Questions About Wisdom Teeth

Third Molar Answers from Dr. Won

Below find questions from people about wisdom teeth and the removal procedure and the answers that Dr. Won provides. For assistance or to schedule an appointment, please call our Oral Surgery office in Raleigh 919-293-0299 or Elizabeth City 252-562-6151.

Depending on difficulty of them. On average most patients take high strength pain pills for about two days after surgery then switch to lesser medicine such as ibuprofen.

Short answer is yes. They are two different class of medicine and metabolized in two different partway. However few things needs to be considered.

800 mg of ibuprofen is high dose even for an adult. If you are smaller adults or someone skinny or someone with any kidney issues, it’s not recommended to take such high dose more than few days isn’t recommended.

Tylenol 3 contains acetaminophen. Also at high doses it can strain the liver or very worst case scenario can cause liver failure.

Have that in mind and take medicine judiciously.

Good question. I get asked that same question a lot. Us humans had larger jaws in the past. Natural selection favored larger jaw because diet and larger chewing muscle based on dietary habit. Modern humans have much smaller jaws compared to past. When you have larger jaw it will accommodate third molars (wisdom teeth) and they don’t typically give any issues. So yes in the many thousands years ago, wisdom teeth rarely caused any issues. More toward modern era before dentistry people had serious problem due to dental infections. Sometimes fatal as seen in some of Egyptian mummies. Dentistry came a long way. Visit your dentist regularly!

Most typical cause of numbness of tongue is due to inflammation after surgery. Along with facial swelling, all the internal parts of the area surgery was done will temporarily swell or also described as inflammatory process. As nerve tissue goes through inflammatory process, it’s function is temporarily affected.

Rare but common cause of numbness of the nerve that give sensation to tongue (lingual nerve) is injury caused during injection of local anesthetics. Since clinicians cannot see whats under the gum, injection is based on landmarks. However, not everyone’s nerve runs at typical location and you may have abnormal position of lingual nerve and may get traumatized during the injection. However, it’s usually has long term effect. Patient usually achieve full recovery.

Very rare cause of numbness of lingual nerve is actual surgical trauma. This is extremely rare case. Nerve can be potentially damaged during removal of wisdom teeth. However, because of location of the nerve, it’s very rare that somehow it can be damaged during surgery with modern technique. I don’t recommend you lose sleep over this one. It’s extremely rare.

Typically numbness will last days to few months. As long as there are small increments of improvement, prognosis of full or close full recovery is very good.

Pericoronitis is caused by the flap of tissue that partially covering the erupting third molar (wisdom teeth). It straps food and bacterial and that leads to intense inflammation and sometimes infection. Depending on the depth of the pocket created by the flap of tissue, sometime it’s very difficult to clean out the pocket. Majority of the cases will require your doctor to either remove the flap (operculectomy) or have that involved third molar removed. If it was healed spontaneously without above mentioned process, then it is likely that the pocket was very small or the inflammation was minor enough that it resolved itself.

Real question is what is the risk and benefit of getting all done versus doing it on multiple occasions. Benefit of getting all done at one time is that you are done after that. Potential risk of getting all four done at the same time is “perceived” risk of too many were done. But millions of case studies has shown that getting all four out is very well tolerated and heals at about same time as if you were to get one done. Therefore, argument “for” getting all four done is that you are over it after one surgery.

Benefit of getting one at a time is that surgical site is limited to one site and it’s easier to take care of. You can eat on the other side with normal food sooner. But the argument against would be now you KNOW you have to get another surgery done in the future. Another surgery means there are risk for surgery all over again: extensive bleeding, numbness for lower wisdom teeth, infection etc. Also later means you are older. This kind of surgeries are better tolerated at younger age than older.

However, one factor didn’t mention was cost. It is very real and very important. If cost is an issue, getting one out that is hurting really bad and doing the rest later is perfectly good decision.

I wouldn’t say it’s normal. Horizontally impacted wisdom tooth rarely (if not ever) grow into normal position into second molar position. It will require orthodontic intervention to move and upright the tooth in the correct position. There are just too many variables including: unpredictable duration of uprighting process and chances of resorption of roots.

Typically, it’s better to remove both infected second molar and impacted third molar first. Then place implant once the socket heals.

Without radiograph my answer would be incomplete. However I can answer your question in parts.

For males there will be more growth of upper and lower jaw. Depending on individual amount may vary. However it’s safe to assume that overall size of jaw will grow. But it’s impossible to know if that’s enough to accommodate your third molars. Statistically speaking, typically expansion of jaw will not accommodate full eruption of the third molars.

By 16–17 years of age, your clinician would have a good idea if you have enough space or not. If there isn’t enough space it’s recommended to remove third molars. Furthermore there could be instances you may not have enough space for remaining 28 teeth. Sometimes orthodontists would recommend removing one premolars from each quadrant.

I recommend close follow up with your dentist and/or orthodontist. Hope this was helpful!

It’s all depends on what is causing pain. Generally pain can be due to inflammation from teeth erupting and due to infection. Inflammation can be mitigated moderately by using anti-inflammatory medicine such as Advil or Motrin. But if it’s due to infection there aren’t much you can do to make the pain go away. You could try to use combination of anti-inflammatory medicine and mouth rinse such as Listerine or Scope. Ultimately, once you start having pain, it will only going to get worse as time passes. I would recommend quick visit to local oral surgeon for x-ray and evaluation. Antibiotics can buy you some time in certain cases! Hope you feel better!

There are different factors involved in choosing what to eat immediately after surgery: size of incision, difficulty of surgery, duration of anesthesia, amount of bleeding, presence of nausea/vomiting, amount of numbness, amount a patient can open and close mouth, etc etc.

Since these factors vary greatly we tend to give parent global recommendation. We typically discourage patients from eating solid food immediately after surgery. We recommend clear liquids, smoothies, or full liquid diet first day to avoid any complications due to food. Then we gradually increase the consistency of food next 3–4 days.

Of course there care many cases where patients eating normal food in same day and other extreme of not being able to do so for a week! But for the most part of you follow the generalized recommendation mentioned above you can assure that you’d avoid food or chewing related complication.

Hope this helps!

hi there,

it’s all depends on what kind of medication and how much medication were used in anesthesia. also, it’s depending your body’s tolerance to medicine and to a lesser degree, state of mind patient is in just prior to induction of anesthesia.

every surgeon has difference preference on anesthetic depending on their desired effect of medicine. there isn’t one standard way to do it. however, generally speaking benzodiazepine medications such as midazolam (versed) can induce patients to be talkative when they wake up. the effect is called disinhibition. so whatever you had it in mind, you would say that if you had higher dose of benzodiazepine. for example if you were happy mood but you were just little nervous before surgery, you gonna be laughing and giggling the whole time when you wake up. if you had some sadness or anxiety even before the surgery, you are likely to express that. if you were angry before surgery, you get the point…

but in general vast majority of patients are relaxed and happy after anesthesia regardless of which medicine. so i wouldn’t worry too much!

hope this helps!

Short answer is pain and swelling. However, incidence of infection from wisdom teeth removal is extremely rare now days. Less than 1%. Dry sockets and late inflammatory response from surgery and/or food impaction within the sockets are more likely reason for pain and swelling.

Typically, infection from surgery such as this takes about a week to show signs. Therefore, if you are showing signs of pain and swelling first week of surgery, it would be prudent to manage the symptoms and close observation. However, worsening pain and swelling after a week, immediate follow up is needed.

If it is indeed infection, patient may show signs of malaise, fever, chills, generalized fatigue in addition to pain and swelling. Professional attention is needed for proper management.

There are two main reasons to consider removal of wisdom teeth. By far most common reason is pain due to infection. Wisdom teeth are last teeth to erupt and commonly we do not have enough space therefore it can trap food and bacteria. Due to it’s far back position also it’s very difficult keep them clean if not impossible. If there are enough food debris and bacteria accumulates around wisdom teeth it can cause local inflammation and/or infection which leads to pain. In order to permanently prevent from pain from occurring again, it is recommended to remove them.

Second main reason is prevention of wisdom teeth from pushing other teeth and causing crowding. Modern human jawbone isn’t big enough to accommodate widsom teeth’s full eruption. They are competing for space in the jawbone. Especially with patients who have had braces in the past because of crowded teeth, these pushing from wisdom teeth can cause relapse of the crowding of teeth. Especially on the bottom front teeth. Patients who does not enough space for wisdom teeth (this can be easily evaluated by your doctor via Pan-Tomogram X-ray or Cone Beam CT scan) it is strongly recommended to have them removed before crowding occurs.

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Underwent a procedure to remove impacted wisdom teeth. Everyone at the clinic was very friendly and followed up through text and calls. I felt very well taken care of and had a great experience!

Divya Ramanujachari

I had my wisdom teeth removed here and they did an excellent job! The staff was very friendly and went above and beyond to keep me comfortable. Had it done for a great price as well. I would highly recommend POMS to anyone needing oral surgery!

Brittany M

I had a wonderful experience with everyone in this office, from the receptionist who answered all my questions on the phone and scheduled my appointment, Anna, Ashley, Nancy the nurse, Michael and Dustin, and of course Doctor Won did a fabulous job. I had all four of my wisdom teeth removed and everyone I knew was telling me how much pain I was going to be in. The whole procedure took 20 minutes. I followed all of the doctor’s instructions and didn’t really feel anything more than mild discomfort. I was back to work the very next day, I had no swelling and felt pretty good , it was the best overall outcome! I would definitely recommend POMS!

POMS is an amazing place!! Dr. Won did both of my daughters oral surgery and they had an amazing experience. No pain no problems. The staff there are very very nice!! It’s a very relaxing place. Highly recommended!!! Dr. Won and his staff are the best.

Dr. Won and his staff were professional and informative. Everyone took the time to explain the procedure, what to expect after and made sure my daughter felt comfortable with the process. We had a question about her medication after the procedure and Dr. Won took time out of his weekend to respond promptly. He is fantastic! Highly recommend.

POMS is outstanding for dental implants. From first consultation to surgery, Dr. Won and his staff were top notch. All of my normal fears and concerns were addressed and not once did I feel belittled or condemned for having poor oral health. We make a plan to get me back to 100%. My dental implant surgery was amazing. Minimal swelling and the healing was better than I’ve ever experienced. Thanks again Dr Won!

The staff at POMS is knowledge and caring, and the facility is extremely clean and beautiful. The staff took their time to explain everything as it was happening, and they made sure I felt comfortable. My wisdom tooth removal was over before I knew it. Overall, I had a great experience, and I would highly recommend Dr. Won and his staff. Thank you!!

I’ve known Dr. Won for 15 years. I moved from Cary to Atlanta in 2010 and have trust issues when it comes to major surgery such as what Dr. Won has expertise with. I drove 6 hours to have him do the work I could trust no one else with. Dr. Won and his dental implant team did a wonderful job. Everyone, Dr. Won, Cameron, Dustin, Mike, Samantha, and several other staff members were tremendously professional yet down to earth and simply made me feel comfortable. I was taken back on schedule and everything was done just as Dr. Won said it would be. I couldn’t have been more pleased. I stayed in town and visited family for 2 days and traveled back but each day for almost a full week Dr. Won checked in on me personally! Samantha even took time to go out of her way to drive a friend back on my behalf when he picked me up and drove me after surgery. I know this isn’t typical of most practices but this service deserved such notice.

Dr. John S. Won is the best oral surgeon in Raleigh, NC. I had done all four wisdom tooth extractions here. Surgery went really well and I had least pain post surgery. I would recommend Dr. John S.Won to everyone looking for an oral surgeon.

I had all 4 wisdom teeth removed here at POMS and it was a great experience. Not only were the staff amazingly nice and attentive to your needs the surgery went amazing. I had a little bruising and swelling which I knew was normal. I will definitely be recommending Dr.Won to family and friends!

I love everything about Dr. Won’s office & his staff. Everyone is very professional & they explain everything to you before they do it. This is the second time having dental implant surgery done there. And if I need anymore I will definitely be coming back again. Even got a call from a lady name Paige from his office to check on me. That was wonderful. She offered help & informed me that if I had anymore questions or an emergency feel free to call. Thanks a million Dr. Won and his staff.

It’s been a little over 3 weeks since I had 4 wisdom teeth removed by Dr. Won and his staff and I have been very satisfied with the whole experience. He took time to explain how the procedure would work and described to me detailed x-rays showing my teeth with surrounding nerves and how the procedure was going to work. I had two wisdom teeth under my gums, so I knew I would be in for some pain afterwards, but the quickness and expertise of the procedure made sure I didn’t suffer from too much pain post-op. The procedure lasted less than an hour and his staff were very friendly. Very satisfied and I would highly recommend Dr. Won and his staff! If I ever need a dental implant I’ll be sure to call again. Thanks Dr. Won

I had my two bottom wisdom teeth removed. They were impacted in the jaw, so I had to be put to sleep. Was very nervous about this, but Dr. Won was very compassionate and professional. The surgery was very quick and pain free. I would recommend Dr. Won and his staff for any oral surgeries, including implants.

It was a great experience. I got 5 wisdom teeth (yes I had an extra wisdom tooth) removed no problem! My stitches healed really quickly and my bleeding stopped after the first day! Everyone was really helpful and calming.

Great experience with my first tooth extraction. The entire process and procedure went extremely smooth and the follow-up care has far exceeded my expectation. I feel I under the best care possible using Dr. Won. The staff and reception area are warm and welcoming and would definitely recommend them to my friends and family.

I had a sinus lift and implant placed by Dr Won and would highly recommend his services to anyone! He was so thorough in explaining the process to me and the surgery went smooth. Everything healed as planned and my dentist also complimented his work, crown went on perfectly Thank you Dr Won!

Best dental experience I’ve ever had. The oral surgeon I was supposed to see had to cancel last minute. I called this practice and they were able to squeeze me in. I had to wait a while but understood since it was a “day of” appointment. From the assistants who were comforting and pleasant, to Dustin who handled the paperwork and insurance details everything surrounding the experience was professional and seamless. And the procedure itself? Dr. Won had state of the art equipment which I appreciated since the extractions I needed were verrrry close to my sinuses and Dr. Won himself was a whirling dervish in the room but with reassuring confidence. And best of all…painless dentistry! I highly recommend this dental practice.

Both of my sons have had their wisdom teeth removed by Dr. Won and have had great experiences. I also value that when I was sent by my dentist to have my daughters wisdom teeth consult he told me to wait and explained in detail all of the downsides of removing too early. Dr. Won’s staff was excellent in preparing me with what to expect following surgery and I was contacted by them to check on his recovery. I will be heading back to him when my daughter is ready for her teeth to be removed.

I had a biopsy done by Dr. Won and it was seamless. I got my results back quickly and everyone there helped to make me feel comfortable during the procedure. I have friends and family who have since gone to have extractions and implants and also had great experiences with Dr. Won and his team. Thank you Dr. Won!

I had my wisdom teeth removed here without any complications. I was impressed with the office and staff throughout the treatment process. I even called John Won’s personal number when I was concerned about bleeding a lot and he actually answered. John Won also gave me referrals for orthodontist and I trust his recommendations. I highly recommend John Won for wisdom tooth extraction and dental implants in Raleigh. I didn’t even bother looking anywhere else because his credentials were superb.

Dr. Won, Paige, Allison, Amber and the team are absolutely amazing! I developed complications and needed a second surgery for my implant. They did a great job of keeping me calm and explaining what was going to happen. Every time I’m in their office everyone greets me by name. I LOVE THIS PLACE! Absolutely recommend!

If you’re looking for one of the best oral surgeons in Raleigh, I would highly recommend Dr. Won and his staff. They made me feel comfortable from the start – I had no problems and I healed great. They took care of all my insurance work and I didn’t have to do a thing (except pay, lol). If I ever need more dental implants, I will definitely use Dr. Won and his wonderful staff. Thank you Dr. Won and staff for taking such good care of me!

I just had my 4 wisdom teeth plus one other tooth removed by Dr. Won. All I can say is that I wish I had done this sooner. I had been in pain but had been putting this off because I was really nervous. Dr. Won and his staff made the whole process so easy and comfortable. I had a very quick recovery and was even back to work the next day. I will be going back for an implant soon and know I will be in the best possible care. Thank you to Dr. Won and his great staff!

I absolutely recommend Dr. Won and his team! The staff was friendly and knowledgeable. The facility was immaculate., and best of all, Dr Won took amazing care of me. I had all 4 wisdom teeth removed and was back to work in a day. I wouldn’t go anywhere else!

This is not a procedure you want handled by anyone else, Dr Won and his excellent staff are fast, efficient knowledgeable and most important caring. I arrived shortly before my 11:00 am appointment had numerous opportunities to discuss the procedure with his staff, all of the eager to answer all the questions I had and be sure of my well being. Despite facing a difficult extraction and implant surgery I was out by noon, well cared for and all questions answered. Even received a follow up call at 7 pm on a friday to ensure there will no lingering problems.

Dr. Jon Won and Staff are an Exceptional, Caring team! Dr. Mayes from Preston referred me to have one sideways wisdom tooth and three impacted wisdom teeth extracted. While I was in Dr. Won’s office I asked if he could take care of that little extra skin under my tongue that made me Slightly tongue tied. I could never stick my tongue too far out my mouth…but now I can touch my cheek!!! Pronunciation was not bad beforehand, but I did lack a little bit of clarity at times. I Love the way I speak now and the way my tongue moves in general. I was concerned about adding on as some doctors don’t like that. But he did not have any problems! Perhaps because I paid right away with credit, or he saw it as a simple thing, I don’t know. The entire surgical procedure seemed as if it happened with a snap of my fingers after I sat in the chair. In fact, after I awoke, I asked if Dr. Won was going to come in and do the surgery now…and was told he is already done! Then I realized the gauze. Yet, I did not have pain. Recovery was not complicated, and the staff was very helpful with any questions I had at any time. Thanks again Dr. Won and staff, I HIGHLY recommend you!!!