Board Certified Oral and Maxillofacial Surgeons, Dr. Kessler and Dr. Monteleone specialize in wisdom tooth removal.

In fact, they perform wisdom tooth extractions routinely on a daily basis. Oral Surgeons receive extensive training to make wisdom tooth removal relatively painless and quick.

Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 21 They are located at the back of the mouth (top and bottom), The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom.”

In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and they become non-functional or worse, chronically infected. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, and possibly cysts or tumors.


There are several types, or degrees, of impaction based on the actual position and depth of the teeth within the jaw:

Soft Tissue Impaction: The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or the tooth’s entire crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.

Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.

Complete Bony Impaction: The tooth is completely encased by jawbone. This will require more complex removal techniques.

Frequently Asked Questions

How are wisdom teeth examined?

As with any surgery, Dr. Monteleone and Dr. Kessler will want to initially conduct a thorough examination of the wisdom and surrounding teeth. Panoramic or 3-D digital Cone beam CT scans may be taken in order for your surgeon to evaluate the position of the wisdom teeth and determine if a current problem exists, or the likelihood of any potential future problems. The x-rays can also expose additional risk factors, such as deterioration or decay of nearby teeth. Early evaluation and treatment (typically 16 or 17) is recommended in order to identify potential problems and to improve the results for patients requiring wisdom teeth extractions. Only, after a thorough examination can Dr. Kessler or Dr. Monteleone provide you with the best options for your particular case.

What does the removal of wisdom teeth involve?

In most cases, the removal of all four impacted wisdom teeth is performed under general anesthesia. In some instances, local anesthesia or nitrous oxide can be used and the doctor will discuss what is best for your situation. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed at your initial consultation.

What can I expect after the operation?

Recovery after wisdom-tooth surgery is generally quite straightforward, but you are likely to experience some discomfort and swelling, particularly in the first 2-3 days. Rarely, complications can occur, such as poor healing of the tooth socket or nerve injury. It is important that you take it easy for two days after the operation.

Why are Wisdom Teeth extracted?

While, not all wisdom teeth require removal, wisdom teeth extractions are most often performed, because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future.

When a tooth doesn’t fully grow in, it’s “impacted”–usually unable to break through the gums because there isn’t enough room. 90% of people have at least one impacted wisdom tooth.

An impacted wisdom tooth can damage neighboring teeth or become infected. Because it’s in an area that’s hard to clean, it can also invite bacteria that lead to gum disease.

Oral bacteria can also travel through your bloodstream and lead to infections and illnesses that affect your heart, kidneys and other organs.

In some cases, a cyst or tumor can form around the base of the impacted tooth, which can lead to more serious problems as it hollows out the jaw and damages surrounding nerves, teeth and other parts of your mouth and face.

If impaction of one or more wisdom teeth is present, and left untreated, a number of potentially harmful outcomes can occur, including:

  • Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease) and possible bone loss.
  • Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth.
  • Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.
  • Tooth Crowding: It has been theorized that impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned (crowded or twisted).