Wisdom Teeth / Oral Surgery / Tooth Removal in Celina and Prosper, TX
Preventing Crowded Teeth and RELIEVING Jaw Pain
Meet Your Doctor
"Removing Wisdom Teeth and relieving pain in patients experiencing discomfort and crowded teeth is one of the biggest reasons I love dentistry." - Dr. Rouse
"But my wisdom teeth aren’t hurting me"...
Why Would I Choose to Have My Wisdom Teeth Removed (Oral Surgery)?
The Following are Some of the Top 9 Reasons to Have Your Wisdom Teeth Removed:
- Crowding of Lower Front Teeth Before OR After Braces – Wisdom teeth begin to push the rest of your teeth forward to make room if your jaw is not large enough, even AFTER braces and permanent retainers are placed. Many patients require a second round of orthodontic treatment for one simple fact: they were never told what would happen. When a middle school or high school aged patient begins treatment, straightening wisdom teeth is almost impossible. After braces, flossing between lower front teeth gradually becomes more difficult for both the patient and the dentist/dental hygienist at routine cleanings.
- Food Trap – Collecting food between the wisdom tooth and the tooth in front of it, leads to a cavity from being unable to floss.
- Pericoronitis – The operculum, or swelling of the gums above the wisdom tooth, causing pain when biting from the tooth directly above it.
- Periodontal Disease around Wisdom Teeth – Increased pocketing around teeth leading to bone disease and loss is a cause even in otherwise healthy mouths for removal of Wisdom Teeth.
- A Cavity on a Wisdom Tooth – Wisdom teeth have the most unique anatomy in general, with deep grooves that may not be on other teeth in the mouth. Even the best tooth brushes can not get to the base of those grooves, leading to cavities on wisdom teeth causing toothaches and if not addressed quickly, leads to a difficult surgery from lacking tooth structure and surrounding bone, requiring sectioning for removal.
- Infection of a Wisdom Tooth – A cyst, or infection that has formed a protective wall around itself – You have a cyst forming (an infection that has formed a protective wall around itself). You have an infection that is affecting your sinuses above upper wisdom teeth
- Bad Breath – Bacteria that is causing bad breath.
- Proximity of Upper Wisdom Teeth Causing Sinus Pain – involvement from upper wisdom teeth into the sinus can be a symptom.
- Proximity of Lower Wisdom Teeth to the Inferior Alveolar Nerve (IAN) – this leads to complications if cavities are formed later on in your life. Make sure to ask your dental professional what concerns they may have about surrounding anatomy such as your sinus above the upper wisdom teeth, and your nerve bundle of the jaw called the INFERIOR ALVEOLAR NERVE in the lower jaw and potential risks or complications of dental surgery.
Why Would I Choose to Have A Tooth Extracted / Removed?
The 4 Main Reasons You May Need an Extraction Are:
1. Cavity – A Cavity So Large That Your Tooth is Not Restorable With a Dental Crown or Due to Lack of Remaining Tooth Structure is a common reason for extraction and placement of a dental implant.
2. Fracture of Your Tooth – From Something Eaten Leading to a Portion of the Tooth breaking, leaving the remaining tooth unrestorable with a crown and a root canal.
3. You Experience Tooth pain or Toothache – If your tooth is radiating lightning-type pain leading to an extraction of your tooth, a Dental Implant may be placed.
4. Infection of Your Tooth – If the surrounding bone of your natural tooth is eaten away by bacteria producing pus, an extraction and Dental Bone Grafting are typically placed to heal the site and a Dental Implant will be placed weeks to months later.
Am I a Candidate For Wisdom Teeth Removal?
If You Answer “YES” to Any of the Following, You May Need Your Wisdom Teeth Removed:
- Are you suffering from unbearable pain?
- Do you feel that your teeth are moving and you don’t know why?
- Do you have swelling or pain near your cheek?
- Repeatedly have headaches or sore throats?
- Do you have swelling or redness in your gums?
- Do you feel pain when you open your mouth or when you eat?
60-Second Wisdom Teeth Questionnaire
Why Choose Open Late Dentistry to Have My Oral Surgery/Wisdom Teeth Removal?
EXCEPTIONAL SERVICE WITH A NAME YOU CAN TRUST
Need Proof? Providing Unforgettable, Trustworthy Service is What We Do!…Just See What Our Celina, TX Patients Are Saying About Why We Are the #1 Best in the Celina/Prosper/Gunter Area
We Save You TIME!
We Can Perform Wisdom Teeth (4 Extractions) With Sedation as early as the next business day after your consultation!
A Great ATMOSPHERE
Our office is a family-friendly environment that offers tons of amenities and helpful staff along your dental journey!
From the moment you start the process, a friendly Celina face will always be there to answer your questions about treatment and walk you through the process of having your surgery completed
We Offer In-House 3D X-Ray Imaging for Patients Who Believe Their Wisdom Teeth May Cause Nerve or Sinus Damage
Small-Town CELINA CONVENIENCE
Have issues along the way? We are right next door, Celina Neighbor!
After Your Surgery, We Are Here to Answer Your Questions!
Big-City TECHNOLOGY in Your Back Yard
We Have Large TV’s that Can Show You Better Than Any Office Exactly How Your Wisdom Teeth Are Oriented and Where, So You Can Discuss With Our Doctor, Dr. Rouse, Any Reservations About Surgery or Complications That May Arise, Directly With Him.
Unlike some offices that use only a 2D image called a Panoramic Dental Radiograph, if we are concerned with possible nerve or sinus involvement, we can perform a 3D X-Ray image called a CBCT (Cone-beam computed tomography) in-house on the spot.
My Orthodontist is Recommending My Wisdom Teeth Be Removed...Why?
The Top 5 Reasons an Orthodontist Might Refer You to Our Office for Wisdom Teeth Removal Are:
- Possibility of Future Crowding after your permanent/removable retainers are placed
- Continued growth of your lower jaw, or mandible, after orthodontic treatment is completed.
- Class III, or underbite, present
- Uneven bite at the end of treatment on the second molars already showing the need for removal of widsom teeth
- Your wisdom teeth poking thru the gums during your orthodontic care, but brackets and wires are on.
Wisdom Teeth Post Operative Care Instructions
Post-op Care for Dental Implants Immediate Postoperative Care Care should be taken in the immediate postoperative period to minimize contact with the implant.
Aside from normal hygiene, it is best to completely leave the implant alone for the first 2 weeks after placement.
You may want to limit foods to softer items and chew in an area away from the implant during the 10 to 12 week integration stage.
Bleeding Minimal bleeding is expected after implant surgery.
Bleeding after surgery may continue for several hours.
The best way to stop bleeding is to fold 2 pieces of damp gauze over the extraction site and gently bite for 30-60 minutes making sure pressure is being applied to the extraction site.
Rest quietly with your head elevated.
If bleeding continues, use gauze for an additional 30 minutes.
Bleeding should always be evaluated by looking directly at the surgical site.
Pink or blood-tinged saliva may be seen for 2-3 days following the surgery and does not indicate a problem.
Suture material may last 2 to 3 days and should be left alone.
You will be asked to return to the office for a 2 week follow-up appointment.
Any sutures remaining at that time may be removed at the surgeon’s discretion.
Do not pull or cut the sutures yourself.
Swelling – Swelling is the body’s normal reaction to surgery and healing.
The swelling will not become apparent until 24 hours after surgery and will not reach its peak for 2-3 days.
After this time, the swelling should decrease but may persist for 7-10 days.
Swelling may be minimized by the immediate use of ice packs.
Apply the ice packs to the outside of the face 20 minutes on and then 20 minutes off while awake for the first 24 hours.
After 48 hours, begin use of a warm, moist compress to the cheek.
Medication / Pain – Unfortunately, most oral surgery is accompanied by some degree of discomfort.
If you do not have an allergy to non-steroidal anti-inflammatory medications (Ibuprofen, Motrin, Advil) we recommend taking this prior to the local anesthetic wearing off.
More severe pain may require a narcotic pain medication.
Alternate Ibuprofen (3 tablets / 200mg each) and the Tylenol #3 medication every two hours if needed.
Once you feel like you can stop the narcotic, use Ibuprofen or Tylenol.
You may also be prescribed an antibacterial mouth rinse which should be used twice daily in the first two weeks following implant surgery.
All medications should not exceed the recommended dosage.
Diet After I.V. sedation – Start with liquids.
While numb, patients should avoid hot liquids or foods.
Patients may have applesauce, pudding, or jello.
Once numbness wears off patients can progress to solid foods, chewing away from the surgical sites.
Oral Hygiene – The best way to prevent infection and ensure healing is to keep your mouth clean.
Clean your mouth thoroughly after each meal beginning the day after surgery.
Use a soft bristle toothbrush and toothpaste after meals and at bedtime.
Should bleeding resume after brushing, repeat the use of gauze as described above.
Do not rinse your mouth the day of surgery.
Activity For the first 48 hours you should rest and relax with no physical activity.
After 48 hours, you may resume activity as tolerated.
Healing Bad breath is common and will disappear as healing occurs.
Two to three days following surgery, white, possible hard tissue may be seen in the surgical site.
This signifies normal, healing tissue.
It’s not unusual to see the silver healing cap appear through gum tissue following procedure.
Antibiotics If an antibiotic is prescribed, take the tablets or liquid as directed.
Take the entire prescription until gone.
Antibiotics can be given to help prevent infection.
Make sure to call the office if a rash or other unfavorable reaction occurs.
Foods to Drink and Eat While Numb AVOID carbonated beverages and hot liquids for 48 hours Drink:
Eat: Water Applesauce Juice Jell-O Ice Chips Pudding Popsicles Yogurt Milkshake (no straw) Add Soft Foods When Numbness is Gone Mashed Potatoes Pasta Eggs Pancakes Creamed Cereals Soups (be careful-not too hot) Increase Diet as Tolerated Other Considerations Your surgeon will notify you and your dentist when your implant is ready for restoration; typically 10 to 12 weeks following implant placement.
What is Dental Bone Grafting and Why Would I Need It?
The best situation for an implant that will last a long time is to have enough supporting bone around it.
Our standard of care is a 3D X-Ray to find out the area future implant will be placed and custom-plan the length, width, and type of dental implant you will need.
We then know before ever performing the surgery where we would need to graft. This saves on cost and lets us know what type of graft is right for you.
Most commonly performed in addition to tooth extraction, Dental Bone Grafting aids in the re-growth of new bone by providing a scaffolding into which material from the patient’s own body can grow and form a ridge for a future implant or help maintain the height of bone the patient had prior to extraction.
Where Does Dental Bone Grafting Come From?
Bone Grafting Can Come From Several Different Sources Including:
The Patient’s Own Donor Site (We Try To Avoid This At All Costs)
A Xenograft from a Bovine Source
An Allograft From A Lab
The new bone growth strengthens the grafted area by forming a bridge between the existing bone and the graft material. Over time, new bone growth will replace much of the grafted material.
Post Operative Care For Dental Bone Grafting
After Care Instructions for Bone Grafts
Your bone graft is made up of many particles. You may find some small granules in your mouth
for the first several days. This is normal. The socket is over packed to allow for the loss of a
small amount of particles. It is normal to have some of them come out of the graft site and into
The following can be done to minimize this:
Rinsing/mouthwash: Do not vigorously rinse or spit for 3 to 5 days. Do not use any over-the-counter mouth wash during any part of the healing process. You may rinse with warm salt water
if desired or a prescription mouthwash if given. If a partial denture or a flipper was placed in
your mouth, be very careful removing and placing it while healing.
Sutures: Most times the sutures that are placed are dissolvable sutures that will dissolve in 10-14
Avoid pressure: Do not apply pressure with your tongue or fingers to the grafted area because
the material is movable during the initial healing.
Avoid pulling/poking area: Do not lift or pull the lip to look at the sutures; this can actually
cause damage to the wound site and tear the sutures. Avoid poking the site with your tongue.
Food: Avoid chewing hard foods on the graft sites. Chewing forces during the healing phase can
disrupt the healing process around the graft.
Smoking/Alcohol: It is highly recommended to discontinue smoking or alcohol for a minimum
of one week after your procedure.
Follow up (1 week): You should have an appointment for a one week post op visit. This allows
us to evaluate how you are healing so that we can determine when your next phase can begin.
Wisdom Teeth Removal F.A.Q.'s
Wisdom teeth extractions come in 5 codes:
Simple Extraction (baby teeth and teeth that are fully erupted). These range from $125-$250.
Soft Tissue Extraction - Teeth covered just by gum tissue can range from $150-$275.
Partially Impacted (partly covered by bone) - $200-$300
Fully Impacted (fully covered by bone) - $250+
Insurance benefits and fee schedules from participating insurance plans play a part. For cash patients, discounts are applied for full payment up front and procedures done at the same time.
Wisdom teeth are classified and categorized by what would be billed to insurance, depending on the level of impaction into the bone.
If contacted with a PPO Dental Policy, we are contracted at those rates.
Most patients require sedation, as well, which is an additional fee.
Cash prices range from $150 to $499 without our In-House Membership Program.
We recommend an evaluation to see what the type of extractions would be.
The Top Reasons for removal include: Crowding of lower front teeth and decay, or cavities, on the teeth in front of your wisdom teeth.
Pain from the wisdom teeth themselves is only one reason for removal.
Paresthesia is a loss of feeling on part of your face after Wisdom Teeth Removal if Part of Your Roots Have Wrapped Around Your Lower Nerve that Provide sensation to your lower teeth and soft tissue to the chin and lip.
We evaluate and describe to patients the possibility for this to happen if they wait too long (sometimes 3-6 months for the next school break) as the tooth's roots continue to form around the patient's nerve.
The recommendation of our doctor is removal when a panoramic x-ray shows 2/3 root formation on a tooth.
4 Types of Medications are Prescribed at Our Office For Post-Operative Care:
- Antibiotics - If teeth are sectioned for removal or teeth were infected
- Pain Pills - Tylenol #3 is used for pain, designed to be alternated with Ibuprofren or Advil to stay ahead of the pain before the local anesthetic wears off. Start early for at least the first 24 hours.
- Medrol Dose Pack - This is for swelling, or "Chipmunk Cheeks". Along with ice, and for patients without a suppressed immune system, a steroid helps with inflammation, which can cause limitation of opening of the jaw and ability to eat.
- Anti-Emetic for nausea, as needed.
However, ice will be your best friend as it is the cheapest alternative and has no side effects.
Most recommendations will be based on what you can eat, not how often.
It is recommended to continue to eat regularly to keep up your strength so your body has the proper vitamins and minerals to properly clot the extraction sites and form gum tissue where the tooth was removed.
You will most likely be able to eat softer foods, attempting to avoid the surgical sites. Sutures may dissolve on their own or you may have to visit the office to facilitate removal. But, the general rule of thumb is to avoid hot foods that may dissolve the blood clot. Your dentist or oral surgeon may provide you with a syringe to irrigate the area and keep out unwanted food particles.
If you experience nausea or vomiting, your dental professional may prescribe an anti-emetic
If you have what feels like a splinter in your gums, it could be a possible bone spicule.
A postoperative visit is in order if it requires removal.
If you have partial numbness or tingling days after the surgery on your lower lip or cheek area, this may be from PARESTHESIA, which could be from a break in a nerve fiber during the removal of a lower wisdom tooth.
At the very least, you will want to meet your doctor and ask any questions about concerns you may have. You will also want to let them know about your medical history and list of medications.
In addition, you will want to let the oral surgeon or dentist know about your family’s history with wisdom tooth removal or if you have any complications with getting numb for dental treatment or poor outcomes during previous dental extractions.
If you plan on sedation, a driver will be required to transport you on the day of surgery and appropriate accommodations should be made so you can take off the next 24-72 hours depending on how the surgery is projected to go.
Some patients are able to return the next day to work.
However, depending on your experience with other dental work and surgeries in the past, it may be best to take off of work for at least one business day.
Wisdom teeth removal by a skilled surgeon or dentist takes less than one hour.
The majority of time is spent taking vital signs and going over the instructions for after the care.
Part of preoperative care is making sure that patients who require sedation are completely comfortable before beginning administration of anesthetic.
The surgery uses a series of sharp scalpel blades, forceps, and instrumentation after local anesthetic has kicked in to remove the tooth.
Sometimes a dental drill is required to facilitate faster and more efficient removal.
In these cases, bone graft or barriers may be placed with suture material for better healing post operatively.
A final panoramic x-ray is typically performed to ensure complete removal of all teeth.
Ice packs are placed and gauze given to limit swelling and stop bleeding.
Most dentists recommend impacted wisdom teeth should be removed when the roots are between ⅓ and ⅔ formed.
Waiting until later is more difficult and increases the risk of complications like injury to your nerves and sinuses.
If they are causing you a lot of problems or pain as they come out, then it may be time for the dentist to surgically remove them.
If you are unsure, it is better to come in for a consultation which is always a simple procedure.
In the first consultation, the patient’s mouth is examined, x-rays are taken.
When a wisdom tooth forms in the mouth but never breaks through the gums, it is referred to as impacted.
One that emerges only part way is called a partially impacted wisdom tooth.
In both cases, the tooth often grows at an angle because of lack of space in the mouth.
Alveolar osteitis, or "Dry Socket", is more painful than the extraction itself in most cases, when it occurs. Extracted teeth take weeks to fully heal, depending on the size of the extraction site. And they heal by a different method than a cut (side-to-side vs. from the bottom to the top). By placing a "Dry-Socket Barrier" in the site at the time of extraction, our office provides a scaffolding for blood vessels to grow into and form bone. It also helps protect the nerve underneath and the sinus for upper teeth.