Wisdom Teeth

By the age of 18, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine, and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth (molar teeth) are used to grind food up into a consistency suitable for swallowing.

The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your third molars, also known as “wisdom teeth.”

Why Should I Have My Wisdom Teeth Removed?

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and 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 they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, 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. Removal of the offending impacted teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.

Oral Examination

With a comprehensive and/or extensive oral examination and Panorex x-ray of the mouth, Dr. Marcantoni can evaluate the position of the wisdom teeth and predict if there are present or may be future problems. This visit can take 90-120 minutes from the moment you walk into our office to when you walk out of the office.  It is not a quick visit like your dentist visit may be.  This is a consultation for surgery.  During this evaluation Dr. Marcantoni and staff will discuss and collect the patient’s medical health and history,current medications, supplements and vitamins the patient is taken, allergies, etc.  Based on the assessment Dr. Marcantoni will decide if the patient’s surgery can be completed in the office or at the hospital on a later date. 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.

Whatever questions the patient and/or guardians/parents have this is the time to ask all the questions you may have and address any of your concerns because you will not see the doctor again until the day of the surgery.  This is why it is good that the parent/guardian that comes to the evaluation for the consultation be the same person that brings the patient and stays in our office during the surgery waiting for the patient and take the patient home and care of the patient.  

All inpatient surgery for wisdom teeth are usually performed with local anesthetic, nitrous oxide/oxygen analgesia and IV sedation with therapeutic drugs (which help with swelling, pain and nausea up to 3 days after surgery).  Outpatient surgery is performed under appropriate general anesthesia at Dell Children’s Medical Center for patients 21 years of age and young to maximize patient comfort and safety.  Outpatient surgery for adults are performed at Dell Seton Medical Center in Austin, Texas to maximize patient comfort and safety. Dr. Marcantoni has the training, license and experience to provide various types of anesthesia for patients to select the best alternative of sedation/anesthesia.

Almost all insurance companies require a preauthorization for surgery.  After the patient’s consultation our office will submit a preauthorization to the patient’s insurance.  Depending on the insurance carrier it can take up to 30 days to receive the preauthorization determination from the insurance company.  Medicaid and CHIP usually takes about 7-10 days and private insurance takes about 30-35 days after they receive the preauthorization request from our office.  


The doctor and two registered dental/surgical assistants are always in the operating with the patient having surgery.  In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia) and IV sedation with therapeutic drugs (which help with swelling, pain and nausea up to 3 days after surgery). These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. Once the teeth are removed, the gum is sutured that will dissolve within 7-14 days after the surgery. To help control bleeding, bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home.

While the patient is in the operating room, their escort/parent and/or guardian will watch a video on how to take care of the patient after wisdom teeth surgery and what to watch symptoms or complications that can occur and/or what to expect after surgery.  

Upon discharge, your postoperative kit will include postoperative instructions, a prescription for pain medication, antibiotics, and know that your sutures will dissolve.  You do not have to come in for a follow-up appointment, if you are healing fine and have no signs of an infection. If you have any questions, please do not hesitate to call us at Austin Office Phone Number 512-372-6230. If at any time after the surgery you have any concerns, do not hesitate to contact the office and/or Dr. Marcantoni.  If you call the office after hours, there will be an option to contact the doctor and it will transfer to his cell phone (only call if there is an emergency). 

Wisdom Tooth Removal Overview

For a brief narrated overview of the wisdom tooth removal process, please click the image below. It will launch our educational MiniModule in a separate window that may answer some of your questions about wisdom teeth.

Wisdom Tooth Removal Overview

Our services are provided in an environment of optimum safety that utilizes modern monitoring equipment and staff who are experienced in anesthesia techniques.