Of the more common procedural risks associated with removal of wisdom teeth is nerve injury. Nerve injury, loss of feeling in the lower lip and chin area, is a risk that carries the most weight. It is typically not debilitating, but it is certainly the most commonly sited complication.

Risk Factors for Nerve Injury During Wisdom Teeth Removal

• Older age
• impaction severity
• root formations
• root anatomy in relation to the nerve

Reduce the Risk of Nerve Injury

If possible, remove your wisdom teeth at an earlier age. I recommend about age 15. At that age, they typically do not have significant root formation so this risk is essentially zero. By about 20 years old, the roots are well developed. As you age further, the attachment of the roots to the bone becomes narrower and maybe calcified, increasing the risk of injury.

Even if you are older, I still recommend an evaluation and I will typically recommend wisdom teeth removal. We can easily assess their position and risks, including the risks to the adjacent structures such as the teeth, sinuses, and nerves.

Experience is key in Wisdom Teeth Removal

When there is risk involved, there is no substitute for experience. We are the experienced care providers for comfortable removal of wisdom teeth. At Dr. Wagner’s office, we are proud to offer comfortable care to patients from Racine and the surrounding Milwaukee area. Call us at (262) 634-4646 to schedule an appointment today.

(Reference: J Oral Maxillofac Surg 70:2508-2514, 2012)

Pregnancy can affect oral health, and so, it is advised that patients who are or who plan to become pregnant should be evaluated and followed closely from a dental standpoint in order to minimize dental problems during pregnancy.

Increased Risk During Pregnancy

In a recent study, the presence of wisdom teeth that have a continuity defect (a communication over the impaction or along the tooth next to the site) are a significant risk factor for developing dental disease during pregnancy.

It is easy to assess wisdom teeth at an early age with a panoramic scan. This allows us to determine the expectation that they may become a problem. Early wisdom teeth removal is associated with less risk, better outcomes, avoidance of related dental problems, and less social complications (life is less complex).

Early Wisdom Teeth Removal is Best Option for Pregnant Women

We do see quite a few patients who develop infections associated with their wisdom teeth during pregnancy and the associated management problems, not to mention risks to the patient and the unborn baby that can be attendant with infections and treatment. I will continue to recommend the early removal of third molar or wisdom teeth to avoid these types of future problems.

Do you Have Questions About Wisdom Teeth and Pregnancy?

At Wagner Oral Surgery, we have experience providing care to women who are pregnant or who may become pregnant. If you have questions about how pregnancy might affect your oral health, we are happy to offer our insight. Call Wagner Oral Surgery and Dental Implant Specialists at (262) 634-4646 today to schedule a consultation.

There are inherent risks with wisdom teeth removal. At Wagner Oral Surgery, we use advanced technology to predict the risk and prepare for surgery.

When removing third molar teeth, there is an increased risk of injury to the sensory nerve in the lower jaw, especially in the adult patient. The risk generally increases with age. A cone beam scan image of the wisdom teeth and nerve canal can provide a significant prediction of injury risk for the third molar tooth extraction.

The sensory nerve in the lower jaw provides feeling in the lower jaw bone. It does not control any muscle function. Injury to the nerve can result in a loss of feeling in the area. It does not cause any paralysis. Because this risk increases with age, it is better to perform this treatment on the younger patient. Twenty years old is better than thirty, thirty years old is better than forty, etc. In my hands, with the teenage patient, the risk is almost zero. As you age the risk goes up, but again in our experience the risk is still in the single digits – meaning less than one percent.

Advanced technology reduces risk associated with wisdom teeth removal

Having said that, if you have this complication it is significant. The x-ray appearance, and especially with the cone beam scan, can be a predictor for this. We now have the advanced technology of cone beam scanning and with this we can visualize the teeth and nerve much more accurately in three dimensions and this allows us to approach the tooth surgically with a greater accuracy and helps to reduce the risk when performing the wisdom teeth removal.

Cone beam scans and wisdom teeth removal at Wagner Oral Surgery

Cone beam scans are not yet a standard of care and there is increased cost with this technology, but it clearly is a great benefit, both to the patient (decreased risks) and to the surgeon (better visualization). I strongly recommend the cone beam scan if you are having your wisdom teeth (third molars) removed.  

(Ref: J Oral Maxillofac Surg 71:2012-2019, 2013)

 “My impacted tooth is too close to the nerve. Can I have an extraction?”

This is a quote that I have heard in the past from both patients and dentists alike. The fear is that a wisdom tooth or other impacted tooth is too close to the nerve to have a safe extraction.

Many articles have been written about this subject. There are varied opinions and techniques concerning impacted teeth being close to the nerve. I have been removing impacted teeth that are on, along side, and around the nerve for over 25 years. We have always taken a careful and methodical approach to this treatment.

Is Extraction Safe if my Impacted Tooth is Close to the Nerve?

I can tell you from experience that trying to avoid this treatment is not a solution. We do now have 3-D cone beam imaging (CBCT). CBCT allows us to basically perform the extraction virtually ahead of time in order to make the procedure that much safer.

Why Should I Have the Treatment Now?

As we age, the complications associated with impacted teeth and the risks of treatment all increase, so in general, I feel it is bad advice to sit and “watch” such a tooth or just practice avoidance. The impacted teeth do not go away, but they just get worse.

Worried about an impacted tooth?

Again, we are careful and gentle, and we do our best to minimize all of these concerns. If you’re worried about an impacted tooth being too close to the nerve, please reach out to us. Call Wagner Oral Surgery and Dental Implant Specialists at (262) 634-4646 today to schedule a consultation. We’ll take care of you and make you feel comfortable.

Can wisdom teeth cause other teeth to move? One of the reasons for wisdom tooth extraction is from the fact that as they try to come in, they give off chemical messages to the surrounding teeth and bone making them more open to shifting. There are many other factors that enter into this, such as the positioning of the other teeth and the bite. All of the teeth in our mouth naturally come into the bite and shift forward. When the teeth are actively erupting during the formative years, having extra teeth in the bite or crowding of the teeth tends to make this problem worse. Even in the adult we will see teeth shift if an opposing tooth or an adjacent tooth is missing.

Will Wisdom Teeth Make Other Teeth Shift?

Teeth form in a soft tissue sack that is around the crown of the tooth and this forms first followed by the enamel, the rest of the crown, and then the root structure. As this formation takes place, we see movement of either the impacted tooth or the next tooth relating to expansion of the follicle and also with expansion of the roots. In some case, this expansion will progressively intrude the impacted tooth such as with cyst formation. When there is not enough room for wisdom teeth to come into the bite, it will become trapped behind the second molar tooth and as it develops the follicle and then the root structure will cause it to push against that tooth. This force can be transferred up the line and possibly contribute to shifting of the other lower teeth.

Once wisdom teeth have fully developed and if there are no problems with the follicle, the wisdom tooth is thought to be dormant and is no longer actively pushing. However, it still can cause other problems.

Suffering from Wisdom Teeth Pain or a Wisdom Tooth Infection?

For a consultation, call Wagner Oral Surgery and Dental Implant Specialists at (262) 634-4646 today — we’ll take excellent care of you.

Wisdom teeth are an extra set of teeth that are not necessary in a normal functional bite. I feel that their main purpose is to provide an extra set of teeth that can come in, in place of teeth that would have been lost earlier in life to dental disease in a person who did not have regular dental care.

Wisdom Teeth Problems

One of the main wisdom tooth problems is that most people do not have functional room for them to come in and for those who do, there is rarely good gum tissue contours around them for proper oral health. As they develop, they start to cause problems on the adjacent teeth and they may also develop in a way that affects and can put adjacent vital structures at risk.

We can make a very good prediction even as early as age 12 using a panoramic scan as to whether a patient will have adequate room for the teeth or that their position will be satisfactory for proper development. Early treatment of wisdom teeth makes sense on a number of levels.

Best time to remove wisdom teeth

I have found that about age 15 is an ideal time for evaluation and wisdom tooth extraction. At that age, there is typically not a lot of root formation and so the risk of surgery to the adjacent vital structures is very low. At that time, the development of the teeth has not adversely affected the adjacent second molar teeth. Because the wisdom teeth are smaller at that time, it is typically a less involved procedure and tolerated better by the patient with less wisdom teeth pain and swelling. Psychologically and socially, it is typically a less complicated time in their life and results in less lost time from work, school, or professional pursuits. The younger patient is often under the care of parents who are able to guide them through the process. Younger patients are typically healthier and more resilient through this type of procedure as well.

As we age, there can be increased risks and concerns in this process. Even in the adult, I recommend evaluation and proactive care. At any age it never gets easier and less risky. There are certainly cases in the adult patient where I may recommend no treatment on a wisdom tooth. It is easy to assess.

With advancing age, comes deterioration in health. When we start to overlay medical problems as well as the normal decreased resistance to disease and general decrease in our immune system, we find that there comes a point where the body cannot hold off the problems associated with the wisdom teeth and we then have to deal with them often in a less healthy patient. This is completely avoidable with proper early diagnosis and early treatment.

As the person who ends up having to treat you at an older age with greater risks and with increased complication possibilities, I feel it is almost inexcusable when proper treatment is not provided early on. Come on in. We will take excellent care of you through your evaluation, consultation, and treatment.

For a consultation, call Wagner Oral Surgery and Dental Implant Specialists at (262) 634-4646 today — we’ll take excellent care of you.

Many people confuse the term bridge with the term partial denture. What are the differences between bridges and partial dentures? A bridge is cemented and a partial denture can be removed.

Bridges and Partial Dentures

What Are Dental Bridges?

A bridge is a dental treatment used to replace a segment of teeth where there is a good tooth on either end of the segment. The teeth on either end are reduced so that they can be “crowned”. Your dentist has a bridge made which is one piece that cements onto the tooth on either end of the segment with artificial tooth or teeth “bridging” the place where teeth had been missing.

What Are Partial Dentures?

A partial denture is a dental treatment also used to replace missing teeth. It is typically used in areas where there are multiple teeth missing and can also be used in areas where there is not a support tooth on either side of the segment where the teeth are missing. A partial denture may be a preferred treatment when there are multiple teeth missing, as it can be used to replace multiple teeth in a dental arch. Removable partial dentures typically has clasps and rests which are attachments onto the remaining teeth which help to hold it in place. Occasionally, dental implants are used along with a partial denture to providing extra points of attachment which can make it more secure.

Dental implants may be viewed as superior to a bridge restoration, in that they avoid “cutting down” the enamel on the adjacent teeth. They also stand alone so any problems with the adjacent teeth will not affect the implants and vice versa. They also have the advantage over a partial denture, that it avoids having to deal with a removable appliance as crowns that are placed on dental implants are cemented and do not come in and out. Implants act and feel more like natural teeth.

For a consultation, call Wagner Oral Surgery and Dental Implant Specialists at (262) 634-4646 today — we’ll take excellent care of you.

Ever wondered how wisdom teeth grow? By your late teens, your jawbone has nearly reached its adult size. But sometimes it isn’t big enough to hold developing wisdom teeth. When this happens, your teeth become trapped in the bone and grow wherever they can. The crown (chewing surface of the tooth) may only partially break through the gum. In other cases, it may remain completely in the bone. The roots, which hold the wisdom teeth in place, may become misshapen or grow dangerously close to a sinus cavity or to the nerve located in your lower jaw. Since wisdom teeth pose a number of serious problems, wisdom tooth extraction is often a necessity.

How Your Wisdom Teeth Grow

Positions of Impaction

Cramped for room, impacted wisdom teeth grow in many different directions, commonly at an angle. A wisdom tooth may grow at an angle toward you other teeth (mesioangular position) or away from your other teeth (distoangular position). Wisdom teeth also can grow into a horizontal or vertical position.

The Advantages of Early Wisdom Teeth Removal

Like all teeth, wisdom teeth develop inside an opening (socket) in you jaw, protected by bone and gum tissue until they erupt. Over time, your wisdom teeth become more firmly anchored in your jaw as their roots lengthen and the jawbone becomes more dense. So, the older you are, the more difficult wisdom tooth extraction can be. Early removal of wisdom teeth offers several advantages such as:

• Easier Procedure
• Less Risks
• Healthier Patient
• Life is Less Complicated
• Less Dental Disease/Problems

At about age nine, the crown of your tooth begins to form in a small sac inside your jaw. The roots begin to grow into the soft, developing bone. By your late teens, the crown often begins to erupt, if there is room. Roots continue to lengthen in the jawbone, which is almost adult size and density. By your early twenties, the crown has emerged or is impacted. Roots are usually completely formed, and the jawbone is adult size and density. By your forties, the roots of your wisdom teeth are solidly anchored to the dense jawbones, making removal more difficult.

Wisdom Teeth Problems

Whether wisdom teeth cause your mouth harm depends on several factors, including the size of your jaw and how your wisdom teeth grow in. Sometimes, wisdom tooth problems can cause wisdom teeth symptoms like swelling or wisdom teeth pain. Or you may have no symptoms at all, but the other teeth in your mouth could be at risk for damage.

Gum disease.

When a wisdom tooth partially breaks through the gum’s surface, bacteria can get under the flap, causing an infection in the gum.

Crowding. 

Impacted or erupting wisdom teeth can push on adjacent teeth, causing them to become crooked or even damaging them structurally.

Decay.

A wisdom tooth that is hard to clean due to its position or because it is partially covered by gum disease may collect cavity causing bacteria. This could also lead to decay in the tooth next to it.

Poor position.

Wisdom teeth that grow toward the cheek can irritate nearby tissue. If an erupted tooth is crooked, it maybe hard to bite down.

Cysts.

If the sac that holds the crown remains in the bone, it can fill with fluid, forming a cyst that can destroy surrounding bone. These can become quite destructive.

Dental Bone Grafting Material consists of many small particles. It’s not uncommon to find some small granules inside your mouth for several days after you receive bone grafting treatment. While it is normal to have some of these Bone Grafting Materials come out of the graft area, there are a few things that you can do to minimize the amount of particles that you experience in your mouth.

Bone Grafting Recovery Tips

• Do not touch, poke, rub or disturb the area.
• You should avoid rinsing or spitting for 2 days. This helps to allow for blood clot and graft stabilization.
• Avoid applying pressure with your fingers or tongue to the grafted area. During the initial healing process, this material is movable. Following your surgery you will be instructed on how to place gauze on the area.
• You do not need to continuously inspect the sutures. Refrain from pulling on your lip to look at them as this can cause damage to the wound site.
• You should not smoke after surgery.
• Rinsing is allowed following the second day of recovery, but this is to be done gently and not too vigorously as you can disturb the bone graft granules.

Sinus Lift Recovery Tips

• Do not blow your nose for at least 4 weeks following your Sinus Lift Surgery. Sniffing is allowed but refrain from blowing until advised by your oral surgeon.
• Do not sneeze while holding your nose. If you need to sneeze you should do so with your mouth open.
• Do not use straws when drinking and do not spit.
• Any activities that could increase sinus pressure should be avoided. This includes activities such as scuba diving, blowing up balloons, playing musical instruments that require blowing and flying in pressurized aircraft.
• You may be prescribed decongestants to help reduce the amount of pressure in your sinuses. You need to avoid anything that causes pressure in your nasal cavity so take these as directed.
• You should not smoke after surgery.

For a consultation, call Wagner Oral Surgery and Dental Implant Specialists at (262) 634-4646 today — we’ll take excellent care of you.

Good oral health care for adults start when we’re still children. As a parent, you want the best oral health for you child during the course of their life. Below you will find the best dental care tips for you child to ensure a beautiful and healthy smile.

Oral Health Tips for Kids

• Introduce your child to the concept of oral health by their first birthday or as soon as they get their first teeth in by taking them to a pediatric dentist.
• By the time their last 2 molars come together you should begin helping your child to floss. This typically happens between the ages of 2 1/2 to 3 years of age. Cavities often begin in between teeth. It’s important that you begin a flossing routine once the teeth come together to prevent plaque buildup.
• You should supervise your children’s brushing habits. Don’t let them brush their own teeth until they are 7 to 9 years old. You want to ensure proper dental care until they are old enough to completely handle it on their own.
• Break any thumb sucking habits before the age of 5 in order to prevent any developmental abnormalities.
• Toddlers should not be allowed to walk around with sippy cups filled with anything other than water.
• Limit their amount of sugary snacks between meals. Eating sugary foods throughout the course of the day is one of the primary causes of cavities. Think about the amount of sugar in breakfast cereals with toast and jelly, mid-morning snacks, chocolate milk and PB&J for lunch and any other sugary snacks they get before super. That’s a lot of exposure to sugar day after day. Take this into consideration when making your grocery list.
• Cut back on the sticky foods your children eat such as fruit roll-ups and raisins. Raisins might be healthy but they also cling to the teeth and get wedged in between them.
• As your children get older, allow them to have sugar-free gum. This actually increases the flow of saliva which helps to neutralize acids on the teeth. Studies have shown that chewing sugar-free gum containing xylitol for roughly 20 minutes after a meal can help to prevent tooth decay.

For a consultation, call Wagner Oral Surgery and Dental Implant Specialists at (262) 634-4646 today — we’ll take excellent care of you.