Wisdom Teeth: A guide for parents & patients

Typically, we each get three sets of molars during our lifetime; the first molars arrive around age 6, the second molars at age 12 and the third molars begin during the mid to late teens or early twenties.  Since this time is traditionally associated with the onset of maturity and becoming wiser, we refer to third molars as wisdom teeth. They are usually the last teeth to develop and are located in the back of your mouth, behind your second molars.

Do You Want Your Wisdom Teeth Removed?

If your wisdom teeth are causing you pain or you want to avoid future problems, contact our office to schedule an appointment.

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Oral And Radiographic Examination

With an oral examination, Dr. Azzopardi, Dr. Moores, Dr. Chames, Dr. Kissoondial, Dr. Haskins and Dr. Coke will take x-rays and may use specialized imaging tools to get a clear picture of the positioning of your wisdom teeth.  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 the recommendation of their dentist or orthodontist.

Wisdom Teeth Removal

The removal of wisdom teeth is a routine procedure in our office, but it probably doesn’t feel that way to you. Most people prefer to be unaware of the experience of having their wisdom teeth removed and usually decide to have an IV anesthetic. The length of your surgery depends on a variety of factors including the type of impaction, the position 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. Once the surgery is complete, you will rest and continue to be monitored under our supervision until you are ready to be taken home.  


Anesthesia is an important part of every oral surgery procedure. We offer solutions to eliminate anxiety while maintaining maximum patient comfort and safety. Utilizing gentle medications that are well tolerated and quickly metabolized, allows for a safe and comfortable procedure, with a quick and smooth recovery.  We will make you comfortable before, during and after your procedure.

Family sitting on a coach

The Day of Treatment

If you are a minor, you will need to have a parent or legal guardian with you at the time of removal. Make plans to have them stay with you for the rest of the day following  your  surgery.

Should I Have My Wisdom Teeth Removed?

If your wisdom teeth properly erupt into alignment and the surrounding 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 inadequate space prevents the teeth from erupting.  If you do not have enough room in your mouth for your third molars to fully erupt, a number of problems can occur.

Impacted Wisdom Teeth: A Common Condition

Rest assured, this is a very common condition that we treat regularly in our office.  Impacted wisdom teeth should be removed before their root structure is fully developed. Early removal is recommended to avoid future problems and to decrease the surgical risk involved with the procedure.

When inadequate space prevents the teeth from erupting into proper position alignment for chewing and cleaning they are called impacted. Impactions occur when wisdom teeth come in at the wrong angle or simply because your mouth is not large enough to accommodate another set of molars. That’s why 9 out of 10 people find themselves with at least one impacted wisdom tooth that requires extraction.

Side-by-side images of a mouth X-ray showing impacted teeth and a digital graphic highlighting impacted teeth

types of Impactions

  • Soft Tissue Impaction: There is not enough room to allow the gum tissue to retract for adequate cleaning of the tooth.
  • Partial Bony Impaction: There is enough space to allow the wisdom tooth to partially erupt. However, the tooth cannot function properly in the chewing process and creates cleaning problems, among others.
  • Complete Bony Impaction: There is NO space for the tooth to erupt. It remains embedded in the jaw bone or if even partially visible requires complex surgical techniques for removal. The impacted wisdom tooth may also be in an unusual position and difficult to remove. This situation can also arise when the shape or size of the jaw bone and other facial structures make the removal of this tooth significantly more complex.
A representation of a wisdom tooth impacted by soft tissueSoft Tissue
An example of a wisdom tooth with a partial bony impactionPartial Bony
An illustration of a wisdom tooth completely impacted by boneComplete Bony


Impacted wisdom teeth don’t always cause symptoms. Pain free does not mean disease free. However, when an impacted wisdom tooth becomes infected, damages other teeth or causes other dental problems, you may experience some of these signs or symptoms:

  • Red or swollen gums
  • Tender or bleeding gums
  • Jaw pain
  • Swelling around the jaw
  • Bad breath
  • An unpleasant taste in your mouth
  • Difficulty opening your mouth


Poorly positioned impacted wisdom teeth that are not removed have the potential to cause problems throughout your life and should not be ignored.

  • Impacted teeth may grow sideways, partially emerge from the gum tissue, and even remain trapped beneath the gum and bone. They can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.
  • When they partially erupt, the opening around the teeth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain, and illness.
  • The pressure from the erupting wisdom teeth 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 teeth, resulting in the destruction of the jawbone and healthy teeth.
A representation of a pericoronitis infection on a wisdom tooth


The most frequent clinical problem we see is pericoronitis, (a localized gum infection). Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.

An example of a cyst formation on a wisdom tooth

Cyst Formation:

Non-infectious diseases may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jaw bone that develop as a result of impacted teeth and slowly expand destroying adjacent jaw bone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.

An illustration of teeth crowding caused by a wisdom tooth

Possible Crowding:

Impacted wisdom teeth may contribute to crowding of your teeth. This is most noticeable with the front teeth, primarily the lower front teeth and is most commonly seen after a patient has had braces. There are a number of factors that cause teeth to crowd after braces or in early adulthood. Retained, impacted wisdom teeth may be a contributing factor. Unless you have an active problem when you see the oral surgeon, the reason for removal is primarily to prevent long-term damage to your teeth, gums and jaw bone.

A visual of a wisdom tooth damaging an adjacent tooth

Damage to Adjacent Teeth:

If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the second molar, can be adversely affected resulting in gum disease, bone loss around the tooth, and/or decay.

When It Comes To Wisdom Teeth, Timing Is Everything

As wisdom teeth develop, the roots become longer and the jaw bone denser. When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the post-operative course can be prolonged and there is a higher complication rate. Treating these complications is often more difficult, the healing may be slower and the chance of infection can be increased.

If your impacted wisdom teeth are not removed in your teenage years or early in your twenties and they are completely impacted in bone, it may be advisable to wait until a localized problem (such as cyst formation or localized gum disease and bone loss) develops.

In general, you will heal faster, more predictably and have fewer complications if treated in your teens or early twenties.

Patient Reviews for Wisdom Teeth Extraction

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Oakland Oral Surgery & Dental Implant Center

5 out of 5 stars based on 155 Wisdom Teeth Removal reviews

Patient Review

It all started with januarry 1st, a sunday, where my bottom right wisdom tooth (which had actaully had a filling 10 months prior) wound up having a piece break off. So i went to my regular dentist whom filled it with a temp filling and instructing me that this tooth needs to be extracted and referred me to this place. I will be honest. i was truly dreading this procedure for the entire month I had to wait to get in. But from the very start the staff was very helpful and friendly. I initially was scheduled for the Livonia Office, but my work was actually closer to the Novi location so i called up Livonia and asked them about it. they were able to easiily and happily reschedule me to go to Novie. Also they were very good about explaining what i need to bring with me. I showed up this past week for my appointment with Dr. Coke. From the very start at the front desk, they were friendly , and informative. I was then called in for a brief talk with Andrea and she was very good at explaining what she needed to and answered questions for me. Dr. Coke was very friendly, very informative, explained everything step by step before during and after. answered questions i had. and was so calming. He told me exactly every detail of what to expect even as i was undergoing the procedure. he made me feel at east and afte rit was all over it was far easier than i expected. and afterwards, when i went to pick up medications, there was an issue at the pharmacy saying they didn't have the extra strength medication so i called in and worked with Melissa on the phone a few times in order to find a place that did, and she was so friendly and helpful, getting me through this. I will be back next week for follow up but my first visit was A+

- Mark R

5 out of 5 stars on

Patient Review

I took my daughter to get her wisdom teeth pulled. The staff and doctor were patient and knowledgeable. They took their time and did an excellent job. Allison had no bruising or swelling and very little discomfort. Doctor Haskins also followed up to make sure she was doing well afterwards.

- Allison B

5 out of 5 stars on

Patient Review

Dr. Haskins was awesome and comforting and made me relaxed.

- David I

5 out of 5 stars on

Patient Review

Dr. Kissoondial and all of the staff are AMAZING! My daughter had all four of her wisdom teeth extracted here a couple weeks ago. From my first interaction when calling to schedule her appointment to her pre op, the staff was so professional, so accommodating, and just as friendly as can be! I received a call that night from Dr. Kissoondial to check up on her, I was so impressed, she had slight discomfort for one evening, and other than that she sailed through this! Thank you all!

- Ella Manolatos C

5 out of 5 stars on

Patient Review

My son needed his wisdom teeth removed. Dr. Azzopardi took the time to thoroughly explain the procedure. He even personally called to check up on my son. The office was immaculate. The staff was really friendly.

- Michelle T

5 out of 5 stars on