Wisdom Teeth Extractions in Waterloo
Your third molars, which you likely know as your wisdom teeth, are usually the final teeth in your mouth to erupt. These four teeth, two on the top and two on the bottom, appear at the back of your mouth near the entrance to your throat, normally between the ages 15 and 25. These teeth earned their name from the thought they erupt at a time many consider to be an age of maturity or wisdom, so to speak.
Unfortunately, an individual’s mouth may not always have enough space to accommodate the correct eruption of wisdom teeth. If this happens to you, your wisdom teeth can become impacted in a painful and even harmful way in your mouth. Should you leave this untreated, impaction can result in infection, cysts, tumors, and damage to the other teeth in your mouth.
While you may think impaction is the same across the board, there are actually different degrees of impaction, based on the depth of your wisdom teeth in your jaw. Here are details to help you identify your specific situation:
Soft Tissue Impaction
In this degree of impaction, the top portion of your wisdom tooth, known as the crown, will have penetrated through your bone. However, your gum, which is also termed gingiva, is still covering the majority of your tooth’s crown (or the entire thing) and is in an improper position. Since the wisdom teeth are in the back of your mouth, they are difficult to clean. With this improper positioning, the food you eat can get stuck below the gum in this area. If left unchecked, this often results in an infection and/or tooth decay, which is characterized by a good deal of pain and swelling in the area.
Partial Bony Impaction
In this instance, your wisdom tooth will be in partial eruption, with a part of the crown still below your gum and surrounding jawbone. As this area is difficult to clean properly, as you know, infection remains a distinct possibility if you leave this unchecked.
Complete Bony Impaction
This is a more serious situation, since complete bony impact requires more complex extraction techniques, as your jawbone is encasing your whole wisdom tooth, though the tooth itself is still impacted.
Why You Should Extract Your Wisdom Teeth
Just because your wisdom teeth are not causing issues now does not mean they will remain that way in the future. The best way to determine the likelihood of problems with your wisdom teeth is to see your dentist and have a Panoramic, or full-head radiograph, to determine the position and angulation of the tooth in relation to your age to predict future concerns.
Extracting wisdom teeth at a young age prior to symptoms setting in has many benefits such as: smaller teeth, easier and more predictable surgeries, safer surgeries, and faster healing as a result of your younger age.
If you have any questions regarding your wisdom teeth please give your dentist a call and have them examined.
- Tooth Damage – The teeth right in front of your wisdom teeth, referred to as your second molars, bear the brunt of the harmful effects of impacted wisdom teeth. They see more cavities, possible bone loss, as well as periodontal disease (commonly referred to as gum disease).
- Disease – Although cysts and tumours are extremely rare results, they can occur around impacted wisdom teeth if the situation goes unchecked and untreated. This will show up on a panoramic radiograph, which is why dentists recommend them for all patients.
- Infection – If you do not take care of your impacted wisdom teeth, you run the risk of bacteria and food particles becoming trapped underneath your gum tissue, causing you to develop an infection. This can cause significant pain as well as danger to the health of your teeth.
- Tooth Crowding – Some dental professionals believe impacted wisdom teeth actually put additional pressure on your other teeth, which can result in misalignment, crowding, et cetera. It is important to note, however, not all accept this theory and scientific studies have not proven it. However, crowding and misalignment of your teeth can cause significant issues should you not receive treatment.
- Examination – Early examination and treatment are the key to the best results after a wisdom tooth extraction. The best time for early examination is normally during an individual’s mid-teen years. It is important, regardless, to have a thorough examination, since your dentist needs all the information they can get to provide you with the best options for your specific case, whether it be extraction or enhanced cleaning measures.
- The Procedure – Wisdom tooth extraction is quite the common procedure. It usually takes place in a dental clinic or an oral surgeon’s office. The reasons an oral surgeon may be involved are the difficulty of the case as well as if you require sedation. At Trillium Dental Centre, we provide local, conscious, and moderate sedation (sedatives and/or laughing gas), though oral surgeons in Waterloo can perform the extraction with general anesthesia or intravenous sedation.
The surgery does not require you to remain there overnight, although you will need someone to pick you up and take you home afterwards, as you will not be in a safe driving state. You will receive detailed post-operative instructions, which often include a prescription for a painkiller and potentially antibiotics to reduce the risk of infection during the healing process. These instructions are designed to manage discomfort, swelling, and make the healing process as comfortable as possible.
If you have any other questions and concerns, please do not hesitate to call to book an appointment.
How a Wisdom Tooth Extraction Visit Works
Wisdom teeth (third molars) are the last teeth to erupt, typically in the late teens or early twenties. About a third of people have all four wisdom teeth that come in normally and function for life. About a third have wisdom teeth that need to be removed because they are impacted (stuck below the gum), positioned at problematic angles, or causing problems with adjacent teeth. The remaining third have wisdom teeth that are present but not actively causing problems and may be monitored rather than removed immediately.
The decision to remove wisdom teeth is individualized. Indications for removal include partial eruption with gum infection (pericoronitis), damage to adjacent teeth, cysts or other pathology around the wisdom teeth, crowding pressure on the front teeth, recurrent decay because they are hard to clean, or radiographic evidence of damage developing even without symptoms. Not every wisdom tooth needs to be removed; consultation with your dentist clarifies what is appropriate for your specific situation.
When extraction is indicated, the procedure is typically straightforward and done in the dental office. Simple extractions of erupted teeth take 15-30 minutes per tooth under local anaesthetic. Surgical extractions of impacted teeth take longer (30-60 minutes each) and may involve removing a small amount of bone over the tooth, dividing the tooth into pieces for easier removal, and stitching the gum closed. Sedation is available for patients who would prefer it; deeper sedation or general anaesthesia is used for very complex extractions or for patients with significant anxiety.
When Wisdom Teeth Need to Come Out
Common reasons your dentist may recommend wisdom tooth removal:
- Impaction — the tooth is stuck below the gum line and cannot erupt fully
- Partial eruption with recurrent gum infection (pericoronitis) — the surrounding gum tissue keeps getting infected
- Damage or risk of damage to the adjacent second molar from pressure or decay
- Cysts or tumours developing around an impacted wisdom tooth (visible on x-rays)
- Recurrent decay because partially erupted wisdom teeth are difficult to clean properly
- Periodontal pockets developing around the wisdom tooth that affect the second molar
- Pressure on the front teeth contributing to crowding (though this is debated)
- Difficulty maintaining hygiene around the wisdom teeth despite consistent effort
- Pre-orthodontic planning where space is needed for tooth movement
- Future risk in patients planning to be in remote settings (military, frequent international travel) where access to emergency dental care would be limited
Asymptomatic wisdom teeth that are fully erupted, well-positioned, and easy to clean often do not need to be removed. Monitoring at regular cleaning visits is often the right approach for these.
Recovery and Aftercare
Recovery from wisdom tooth extraction varies with the complexity of the procedure. Simple extractions usually involve one to three days of mild discomfort, managed with over-the-counter pain medication, and a soft diet for two to three days. Surgical extractions of impacted teeth involve more swelling and discomfort — peak around days two to three, gradually resolving over five to seven days. Ice packs on the cheek during the first 24 hours help reduce swelling. Sleep with the head slightly elevated for the first few nights.
Diet for the first few days is soft, room-temperature foods — yogurt, smoothies (no straw — straws cause dry socket), soft pasta, scrambled eggs, mashed potatoes. Avoid hot, spicy, hard, or sticky foods that could disturb the surgical sites. Avoid smoking for at least one week (longer if at all possible) because it significantly increases risk of complications including dry socket, where the protective blood clot is lost and the bone is exposed. Gentle home care with prescribed antimicrobial rinses; avoid brushing directly on the extraction sites for the first few days.
Most patients return to normal activities within a few days for simple extractions, three to five days for surgical extractions. Sutures (when used) usually dissolve on their own or are removed at the one-week follow-up. Persistent pain getting worse rather than better after day three, persistent bleeding, or unusual swelling warrants a call to the office — most complications are minor when caught early.
Cost and Insurance Coverage
Wisdom tooth extraction cost depends on the position of the tooth (erupted, partially erupted, fully impacted), the complexity of the extraction, whether sedation is used, and whether all four are done at once. Trillium follows the current Ontario Dental Association Suggested Fee Guide for oral surgery procedures. We provide a written estimate at the consultation that includes all anticipated charges.
Most private dental insurance plans cover wisdom tooth extraction under their oral surgery benefits, typically at 70-80 percent. Sedation may be billed under a separate code and have different coverage. CDCP includes wisdom tooth extractions within its annual benefits framework. We submit pre-determinations to your insurer before scheduling treatment so coverage is clear in advance.
Frequently Asked Questions
Do all wisdom teeth need to be removed?
No. About a third of people have wisdom teeth that come in normally and never need removal. The decision is individualized based on the specific position, function, and any problems they are causing or are likely to cause.
What is dry socket?
Dry socket happens when the protective blood clot at an extraction site is lost too early, exposing the underlying bone. It causes significant pain that develops two to four days after the extraction. Risk factors include smoking, using straws, vigorous spitting, and certain medications. Treatment involves a medicated dressing that relieves pain while the area heals.
Can I get all four removed at once?
Yes, this is common practice especially under sedation. The trade-off is more swelling and longer initial recovery (one longer recovery instead of multiple shorter ones). Removing in pairs (upper and lower on one side, then the other) is another option some patients prefer.
How painful is the recovery?
Most patients describe discomfort as moderate for two to three days and manageable with over-the-counter pain medication. Pain that worsens after day three or does not respond to medication warrants a call. Some patients have minimal discomfort and barely use any pain medication; others have more significant discomfort. Individual response varies.
How long until I can eat normally?
Soft foods for the first two to three days. Gradual return to a normal diet over the following week. Avoid chewing directly on the extraction sites until the area is fully healed (usually three to four weeks). Avoid very hot, spicy, hard, or crunchy foods early in recovery.
Will I be conscious during the procedure?
Most wisdom tooth extractions are done under local anaesthetic with the patient awake but the area completely numb. Sedation (oral or IV) is available for patients who would prefer to be more relaxed. General anaesthesia is reserved for very complex cases or specific medical situations.