Wisdom Teeth Portland OR

What are Wisdom Teeth (Third Molars)?

We each get three sets of molars during our lifetime – the first molars arrive at age six, the second at age 12, and the third molars develop during the late teens and early twenties. Because it is during this age that children become wiser and transition into adulthood, we refer to the “third molars” as “wisdom teeth”.

Your mouth was designed to hold 28 teeth, not 32. By the time your wisdom teeth start to grow, those 28 slots are already filled, making it difficult for them to grow in properly. That’s why 9 out of 10 people find themselves with at least one impacted wisdom tooth that requires extraction. Even when properly positioned, wisdom teeth can easily become infected, and are at risk for cysts and tumors.

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Wisdom Teeth Problems

All of this crowding results in the wisdom teeth being unable to erupt through the gums properly – a condition commonly referred to as “impacted”. Often they grow in sideways, backward, tilted, and, sometimes, they may even remain completely under the surface of the jawbone.

A representation of a wisdom tooth impacted by soft tissue   Soft Tissue Impaction: The upper portion of the tooth has erupted through the bone but not all the way through the soft (gum) tissue.
An example of a wisdom tooth with a partial bony impactionPartial Bony Impaction: The tooth is still mostly located within the jawbone, although a small portion has pushed through.
An illustration of a wisdom tooth completely impacted by bone  Full Bony Impaction: The entire tooth still lies within the jawbone.

While you may feel nothing out of place, impacted teeth are at significant risk for becoming infected, fracturing the jaw, or damaging neighboring teeth. For this reason, it is often necessary for the doctors to remove them.


A representation of a pericoronitis infection on a wisdom tooth
Your gums can become infected, a condition is known as “pericoronitis”, due to the wisdom teeth unsuccessfully trying to push through the gum tissue. This condition, which causes pain, swelling, and problems swallowing, can recur periodically.

Cysts and Benign Tumors:

An example of a cyst formation on a wisdom tooth
Cysts are fluid-filled pockets that can form inside the jawbone when wisdom teeth are impacted. They can be very damaging and difficult to treat as they destroy jawbone and even neighboring teeth.

Crowding and Alignment Issues:

An illustration of teeth crowding causes by a wisdom tooth
It should be no surprise that impacted wisdom teeth crowd your smile, causing misalignment issues, even if you have had braces.

Damage to Nearby Teeth:

A visual of a wisdom tooth damaging an adjacent tooth
Wisdom teeth are notorious for damaging their neighbors by making it difficult to practice good hygiene in the area. This often results in decay, gum disease and sometimes bone loss.

Wisdom Teeth Removal Portland

Third Molar Extractions

We are committed to making your experience a great one! Thanks to rapidly advancing technology, new medicines, sterilization and infection control options, doctors are able to perform the procedure in a way that promotes quicker healing and minimizes pain.

During your initial consultation, we will take x-rays and use specialized imaging tools to get a clear picture of the positioning of your wisdom teeth.

The length of your surgery depends on a variety of factors including the level of impaction of your teeth and the number of teeth being removed. However, most wisdom teeth extractions can be performed in about an hour. During that time you will be kept comfortable with anesthesia.

Post-op soreness can typically be managed with over-the-counter medications, however all medication options will be discussed ahead of your surgery to ensure that you have adequate pain relief at home as the anesthesia wears off.

Non-Opioid EXPAREL

The Day of Your Procedure

Prior to your wisdom teeth removal surgery, we will send you home with very specific pre and post-surgical instructions so that you know what to expect.

A few key items:

  • Don’t eat or drink the day of your procedure. (Pre-approved medications may be taken with a sip of water.)
  • Anesthesia: Most people prefer to be sedated for the procedure, however we do offer a variety of levels of anesthesia to accommodate personal preferences. We are trained and highly experienced with anesthesia to provide you with a safe and comfortable experience.
  • Bring a Parent (or responsible adult): It is necessary that you bring a responsible adult with you to the office and that they remain with you throughout the day. We will not be able to release you alone.
  • Medications: Make sure you have your pain medications (over the counter and prescription if necessary) ready to go for when the anesthesia starts to wear off at home.
  • When You Get Home: You will feel sleepy for the remainder of the day. You may have numbness in the jaw (which shouldn’t be confused with nerve damage) and possibly a sensation of your gums feeling swollen and pulling away from your teeth – all of this is a normal part of the healing process.
  • Foods: Specific instructions will be sent home with you regarding the reintroduction of foods. But, as a general rule, start with clear liquids and progress to other soft foods slowly. Avoid dairy products the first day, as they tend to interact with anesthesia, sometimes causing nausea.
  • NO Straws: Throughout the healing period, you may not use straws (or tobacco). Using straws can dislodge the clot that is covering your extraction site, resulting in a very painful condition called “dry socket”.

Wisdom Teeth Complications

Luckily, complications following wisdom teeth removal are rare, and largely avoidable. However, if you suspect any of these complications, please call us for instructions:

Dry Sockets:

A visual of dry socket that developed after the removal of wisdom teeth

The most common complication following a tooth extraction, “dry socket”, occurs when the blood clot in an extraction site becomes dislodged or never develops properly. This can happen for a variety of reasons, including smoking and straw use, improper home-care such as vigorous rinsing, and unknown infections. If you have symptoms of dry socket, please call our office immediately so that we can get you proper care and pain control. Dry socket symptoms typically appear several days after your surgery, and may include:

  • Significant pain.
  • Pain radiating to the ear, cheek, etc.
  • Bad breath or unpleasant taste in the mouth.
  • Visible bone or an empty-looking socket.


A diagram depicting an infection that occurs after wisdom teeth removal
Signs of infection include fever, worsening pain and swelling.

Damage to Sensory Nerve:

A representation of numbness caused by damage to a sensory nerve
It is normal to feel some numbness or tingling in the lower lip, chin or tongue following surgery. However, very rarely, sensory nerve damage occurs that causes the sensation to stay permanently. Having your wisdom teeth out early (before 18) lessens the likelihood that this condition will develop – another reason to take care of this important procedure during the teen years!

Sinus Communication:

A diagram showing the opening that can occur between your mouth and sinuses
Because the upper wisdom teeth are so close to the sinus cavities, occasionally an opening appears between the sinuses and the mouth following extraction. This “hole” will usually close on its own, provided that you follow specific instructions (avoid blowing your nose, sneeze with your mouth open) to avoid a pressure buildup in the sinuses for a few days. Very rarely, we must perform an additional procedure to close the opening.

Cost of Wisdom Teeth Removal

Every patient’s situation is different, which is why we have a consultation with you prior to the surgery. This allows us to present any possible costs upfront, and help you decipher your insurance benefits.

Factors that affect wisdom teeth cost:

  • Anesthesia Used
  • Dental Imaging
  • Number of Teeth Extracted
  • Level of Impaction

Does insurance cover wisdom teeth removal?

Many dental insurance policies include a benefit for wisdom teeth removal. Our staff will help you navigate your insurance benefits so that you can obtain the maximum benefit from your provider.

The Cost of NOT Having Wisdom Teeth Removed

While the cost of wisdom teeth removal may seem prohibitive, the price of not having them removed may cost more money (and pain) down the road, as extractions get more and more complicated with age.

Financing the Cost of Wisdom Teeth Extraction

We offer a variety of options to our patients and their families to ensure that they get the care that they need. A quick phone call to our office will help you understand the financing options available to you.

Wisdom Teeth FAQs

What is the best time to remove the wisdom teeth (third molars)?

Usually, it is best to remove wisdom teeth during their formative time, between the ages of 17 and 25 years. Root formation at this time is incomplete, resulting in less surgical complications.

How long will the surgical procedure take?

Usually, most patients spend an hour in our clinic. This includes the anesthesia, surgery and recovery time for the patient. Occasionally, the procedure may exceed one hour, but this is rare.

Do I have to go to sleep in order to have my wisdom teeth removed?

The removal of 4 impacted third molars is best completed with IV sedation. This is not a procedure that is easily done with just local anesthesia. Patient comfort is paramount to a good outcome and the sedation will improve the patient outcome.

Do I have to return to the office after the removal of my third molars for a follow up appointment?

Most patients do well enough that they do not need to return for a follow up appointment. You will be called within 24 hours at home and your progress will be reviewed. If you experience a problem we will see you immediately for a follow up visit. You will leave the office with a package of home care products including instructions that should help with your care. 24/7 care is available if you should you have a problem with your recovery.

Can my dentist remove my wisdom teeth?

Many general dentists remove third molars, however that does not mean that they are surgically trained. For comparison, consider this analogy: would you have your family doctor do your total hip or heart surgery? Probably not. Oral and Maxillofacial surgeons are specially trained in this area of care. We have the most experience and can provide the supportive care needed for complications.

Does it cost more to go to a specialist for wisdom teeth removal?

Most Oral and Maxillofacial Surgeons belong to the same health panels as general dentists. There are no special rates for specialists. They must file their fees the same way a general dentist does, so the question of charging more is simply false.

Can I avoid narcotics for pain control? I am concerned about the Opiate addiction issues that I read about in the press.

Fortunately, postoperative pain control has moved to new parameters. We now have local anesthesia that will last 3 days, controlling the acute post-operative pain and negating the need for opiate pain medications. Ask about Exparel injections for long-term pain control instead of chronic medications. This is an additional medication available for your comfort and safety.

What can I do to eliminate food impaction in the 3rd molar sockets after surgery?

An irrigation syringe will be in you care package to use after the first few days in order to keep the socket sites clean of food and debris. You will need to follow the instruction carefully in order not to disturb the normal healing.

We are here to support our parents and patients: please call our friendly team at Portland Office Phone Number 503-292-8824 for more information.

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Definitely will be coming back to Dr. Mike for any more needed work that may have to be done in the future!

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Surgery was very painless considering I had 8 teeth pulled at once.

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