I have wisdom teeth that are beginning to hurt and I am worried about feeling pain and having a bad experience. Do I need them out? What do you recommend?


Wisdom teeth, often times, have to be removed for several reasons such as inability to keep clean, more prone to getting cavities, can cause shifting of teeth, can develop unusual pathology such as tumors, and can cause diffuse pain in the jaw as well as the jaw joints. Wisdom teeth can fully erupt through the gums, or partially erupt, or never erupt (called an impacted wisdom tooth). Depending on the level of eruption, a general dentist may be able to take the wisdom teeth and often times I refer to an oral surgeon who specializes in taking out more difficult teeth.


Because wisdom teeth are typically more difficult to take out, one can experience more discomfort and pain following. Again the level of eruption will determine how difficult it will be to remove which further determines how much discomfort afterwards. I typically recommend sedation for wisdom teeth in 3 different options:

1. Nitrous oxide (laughing gas during procedure)
2. Oral sedation(oral medication before procedure)
3. IV sedation ("put to sleep" with medications through an IV). Ask your dentist what is most appropriate for you.


The advantage to oral and IV sedation is also that it can cause amnesia which prevents the patient from remembering the procedure. Most patients wake up without any recollection of what happened, how long it lasted and how the procedure went. So yes I would recommend removing wisdom teeth ~85% of the time and I would recommend sedation for the procedure.


Its too bad that wisdom teeth are most likely the most "unintelligent" teeth in the mouth. How's that for irony!