Wisdom Teeth Removal and Cost

Having your wisdom teeth removed is an unofficial rite of passage. It's a step beyond the childhood experience when your teeth fell out and a "fairy" gave you a quarter in exchange. Wisdom teeth removal coincides with early adulthood and is one of the most common procedures in the field of modern dentistry. However, as with any medical operation, it's important to inform yourself and understand the procedure as well as the risks and costs involved. 

What Are Wisdom Teeth?

Wisdom teeth are the third and final set of molars to form in humans. Molars are the large, flat teeth in the back of the mouth used to grind food while eating. Wisdom teeth get their name from the time when they appear - most humans develop them between ages 17 and 25.

Wisdom teeth removal costs are a common expense for parents and young adults.

Why Do Humans Have Wisdom Teeth?
Wisdom teeth were necessary for emerging humans as part of their hunter-gatherer lifestyle. The food these individuals ate was tougher to consume than modern day-meals full of soft starches and tenderized meats. Our human ancestors mainly ate a diet full of raw and unprocessed seeds, fibers and tough meat. Their longer jaw bones were able to accommodate 32 teeth, allowing them to handle these rough diets.

As humans developed from their ancestors, they had four sets of three molars spread across the upper and lower jaw. Since adult teeth fell out periodically, there was plenty of room for wisdom teeth to grow. Unlike other mammals, however, the human brain developed at a rapid rate over a short period of time. This forced the jaw to narrow in order to remain connected to the lower part of the skull. Unfortunately, despite the narrower jaw, the size and number of teeth in the average human did not change. Thus, as wisdom teeth came in later in life, they had to force their way up to make room. What's more, as dentistry and oral hygiene grew more advanced, people lost fewer teeth. As a result, many young adults today have problems with their wisdom teeth and get them removed.

Does Everyone Have Wisdom Teeth?
Although most modern humans have four wisdom teeth, some have fewer or none altogether. According to Live Science, approximately 45 percent of Inuit persons and 40 percent of Asian Americans lack at least one wisdom tooth. Only 11 percent of African Americans and about 10 to 25 percent of Americans of European heritage can say the same.

Why Are Some People Missing Their Wisdom Teeth?
Per Live Science, a mutation originating several hundred thousand years ago accounts for the lack of wisdom teeth in some people today. Researchers believe the mutation first occurred in China between 300,000 and 400,000 years ago, as a jawbone from this location and time period never developed wisdom teeth. This is the oldest such jawbone on record.

Scientists speculate that as the human jaw decreased in size, the resulting wisdom tooth pain and increased rates of infection caused those without the mutation to reproduce less. Humans with the mutation therefore increased their percentage in the overall population over time.

Some scientists expect wisdom teeth will disappear completely as humans continue to evolve. The teeth have decreased in size for over a century, and a study on mice supports the hypothesis that humans will eventually stop growing third molars. Researchers discovered that tissue in the jaw is responsible for triggering tooth development. As the tooth grows, it secretes a substance that slows the development of the teeth around it. Thus, the first molar inhibits the growth of the second which does the same to the third. As man's early ancestors had larger molars that have decreased in size throughout the years, scientists expect the third molars will eventually fade away.

How Much Does Wisdom Teeth Removal Cost?

The price of oral surgery varies depending on your surgeon, the number of teeth you need removed and whether or not you have insurance. A simple procedure on one tooth can cost as little as $99, whereas removing an impacted tooth can cost more than $350.

How Can I Save Money On My Wisdom Teeth Operation?
Always discuss expenses with your dentist before agreeing to surgery. He or she may know of ways to cut costs or can help you establish a payment plan. You should also call around or consider traveling to a cheaper area. Most accredited dental schools also provide wisdom teeth extraction services at a lower cost than established professionals. The waiting period for these clinics is longer than average, and patients are usually randomly selected after submitting an application. What's more, most states only have one or two dental schools, so you may find yourself traveling far for your appointment. If you need immediate treatment, it's probably best to find an alternative.

When Should I Have My Wisdom Teeth Removed?

Severe pain in the back of the mouth is a signal your wisdom teeth may require attention. You may be unable to reach the back of your mouth with floss or a toothbrush and have developed cavities or gum disease. Otherwise, your teeth may be impacted, meaning they are partially exposed above the gums. Jaw pain or stiffness is another sign, as is swelling of the face or gum tissue around your third molars.

Your dentist may look at your records and recommend you have an oral surgeon examine your teeth. Your mouth might not have room for an additional set of molars, resulting in your wisdom teeth remaining in the jaw or gums. If allowed to grow in, your wisdom teeth would shove your other teeth out of the way. This can cause moderate to severe pain and creates a spacing issue that makes it hard for you to floss. Either the surgeon or your dentist may recommend you have your wisdom teeth removed before any major problems appear to avoid a more complicated or painful procedure. As the molars continue to develop and shift, your wisdom teeth become more difficult to extract.

What Happens if I Don't Have My Wisdom Teeth Removed?
If you're able to brush and floss your teeth comfortably and your third molars aren't impacted, you might be fine without having your wisdom teeth removed.  However, ignoring your wisdom teeth when they need to be extracted can result in inflammation or infection. Sometimes, an operculum emerges over the part of an impacted wisdom tooth still below the gum line. The operculum is essentially a flap of tissue under which food can get trapped. Bacteria under the operculum leads to an infection called pericoronitis, which occurs more often on the lower molars than the upper ones. Pericoronitis symptoms include halitosis, swollen gums, pain around the infected area or a persistent bad taste in your mouth. You may also be unable to open your mouth completely.

In other cases, wisdom teeth cause gum recession or periodontal pockets that spread to the areas around other healthier teeth. Your third molars may continue to push others out of the way, resulting in misaligned teeth and jaw pain.

What Can I Do About Impacted Teeth and Pericoronitis?
If you develop an operculum, keep the area clean by brushing and flossing daily and rinsing your mouth every few hours. Should an infection occur, have a dentist professionally clean the area. He or she will likely prescribe antibiotics.

Unfortunately, until the wisdom tooth is removed or fully emerges from the gum line, your pericoronitis may come back. Removing the operculum can help but won't necessarily solve the problem. In such cases, it's best to have the tooth removed completely.

What is the General Wisdom Teeth Removal Procedure?

While complications can arise from any surgical operation, thousands of people get their wisdom teeth removed without incident each year. The procedure is simple and most people recover after a few days.

What Should I Do Before Surgery?
You should ask a friend or family member to take you to and from your dental appointment. The anesthesia will likely impact your ability to drive or navigate public transportation. Your surgeon will also have you fast for approximately eight to 12 hours before surgery, although diabetics may be instructed to eat breakfast the day of their operation.

What Happens During the Procedure?
Your doctor will begin by giving you one of three types of anesthesia. The first, local anesthesia, is injected directly into the area near the wisdom teeth. Your dentist will usually apply a numbing gel to your gums beforehand. Local anesthesia does not put you to sleep during the dental procedure, but you won't feel any pain.

The second type of anesthesia, sedation, is administered through an intravenous line. You'll fall asleep and won't experience pain, and it's unlikely you'll remember much of the operation. The final category, general anesthesia, is either inhaled or given through an IV line and also puts you to sleep.

During the operation, your dentist or oral surgeon makes an incision in your gums to expose the tooth and bone. He or she then removes a bit of the bone to access the root of the tooth. The doctor doesn't pull out your molar all at once but rather dissects it into smaller pieces, making it easier to extract. Your dentist or surgeon finishes the operation by cleaning the wound to remove bone and teeth fragments, stitching the area if necessary, and applying gauze to control bleeding and help a clot develop.

What Should I Do After Getting My Wisdom Teeth Removed?

You'll likely have to spend a few moments recovering in the dentist's office immediately after surgery, but how long depends on the type of anesthesia you received. Your friend or family member can take you home where you can continue resting. If you decide to recover in bed, arrange yourself in a comfortable, reclining position supported by pillows.

Your dentist or surgeon will give you more detailed instructions concerning oral care and pain management. If you received stitches, they'll either dissolve on their own or you'll have to schedule an appointment to remove them. Replace the gauze in your mouth periodically per your dentist's instructions and use an ice pack to reduce swelling or bruising.

Some people can tolerate the pain of wisdom tooth surgery with an over-the-counter pain reliever. Still, your oral surgeon will probably give you a prescription for painkillers, especially if he or she had to remove a significant amount of bone during the procedure.

You should refrain from brushing your teeth or using mouthwash for 24 hours after your operation. When you do resume your regular oral care, be gentle around the back of your mouth and rinse with warm salt water.

What Foods Are Safe to Eat After Oral Surgery?
Water and soft foods are recommended for the first 24 hours after having your wisdom teeth extracted. Eat progressively harder foods only as soon as you can tolerate them without too much pain. Meanwhile, avoid anything overly tough, chewy, hot, cold or spicy. It's best to abstain from alcohol, caffeine, hot drinks and sodas or other carbonated beverages. You should also avoid smoking and drinking through a straw, as the sucking action can dislodge the blood clot from the socket. Spitting can have the same effect.

How Long Will it Take Me to Recover From Having My Wisdom Teeth Removed?
It generally takes about 48 hours for the swelling and pain to subside. Common extractions take about one to two weeks to heal completely. More extensive procedures like jaw surgeries can take a month or more.

What Should I Do if My Surgery Isn't Healing As Scheduled?
If you've noticed your surgery is taking a long time to heal or is particularly painful, contact your dentist or surgeon as soon as possible. This may be the result of complications during the procedure.

What Are the Risks Associated With Oral Surgery?
Dry socket can occur within three to five days after surgery if a blood clot is dislodged from or fails to develop in the tooth socket. It's one of the most common complications of wisdom teeth surgery and causes a throbbing pain in the gum or jaws. You might also experience a bad smell or taste from the exposed site and see jawbone instead of a clot.

Follow your dentist's instructions as closely as possible to decrease your chances of developing dry socket. If you're over 25, smoke, have experienced dry socket before or underwent a complicated procedure, you're at a higher risk for developing the condition.

Nerve damage is far less common than dry socket, occurring in less than 1 percent of surgeries. However, the risk increases with age. The third branch of the trigeminal nerve runs close to wisdom teeth. This branch, called the inferior alveolar nerve, is responsible for sensation in the gums, lips and part of the tongue.

Although rare, osteomyelitis - an infection in the bone - can occur after getting your wisdom teeth extracted. People with osteomyelitis must be hospitalized and treated with numerous antibiotics and surgery.

It's important to realize that even if your wisdom teeth aren't currently causing you trouble, getting them removed at your dentist's recommendation helps prevent expensive procedures in the future. There isn't much reason to hold on to them, as third molars left unattended can cause pain, crowding and infection.