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Wisdom Teeth Extractions


Wisdom Teeth

Most people start getting their third molars (also called wisdom teeth) when they reach their late teens or early twenties. In many cases, the jaws are not large enough to accommodate these teeth and they remain under the gum (impacted).


When a tooth develops, it travels to its appropriate position in the dental arch. If the path to eruption through the gum is prevented due to the size of the jaw, the tooth will become partially or totally blocked (impacted).


Serious problems can develop from partially blocked teeth such as infection, and possible crowding of and damage to adjacent teeth. More serious complications can develop when the sac that surrounds the impacted tooth fills with fluid and enlarges to form a cyst, causing an enlargement that hollows out the jaw and results in permanent damage to the adjacent teeth, jawbone and nerves. Left untreated, a tumor may develop from the walls of these cysts and a more complicated surgical procedure would be required for removal.

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.



Generally, after surgery the patient experiences some swelling and discomfort. However, with personalized postoperative instructions and medications, Dr. Skigen can reduce the possible discomfort following surgery. If you should have any problems such as excessive bleeding, discomfort, or difficulty in opening your mouth, call our office immediately for further instructions or additional treatment recommendations.

Four Different Types of Impacted Wisdom Teeth:

When a wisdom tooth erupts through the gums and into the open it is known as an eruption. However, when a tooth doesn’t fully grow in, it is “impacted” – usually unable to break through the gums because there isn’t enough room.

There are four common types of impaction we see at First Coast Oral Surgery. Understanding the different types of impacted wisdom teeth is helpful. Depending on which type you experience, it may or may not require surgery and removal.

Vertical Impaction


This happens when your third molar puts pressure on the underside of the molar in front. Vertically impacted wisdom teeth can normally be extracted using a local anesthetic. IV sedation would only be required in the case of an extremely nervous patient.

Distal Impaction


Distal impaction is the least common of the four types of impactions and is the exact opposite of a mesial impaction – the tooth is angled toward the back of the mouth. Depending on the severity of the impaction, IV sedation or even general anesthesia may be required to undergo the surgery.

Mesial Impaction


Mesial impaction is the most common type of wisdom tooth impaction, in which the tooth is angled toward the front of the mouth, pushing against the molar in front of it.  Mesial impactions most often lead to a partial eruption, where only the bottom of the tooth pokes into the gums.

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!

Type of Impaction

Choosing the Right Doctor for You

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:

What is the right time to remove your Wisdom Teeth?

The key to timely attention to third molars is regular x-rays of the mouth. With the help of these pictures Dr. Skigen can frequently predict if the wisdom teeth are going to cause trouble, either in the near future or later in life. If so, chances are Dr. Skigen will recommend their removal rather than wait for trouble to occur. Removal is easier in younger patients. Roots are not yet fully developed and the bone is less dense. Recovery is also easier if the surgery is done at an earlier age. Please call us with any questions! We have three conveniently located First Coast Offices around North Florida, Jacksonville, FL, Amelia Island, FL, and Lake City, FL - every office is dedicated to the success of your oral health!

Anesthesia and Sedation Options

The vast majority of patients have their wisdom removed right in one of our offices - Jacksonville, FL, Lake City, FL, or Amelia Island, FL. Improvements in surgical technique and sedative medications allow patients to have their impacted wisdom teeth removed comfortably and efficiently in a pleasant environment that is far less costly and intimidating than the hospital setting. There are several anesthetic options available to provide patients with the optimum in comfort during their surgery and minimize the postoperative side effects. You will have the opportunity to discuss these options, as well as your individual needs and concerns

with Dr. Skigen at the consultation appointment.


General Anesthesia | General Anesthesia affects the brain as well as the entire body. It is for patients who are extremely anxious or for procedures that can be uncomfortable. It is given thru an IV and combinations of medications provide the effects. With general anesthesia, you are completely unaware and wake up with the procedure being finished. Patients who choose this option are required to not eat or drink anything for eight hours prior and have a responsible adult to care for them and drive them home.


Local Anesthesia  | Without a doubt every patient’s anxiety starts with “the shot”. Of course, it is better to be numb than not during the procedure, so we make every effort to alleviate any discomfort. We start with a topical anesthetic that pre-numbs the injection site. We wait adequate time for the anesthetic to work and test the area before beginning any procedure. When the lower jaw is anesthetized the patient should feel tingling or numbness in the lower lip. When the upper jaw is anesthetized, the upper lip or nose might feel numb or tingling.

Learn more about our Anesthesia and Sedation Options!


The Trouble with Wisdom Teeth

There are unhealthy circumstances that might prompt your dentist to recommend removing your impacted wisdom teeth:



Impacted wisdom teeth often become decayed or infected because they're hard to reach with your toothbrush. Bacteria around the impacted tooth can lead to gum disease and enter your bloodstream, adversely affecting your heart and other organs of your body.

Cysts and Benign Tumors:


Fluid-filled cysts or tumors occasionally form around the bottom of an impacted wisdom tooth, causing damage to the jawbone, nerves in the area and nearby teeth.

Crowding and Alignment Issues:


Impacted wisdom teeth crowd your mouth, causing misalignment issues as they erupt and mature, even if you have had braces

Damage to Nearby Teeth:


Healthy teeth can be damaged as impacted wisdom teeth push against your neighboring second molars.

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!

Do you still have questions? Schedule an Appointment Today!

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