Tri-Cities Oral & Facial Surgery

What Are Wisdom Teeth?

The wisdom teeth are the third set of molars that erupt in the very back of the mouth. As humans have evolved and dental care has improved, these extra molars are no longer necessary and can be safely removed to prevent future problems. These teeth typically emerge during the mid-teens to early 20s.

In some cases, the wisdom teeth grow straight and fit snugly alongside adjacent teeth without any problems. In other cases, the jaw is too small to accommodate them, they grow at an angle, or they fail to fully break through the gums, which can lead to pain, infection, or damage to adjacent teeth. Impacted wisdom teeth that never erupt are at risk for the development of cysts later in life, which can compromise the jaw bone and require larger surgeries to address.

When Is Wisdom Teeth Removal Recommended?

Wisdom tooth removal is easier when the teeth first develop because the roots are shorter and straighter, and the jawbone is less dense. Younger patients also tend to recover more quickly with fewer complications. However, wisdom teeth can be removed at any age if problems develop. Over 1/3 of people who elect not to have their wisdom teeth extracted early will invariably need 1 or more of their wisdom teeth extracted later in life due to pain, infection, or pathology.

Why Get Your Wisdom Teeth Removed Early In Life?

Getting your wisdom teeth extracted at a young age can prevent the following complications:

  • Discomfort and sensitivity around the impacted teeth
  • Infection associated with the impacted teeth
  • Increased risk of cavities in the back molars
  • Damage to adjacent teeth
  • Inadequate space for proper orthodontic therapy
  • Cysts within the jawbone
  • Increased risk of nerve damage from extractions later in life due to roots growing closer to the nerve
  • Longer healing time and increased pain from extractions later in life due to increased bone density around roots and slower regenerative healing rate with age.

Why Are Wisdom Teeth At Greater Risk for Infection?

Often, wisdom teeth are contaminated with oral bacteria before they are visible in the mouth. For impacted teeth, this can go on for years, leaving the patient prone to cavities or gum disease around the wisdom tooth and adjacent molar. This can result in pain and damage to the jaw bone and teeth in this area. If left untreated long enough, the infection can spread leaving the patient prone to more serious infections and abscesses involving the face and neck.

Even when these wisdom teeth erupt in an optimal manner, due to their position deep in the mouth, it is often very challenging to maintain proper hygiene for them. It is also challenging to have routine dental work performed on them. If a cavity does form in a wisdom tooth, the location and lack of visibility that far back in the mouth pose a challenge for dental providers to render adequate care to mitigate the infection. If an infection develops in the gums around a wisdom tooth or a cavity develops in a wisdom tooth, that tooth often needs to be removed.

If you are experiencing discomfort or are concerned with how your wisdom teeth are developing, Dr. Smiley can evaluate them to determine if extraction is recommended. He carefully reviews the risks and benefits so you can make informed decisions for the future of your oral health.

Our Wisdom Tooth Removal Process

At Tri-Cities Oral & Facial Surgery, we take the time to listen to your concerns in order to create a personalized treatment plan that fits your needs and goals. Dr. Smiley begins by asking about what made you seek care and any pain you may be experiencing. Next, he will:

  • Examine your teeth and take any necessary imaging to identify any signs of disease and see how your wisdom teeth are developing.
  • Review the results and let you know if extraction is recommended, going over the benefits and potential risks.
  • Discuss options for anesthesia, ranging from a local anesthetic to light sedation to general anesthesia. The goal is to keep you as comfortable and pain-free as possible to create a more positive experience.
  • Answer any questions you may have and go over pre- and post-op instructions to help you prepare for surgery and feel more confident about treatment.

Wisdom teeth removal is a very common procedure performed by oral surgeons every day. Our team is highly trained in safely administering anesthesia and monitoring you throughout surgery and recovery. Dr. Smiley will use the results of his exam and imaging to design an individualized treatment plan based on the position of your wisdom teeth, whether they are completely or partially impacted, and how developed the roots are.

Once the anesthesia has been administered and the area is numbed, he will expose the tooth if it has not fully erupted through the gums, remove a small amount of surrounding bone to reach the tooth root if necessary, and remove both the crown and root. It may be removed all at once, or the tooth may be removed in pieces. The empty socket will be cleaned, and the gums will be sutured (stitched) to close the gums over the socket. A gauze will then be placed over the wound to bite on. Once you are awake and alert, a trusted adult will be allowed to take you home.

Wisdom Teeth Post Op Recovery

It is normal to experience some swelling or bruising following surgery. You can apply an ice pack wrapped in a towel to your cheek at 20-minute intervals to help manage any discomfort. The swelling should subside within a day or two. Many patients find that over-the-counter ibuprofen and acetaminophen are enough to manage any pain once the anesthetic wears off, but you may be prescribed pain medication as well to ensure you are comfortable.

If you experience any bleeding, bite down firmly on a piece of clean gauze until it stops. This may take 20-30 minutes of continued pressure. You will want to keep the gauze in place to protect the empty socket until a blood clot has formed.

Keep drinking water to stay hydrated, but avoid using a straw, as the suction can dislodge the blood clot and cause a dry socket. You can eat after surgery but should choose soft foods that require little to no chewing, such as ice cream, yogurt, pudding, or applesauce. Within a day or two, you can begin eating firmer foods as tolerated, but chew away from the surgical site if possible.

After the first 24 hours, you should gently rinse your mouth with a warm salt water solution after meals and resume carefully brushing your teeth. If you have any questions or concerns, do not hesitate to contact Tri-Cities Oral & Facial Surgery. We want to ensure you have a smooth, safe recovery.

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5 STAR REVIEWS Read Patient Reviews

“When I saw Dr. Smiley he was able to put my dental anxiety at ease. I’ve struggled with this anxiety since childhood, but Dr. Smiley’s bedside manner made me feel comforted and safe. I knew I would be well cared for with him.”


Tri-Cities Oral & Facial Surgery Dental Implants & Wisdom Teeth in Richland, WA

Richland | Pasco | Kennewick

Tri-Cities Oral & Facial Surgery is proud to serve patients throughout Richland, Pasco and Kennewick, WA and surrounding areas. We offer a wide range of oral surgery services including dental implants, wisdom teeth removal, tooth extractions, and bone grafting, as well as sedation options to enhance your safety and comfort. Centrally located near Pasco and Kennewick, WA, we are the convenient practice to visit for your wisdom teeth, dental implant and other oral surgery needs.