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Nathan T Cary, DDS

Phillip G Cary, DDS


500 North Main Street, Canandaigua, NY 14424,  585.394.3322

Wisdom Teeth

Extraction of wisdom teeth (also called 3rd molars or 18 year molars) is advisable when they do not have adequate space to erupt properly into the mouth. They may grow sideways, partially emerge from the gum and even remain trapped beneath the gum and bone (complete impaction). Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.

Poorly positioned or impacted wisdom teeth can cause many problems. When they are partially erupted, the opening of the gum tissue allows bacteria to grow. This will eventually cause an infection or decay.  Sometimes an adjacent tooth becomes compromised with decay, periodontal bone loss, or damage to the root structure as well. The result: swelling, stiffness, pain, possible damage or loss of an adjacent tooth, and illness. The bacteria that grow in these areas may lead to the development of gum disease in other areas of the mouth.  Recent evidence suggests that chronic infection and inflammation are associated with the development of other diseases and conditions of the body. It is generally held that the pressure from an erupting wisdom tooth may move other teeth and disrupt their alignment. The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth.

Removing the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with this procedure. Having complete soft tissue coverage when wisdom teeth are certain removed facilitates wound closure and less potential for problems.  Further, young patients heal faster and more completely.

With an oral examination and x-rays of the mouth, we can evaluate the position of the wisdom teeth, their spacial orientations, relative maturity, and the availability of space for eruption. We can then determine if there are present problems, and with reasonable certainty if there will likely be future problems. 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 their Dentist, Orthodontist, or by an Oral and Maxillofacial Surgeon.



All oral surgery is performed under appropriate anesthesia to maximize patient comfort and minimize stress and anxiety. Our Doctors and our Surgical Assistants have the training, license and experience to provide various types of anesthesia. These include local anesthesia and intra-venous (IV) anesthetic agents. These options as well as the surgical risks will be discussed with you before the procedure is performed.

Our services are provided in an environment of utmost safety that utilizes modern monitoring equipment and staff that are experienced in anesthesia techniques. Once your wisdom teeth are removed, you will rest under our supervision in the office until you are ready to be taken home. You will be discharged with a post-operative kit that will include postoperative instructions, gauze packs, ice packs (if needed), a prescription for pain medication, and a prescription for antibiotics, if needed. Appointments for follow-up care will be made for you if further care is needed or anticipated.

Initial postoperative bleeding is normal, and can generally be controlled with biting pressure applied to gauze packs placed over the extraction sites. All patients should expect some degree of postoperative pain or discomfort. Some patients will experience swelling of the cheeks or lower jaw, which ranges from minimally apparent to significant amounts. A variable amount of jaw stiffness and discomfort when swallowing is not uncommon.

We generally recommend anywhere from three to five days of rest prior to resuming all activities. You will be provided with written postoperative instructions to help guide you through the healing process, and phone numbers with which you can get in touch with us for any questions or instruction.

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