Wisdom Teeth Removal in Woodland Hills, CA

No — and this deserves stating plainly, because the assumption that every wisdom tooth must be extracted is not supported.

A wisdom tooth can stay if it is fully erupted, correctly positioned, functional in your bite, cleanable with a brush and floss, and free of decay and gum inflammation.

A wisdom tooth should come out if it is causing or is very likely to cause a problem.

Reasons for Removal

• Impaction. The tooth cannot erupt into a functional position and is trapped in bone or against the adjacent molar
• Pericoronitis. A flap of gum partially covering an erupting tooth traps food and bacteria beneath it, producing painful, recurrent infection. This is one of the most common presentations we see
• Decay. Wisdom teeth are extremely difficult to clean and frequently decay. Restoring them is often impractical
• Damage to the second molar. An angled wisdom tooth pressing against the root of the tooth in front can cause decay or resorption on that neighbour — losing a healthy, functional molar to protect one that is not
• Cyst formation around an unerupted tooth, which can destroy surrounding bone
• Gum disease in a region impossible to clean properly
• Orthodontic considerations. Sometimes recommended before or after treatment, though the belief that wisdom teeth cause front-tooth crowding is not well supported by evidence
• Pain, swelling or recurrent infection

Types of Impaction

Consultation and Imaging

We examine the area and take radiographs — typically a panoramic image showing all four wisdom teeth, their angulation, root development and their relationship to critical structures.

Two structures matter most: the inferior alveolar nerve, which runs through the lower jaw close to the roots of lower wisdom teeth and supplies sensation to the lip and chin, and the maxillary sinus above the upper wisdom teeth. Where a lower root appears to be in intimate contact with the nerve, we take a 3D cone beam scan to see the true relationship in three dimensions. See our technology.

This imaging is what allows us to plan a safe extraction — and to identify the small number of cases better referred to an oral and maxillofacial surgeon. We would rather refer you than take on a case that belongs in a surgical specialist's hands.

Anaesthesia and Sedation Options

• Local anaesthetic alone — sufficient for straightforward extractions
• Nitrous oxide with local anaesthetic — takes the edge off anxiety, wears off within minutes, and you can drive yourself home
• Oral conscious sedation — a tablet taken beforehand leaves you deeply relaxed and typically with little memory of the procedure. You will need someone to drive you

For anxious patients and for multi-tooth extractions, sedation makes a substantial difference to the experience.

The Extraction

For an erupted, well-positioned tooth: the tooth is loosened and lifted out. Minutes.

For an impacted tooth: a small incision is made in the gum, a conservative amount of bone covering the tooth is removed, and the tooth is often sectioned — divided into pieces — so each piece can be removed through a smaller opening. Sectioning sounds alarming and is actually the conservative approach: it removes far less bone than extracting the tooth whole. The site is then cleaned and stitches placed if needed.

You will feel pressure and hear noise, but not pain. Removing all four typically takes 45 to 90 minutes.

Dry socket (alveolar osteitis). Occurs in roughly 2 to 5 percent of extractions and considerably more in smokers. The blood clot protecting the socket is lost, exposing bone. It produces severe, throbbing pain typically starting three to five days afterwards, often radiating to the ear, and frequently a bad taste. It is treatable — we clean and dress the socket, and relief is usually rapid. Call us; do not endure it.

Infection. Uncommon. Signs are increasing pain and swelling after day three, fever, pus or a persistent bad taste.

Nerve involvement. The main risk of lower wisdom tooth removal. Temporary numbness or tingling of the lip, chin or tongue occurs in a small percentage of cases and usually resolves over weeks to months. Permanent alteration is rare. This is precisely why 3D imaging is used when roots appear close to the nerve, and why some cases are referred to a surgeon.

Sinus communication. Possible with upper wisdom teeth whose roots sit near the sinus. Usually managed with precautions and heals without issue.

Prolonged bleeding, jaw stiffness and bruising are common but generally self-limiting.

Call Us If

Bleeding does not slow after several hours of pressure; pain worsens after day three rather than improving; swelling increases after day three; you develop fever; you have difficulty swallowing or breathing; or numbness persists beyond a day after treatment.

Difficulty breathing or swallowing, or rapidly spreading facial swelling, is a medical emergency. Go to an emergency room.

• Thirty-plus years in practice, USC-trained, with extensive extraction experience
• Proper imaging before every case, including 3D cone beam scans where the nerve relationship needs assessing
• Sedation options — nitrous oxide and oral conscious sedation — because anxiety about this procedure is common and entirely reasonable
• Conservative technique. Sectioning teeth to remove less bone means less trauma and faster healing
• Socket preservation grafting where indicated, to maintain bone volume
• Honest referral. High-risk cases go to an oral and maxillofacial surgeon. Your safety comes before keeping the case
• Same-week and emergency appointments — pericoronitis is genuinely painful and should not wait
• A dental spa environment, 4.6 stars across 80 Google reviews