Wisdom Teeth

By the age of eighteen, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth or molar teeth are used to grind food up into a consistency suitable for swallowing.

The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your Third Molars, also known as “wisdom teeth.”

Why Should I Remove My Wisdom Teeth?

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain and illness. The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.


Most often, if you need to have one or more wisdom teeth removed, you will be scheduled for a consultation. This is a very necessary first step in providing patients with excellent care. At this visit, the doctors have the opportunity to meet with you and perform a thorough oral and radiographic examination. With an oral examination and x-rays of the mouth, Dr. Bontempi and Dr. Paolella can evaluate the position of the wisdom teeth and predict if there may be present or future problems. The doctors will discuss the various risks and benefits of the procedure and help you decide the best form of treatment. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid- teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.

Wisdom Teeth Presentation

To provide you with a better understanding of wisdom teeth, we have provided the following multimedia presentation. Many common questions pertaining to wisdom teeth are discussed.

Wisdom Teeth Presentation

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. All of the doctors at Berkshire Facial Surgery have the training, license and experience to provide various types of anesthesia for their patients.In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia) or general anesthesia. These options, as well as the surgical risks (i.e. potential nerve injury, sinus complications) will be discussed before the procedure is performed.

Before leaving the office, you will receive our special “third molar survival packet”. In this folder is everything you will need to know before having your third molars removed. The folder has pre-operative and post-operative instructions, your prescriptions and valuable information regarding your anesthesia.

Day of Surgery

On the morning of surgery, you will be instructed to arrive at the office approximately 15 minutes before your scheduled appointment. You are reminded not to eat or drink anything for at least six hours before the surgery and make sure you have a responsible adult who will be able to take you home afterwards.

Once in the office, you will be escorted by one of our assistants into the procedure room. During the surgery, we will be using several different types of monitors including blood pressure and EKG, so it is preferrable that you wear loose-fitting clothing such as a tee-shirt or tank-top. The doctor will start by placing a small rubber band above your arm or wrist in order to start a small intravenous line. Through this “IV” line, medicines will be given to put you to sleep. It will seem as if you were only asleep for a minute and when you next open your eyes, the procedure will be completed. As you are waking up, you will notice two things: 1) you have gauze in your mouth and 2) you are numb. Once the teeth are removed, the gum is sutured and gauze is placed over the surgical areas to control bleeding. Also, while you are asleep, local anesthesia is given so that when you wake up, you do so comfortably, without any pain. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge, you will be scheduled for a follow-up appointment in one week. If you have any questions, please do not hesitate to call us at (413) 318-0043.