfortable experience you are looking for!


Choosing the Right Oral Surgeon for your Child

As oral surgery specialists with extensive training and experience, we are able to offer a different kind of “wisdom teeth experience” to our patients and their families. We are with you every step of the way and pay extra attention to the most critical parts of your child’s care, including:

  • We offer multiple forms of Anesthesia and IV Sedation.

  • Compassion and comfort to make the experience as pleasant as possible.

  • Home care and after-hours contact information.

  • A thoughtful surgical strategy to minimize the need for invasive techniques.

  • Careful consideration of timing to ensure the easiest recovery possible.

Learn more about our doctors:

Anesthesia and Sedation Options

Anesthesia | Several methods of anesthesia are available. The method of anesthesia that is chosen for or by a patient depends upon the nature of the surgical procedure and the patient’s level of apprehension. Learn more about Anesthesia here.

Sedation | Our office offers our patients the option of Intravenous Sedation or Dental Intravenous Anesthesia or to some it is referred to as “Twilight Sedation” for their dental treatment. Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed under intravenous sedation. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”. Learn more about IV Sedation here. 

Learn more about our Anesthesia and Sedation Options!


The Trouble with Wisdom Teeth

As with any surgical procedure, there are some possible complications associated with the removal of the third molars. However, since the procedure has been very well tested, these complications (nerve injuries, fractures and injury to the joint) are very rare, and, if the surgery is performed at an early age, the risk is even less.

Are you still feeling unsure? Consider this: Wisdom teeth that are not removed can cause the following problems throughout your life:



Your gums can become infected, a condition known as “pericoronitis”, due to the wisdom teeth unsuccessfully trying to push through the gum tissue. This condition, which causes pain, swelling and problems swallowing, can recur periodically.

Cysts and Benign Tumors:


Cysts are fluid-filled pockets that can form inside the jawbone when wisdom teeth are impacted. They can be very damaging and difficult to treat as they destroy jawbone and even neighboring teeth.

Crowding and Alignment Issues:


It should be no surprise that impacted wisdom teeth crowd your smile, causing misalignment issues, even if you have had braces

Damage to Nearby Teeth:


Wisdom teeth are notorious for damaging their neighbors by making it difficult to practice good hygiene in the area. This often results in decay, gum disease and sometimes bone loss.

If you have been putting off wisdom teeth surgery, give us a call – we can give you the calm, safe, comfortable experience you are looking for!

The Cost of Wisdom Teeth Removal

The cost of wisdom teeth removal varies depending on several circumstances (positioning, level of impaction, number of teeth) that are unique to your teen’s case. We will discuss all costs with you upfront and can help you determine whether your insurance offers any benefits for the procedure.

Because it is so common for wisdom teeth to cause problems such as infection, pain, damage to neighboring teeth and, in rare circumstances, cysts and tumors, it is generally recognized as standard practice to remove them in most people during the late teens and early twenties, before the roots have fully developed. Waiting to remove them increases the likelihood of problems and complications should they need to be removed down the road.


Frequently asked questions

Is wisdom tooth removal painful?

You shouldn't feel any pain when your wisdom teeth are removed because the area will be numb. However, if you do feel pain during the procedure, tell your oral surgeon so they can give you more anaesthetic.

How long does it take to recover from a wisdom tooth extraction?

Most people fully recover from wisdom teeth surgery in three to four days. If your teeth were impacted or came in at an awkward angle, it could take a full week to recover. The wound left behind after surgery won't be completely healed for months.

When should wisdom teeth be extracted?

Most oral surgeons think it's best to have impacted wisdom teeth extracted before you're 20 years old, because it's easier to take them out when the roots and bones of your teeth are softer and not fully formed. Also, when you're younger, you tend to heal faster. You may never have any problems with your wisdom teeth, especially if you're already older than 30.

Should I get all my wisdom teeth pulled at the same time?

Because of their location in the back of the mouth, wisdom teeth are frequently difficult to keep free from plaque and food and might trap harmful bacteria that can contribute to gum disease, decay and infection. Even wisdom teeth that are buried under the gum tissue may cause these same issues. But why not adopt a wait-and-see approach to wisdom teeth coming in (or yet to erupt) that haven’t caused any trouble? Here are some items to consider:

  • Typically, it is easier to remove wisdom teeth in younger patients because the roots of the wisdom teeth are not completely formed, surrounding bone is softer and there is less chance of damaging nearby nerves or other structures. Overall risk of surgical complications is more common in adulthood.
  • Each visit will take more of a patient’s time, including time off from school or work.
  • Each additional visit for a tooth extraction requires an additional healing period with a restricted diet.
  • Properly caring for any remaining wisdom teeth requires routine inspections and X-rays.
  • It can be more expensive to visit an OMS multiple times for additional wisdom tooth extractions should they become problematic later.
For these reasons, you and your oral surgeon should discuss whether you should have all four wisdom teeth extracted at the same time. Click here to read more. American Association of Oral and Maxillofacial Surgeons

What are signs you need your wisdom teeth pulled?

  • Jaw pain and stiffness.
  • Pain at the tooth site.
  • Swelling in the gum tissue.
  • Evidence of gum disease at the back of the mouth.

Can you take all 4 wisdom teeth out at the same time?

Every case is different, some taking longer than others. In most situations it will be recomended to remove all four in one procedure - it will usually take less than 1 hour for treatment to be completed.

Do you still have questions? Schedule an Appointment Today!