IV Sedation Dentistry & PRF in Wisdom Teeth Surgery

wisdom teeth removal dentistAre you looking for a dentist who removes wisdom teeth in Burtonsville near Silver Spring, Clarksville or Columbia Maryland? Dr. Gary Adams is one of the best dental surgeons for wisdom teeth removal in the DC and Maryland areas. People travel from all over the DC metro, US and abroad. Two things that separate our oral surgery practice are 1) wisdom teeth removal anesthesia and IV sedation options 2) Dr. Adams holistic and natural approach to wisdom teeth surgery. Dr. Adams uses platelet rich fibrin or PRF in wisdom teeth surgery sites to reduce pain, swelling and recovery time.

Call 301-421-1996 for a consultation with Dr. Adams

PRF in Wisdom Teeth Surgery Video:

Dr. Adams has removed thousands of wisdom teeth. If you have dental anxiety, Dr Adams offers different dental anesthesia options. We will not judge you for being nervous. We offer complimentary consultations. Contact us if you want to meet Dr. Adams and find out how much it costs to get put to sleep and have impacted wisdom teeth taken out.

How to Extract Wisdom Teeth?

wisdom teeth removal costIt’s best to to remove teeth as carefully as possible without using much force and without causing unnecessary trauma. (sedation dentistry is a good idea if you have dental anxiety) For example, what you would not want to do is pull as hard as possible to get the tooth out quickly. A better approach is to separate a multi-rooted tooth into pieces and take it out one root at a time. This approach to tooth extraction is often called “atraumatic tooth extraction” procedure. When a tooth is taken out carefully with less force, it results in less swelling and pain, faster wisdom tooth healing period. We use some of the most careful oral surgery techniques available for tooth removal. Additionally, we have treatments such as PRF and ozone dental therapy that helps speed up wisdom teeth surgery healing times.

PRF in Wisdom Tooth Surgery Procedures:

prf wisdom teeth removalPRF is a treatment that helps oral surgery procedures recover faster and decreases the risk of extraction socket infection. PRF is made by drawing a small amount of patient blood and spinning it in a centrifuge for 13 minutes at 2700 RPM. The Spinning process will separate out the yellow PRF layer of interest. PRF consists of fibrin, white blood cells and bone growth factors. The primary growth factor is bone morphogenic protein. PRF looks like a yellow jello-like substance that can be put into extraction sites and dental implant surgery site.

Ozone O3 and Oxygen O2 promotes healing and removes bacteria and fungus in Surgical Sites

Dental ozone and oxygen gas is placed into extraction sites to promote healing of gum and jaw bones. Ozone also kills bacteria, fungus and other pathogens and toxins hiding in the pores of bone cells. Bone does not have a lot of blood supply and is particularly susceptible to infection and healing delays. Ozone is especially helpful in preventing dry sockets. Once a tooth is extracted, it is very important to remove the PDL or the periodontal ligament and any irregular granular tissue / scar tissue. Once the extraction socket is cleaned then the ozone should be used in the extraction socket. This completes the extraction and cleansing of bony socket. The final step in natural holistic extraction technique is to place PRF into the extraction socket.

 Impacted Surgical Techniques?

How to remove a two rooted wisdom tooth and preserve bone and the extraction socket. Basically, the roots are separated into two pieces and removed one root at a time. This technique can be done without the need to apply much force.

Different types of Impacted Teeth:

wisdom tooth removal types

Partial Bony Impaction:

  1. The gum tissue should be gently reflected (not ripped off and all the way displaced), like peeling away but not removing, a small piece of an orange peel. The gum should be manipulated so the tooth can be properly accessed and visualized.
  2. Careful removal of any small amount of jawbone that has grown up and around the crown portion of the tooth.
  3. Separation of the two roots with a dental drill.
  4. Removal of the back root first. This needs to be done because the front root is normally stuck underneath the crown of the 2nd molar tooth in front of it. Removal of the back root is easy once it is separated from the front root.
  5. Removal of the front root, which can be easily scooted into the space created by removal of the front root.
  6. Placement of PRF is highly recommended especially in lower tooth extraction sites since the lower jaw has less blood supply and is more susceptible to infection.
  7. PRF Treatment

Angular Impacted Removal:

  1. The gum tissue should be gently reflected. The gum should be manipulated so the tooth can be properly accessed and visualized.
  2. Careful removal of any small amount of jawbone that has grown up and around the crown portion of the tooth.
  3. Removal of the entire crown of the tooth with a dental drill. In this case the entire crown of the tooth will be underneath of the tooth in front of it.
  4. Separation of the two roots with a dental drill.
  5. Removal of the back root
  6. Removal of the front root by sliding it into the space where the back root was, and then out of the extraction site.
  7. PRF Treatment

Horizontal Bony Impaction Removal Strategy:

  1. The gum tissue should be gently reflected. The gum should be manipulated so the tooth can be properly accessed and visualized.
  2. Careful removal of any small amount of jawbone that has grown up and around the crown portion of the tooth. Horizontal teeth may have more bone removal than partial bony and angular impactions. The extra bone removal called “alveoloplasty” is necessary because there is more bone volume burying the tooth and more access is needed to get the Horizontal tooth out of the jaw bone.
  3. Complete removal of the crown of the tooth
  4. Separation of the roots.
  5. Removal of the top root up and out of the jaw
  6. Removal of the bottom root, with the access created by removing the top tooth.
  7. PFR Treatment

Vertically Impacted Technique:

  1. The gum tissue should be gently reflected. The gum should be manipulated so the tooth can be properly accessed and visualized.
  2. Careful removal of any small amount of jawbone that has grown up and around the crown portion of the tooth. Vertical teeth may have more bone removal than partial bony and angular impactions. The extra bone removal is necessary because there is more bone volume burying the tooth and more access is needed to get the Vertical tooth out of the jaw bone.
  3. Separation of the roots.
  4. Removal of the back root
  5. Removal of the front root into the space created by removal of the back root.
  6. PRF Treatment

Wisdom Teeth Surgical Procedure Tips:

  1. Quickly and Carefully
  2. Taken out the “smart way” or strategically
  3. Without high force
  4. With minimal disturbance to the surrounding tissues
  5. With PRF treatment into the extraction socket and the best clean-up techniques possible
  6. perfect post operative instructions
  7. Appropriate prescriptions including antibiotics, anti-inflammatories, pain medication when necessary

Cost of Wisdom Teeth Surgery

Wisdom teeth removal cost is $300 – $750 each depending on the position in the jaw and what is covering it.  Dental Insurance will often cover up to 80% of surgical costs. Dental anesthesia and sedation procedures are an option but add to the cost of wisdom teeth removal procedures.

Do I need to get put to sleep?

wisdom teeth removal anesthesiaNo, but It would not be a bad idea. It is only necessary to keep you calm and comfortable during the procedure. Sleep sedation will help you remain calm and comfortable throughout the procedure while your body can preserve it’s energy for healing and recovery. People who have sedation report less dental anxiety during the procedure and for future dental appointments. Sedation dentistry usually results in less pain and swelling and complications after the procedure. Full Sedation requires having someone drive you to and from your dental appointment and you will not be able to drive or work for 24 hours.

Do I need a 3D Cone Beam / CT Scan?

oral surgeon in burtonsvilleYes. For oral surgery services we need to identify where the wisdom teeth are and vital structures such as nerves and arteries in your jaw to avoid aggressive surgical incisions and unnecessary trauma or permanent damage during the procedure.

 Is it Necessary to Remove Wisdom Teeth?

It is always best to remove impacted wisdom teeth, but… sometimes removing impacted wisdom teeth can do more harm than good. For example, if a horizontal wisdom tooth impaction is removed and the patient experiences permanent jaw nerve damage, hindsight may suggest the tooth may have caused less harm had been left alone. Removing wisdom teeth may be a matter of whether or not there is infection present or whether or not the impacted wisdom tooth is harming the root of the molar in front of it. It is best to get a consult from an oral surgeon or another dentist with a oral surgery experience.Do I need to remove wisdom teeth? Maybe.

If they are too far back to clean or if there is not enough room in the mouth for them to grow into the mouth, than Yes. If you do not take them out, one day your jaw will swell and you will be forced to drop everything you are doing.

What are the potential complications?

Damage to the nerve in the lower Jaw causing partial or complete numbness to the lip area. Very uncommon and usually only temporary. Communication into the upper sinus. Usually happens when a root has grown into the sinus. Usually heals on its own.

Wisdom Teeth are too far back to properly clean.  In fact cleaning wisdom teeth in many cases is impossible.  Wisdom teeth can cause dental cavities, periodontal or gum disease.  Wisdom Teeth can have cysts form around them and severely damage the jaw bone.  Wisdom Teeth also can interfere with proper closure of the upper and lower jaws.  Wisdom teeth can cause a poor bite and can lead to TMJ pain.

By retaining WT, most individuals will get dental cavities or dental caries, periodontal or gum disease and TMJ problems.  Many people can have severe damage to their second molars which are the teeth in front of the Wisdom Teeth.  Often WT can come in sideways.  When the teeth come in sideways which is also called horizontally impacted, the can cause severe dental decay on the second molars.  Sometimes the damage to a second molar can be so severe, the patient will lose both their Wisdom Teeth and 2nd molars.  Most of the time removal is a matter of health and preventative dental care.

What is the Recovery period?

Usually some pain for 1-2 days (relieved by ibuprofen and pain meds) followed by soreness for a week or so.

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