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Tag: wisdom teeth removal

It’s normal to feel anxious before oral surgery, but proper preparation and knowing what to expect will help ensure that everything goes smoothly. One aspect of preparing for oral surgery is discussing your anesthesia options with your physician. Here’s an overview from NYC oral surgeon, Ruben Cohen, DDS, about anesthesia for oral surgery.


patient relaxed about oral surgeryWhat does anesthesia do?

The term anesthesia comes from the Greek for “loss of sensation”, but that’s not the only effect it can cause in your body. Depending on the type(s) and amount used, anesthesia can relieve pain, induce amnesia, reduce anxiety and temporarily paralyze your muscles so that a physician can perform pain-free surgical procedures.


What types of oral surgeries use anesthesia?

Anesthesia may be used for many types of oral and maxillofacial surgeries. At our accredited Upper East Side practice, procedures commonly performed with anesthesia include:

  • Wisdom teeth removal
  • Dental implants
  • Surgical exposure of impacted canines and other teeth

Park Avenue Oral & Facial Surgery is one of just a handful of New York City practices that also specializes in pediatric oral surgery. Our medical staff is trained in treating infants and young children with special needs and complex health issues. Get more tips to prepare for a child’s oral surgery by reading our blog post, Calming Fears About Your Child’s Oral Surgery.


What types of anesthesia are used for oral surgery?

There are several anesthetic options for oral surgery. Depending on a patient’s needs and the procedure he or she is undergoing, more than one kind of anesthesia may be used.

  • Local anesthesia – With local anesthesia, the patient remains totally awake and will be fully aware of everything during the procedure. An anesthetic (e.g., lidocaine) is administered in the area where the surgery will be performed. Local anesthesia is commonly administered in conjunction with another type of anesthesia to eliminate pain during a procedure and minimize post-operative discomfort as well.
  • Nitrous oxide (laughing gas) – Nitrous oxide is a colorless gas with a sweet odor and taste, which produces insensitivity to pain when inhaled. It is administered with a comfortable mask placed over the nose through which the patient breathes to achieve the sedative, relaxing effects.
  • Intravenous anesthesia – Intravenous anesthesia, also referred to as “twilight sedation”, is a form of anesthesia wherein the patient is not fully unconscious, but he or she is drifting in and out of sleep in a comfortable, calm and relaxed state. This type of anesthesia can be administered by Dr. Cohen in one of the operating rooms at our accredited practice. Twilight sedation may also be used for patients who suffer from dental anxiety or dental phobia when they are undergoing minor procedures.
  • General anesthesia – With general anesthesia, sedation medications are administered through an intravenous line and closely monitored by Dr. Cohen. The patient is completely asleep during the procedure and will not remember anything about it.


What training do oral surgeons receive in order to administer anesthesia?

Oral and maxillofacial surgeons are trained in all aspects of anesthesia administration. Following dental school, they complete at least four years of training in a hospital-based surgical residency program alongside medical residents. During this time, they serve on the medical anesthesiology service, where they evaluate patients for anesthesia, deliver the anesthetics and monitor patients during and after surgery. As a result of this extensive training, oral surgeons are well prepared to appropriately administer all forms of sedation and general anesthesia in an outpatient setting.


What is office-based anesthesia?

Office-based anesthesia refers to the administration of anesthesia from the comfort and convenience of the oral surgeon’s medical practice. At Park Avenue Oral & Facial Surgery, we are pleased to offer the majority of oral surgery procedures from our office. The advantage of office-based anesthesia is that it minimizes patients’ waiting and recovery time, as compared to having the same procedure performed in a hospital or outpatient surgery center. In addition, in-office procedures and anesthesia delivery are usually less expensive than similar care in a hospital or outpatient surgery center.


Visit our sedation dentistry page to learn more about this topic. If you have any questions about oral surgery and anesthesia, please get in touch with our office by calling (212) 988-6725. We are here to ease your concerns about oral surgery and ensure that you are well informed about your anesthesia options long before your procedure.

Woman with toothacheWisdom teeth typically arrive as you are entering into adulthood and are therefore “wiser” than when your other teeth erupted. But when exactly is the “wise” time to have them removed? This is a common question we hear from patients and parents alike. While the timing may be slightly different for each person, generally speaking the best time to see an oral and maxillofacial surgeon is during the early teenage years when the wisdom teeth have started to grow.


A number of studies have defined the development and eruption pattern of wisdom teeth, also known as third molars. The wisdom teeth usually become visible on an x-ray by the age of nine. In most cases, the crowns of these teeth are formed completely by the age of 14 and the roots are about halfway formed by age 16. By your twenties, wisdom teeth have typically erupted (if there is enough room for them to erupt), and are therefore visible in the back of the mouth. In these late teen years, it is quite common to see impacted wisdom teeth, meaning that the teeth are unable to break through the gums because there is not enough space present. A lack of space in the jaws is one factor that will be considered by an oral surgeon when making a recommendation to have your wisdom teeth extracted.


Why are the teenage years best for wisdom teeth removal?

Wisdom teeth are easiest and safest to remove when patients are in their teenage years due to the fact that the roots are not completely formed yet and the surrounding bone is still soft. Wisdom teeth removal becomes more complicated as the roots of the wisdom teeth develop and grow closer to the mandibular nerve in the late teens and early twenties. Injury to the mandibular nerve can cause numbness to the lower lip and chin, so removing wisdom teeth while the roots are far from the nerve is always safer and preferred. Early removal of wisdom teeth has been shown to result in very predictable and successful outcomes, including a faster recovery with minimal risk of complications.


Why do wisdom teeth need to be removed at all?

Still not convinced that your wisdom teeth need to be taken out? Check out our blog post, Wisdom Teeth – What’s the Big Deal?, about why it’s important to have this procedure done and how it can prevent health problems down the road. If you’re interested in learning more about all the factors that are evaluated before Dr. Cohen will recommend wisdom teeth removal, he addresses that topic in an article for the Huffington Post.


Not all patients will need to have their wisdom teeth extracted, but a consultation with an oral and maxillofacial surgeon that involves radiographic imaging will be necessary to evaluate your condition.


Looking for an oral surgeon in NYC for wisdom teeth removal?

Dr. Ruben Cohen at Park Avenue Oral & Facial Surgery can perform the procedure from his state-of-the-art office on the Upper East Side, an accredited surgery center that’s also a comfortable environment designed to put you at ease throughout the entire process. Check out our patient testimonials to see what other patients are saying about Dr. Cohen. A consultation at our practice is just a call or click away. You can reach us by calling (212) 988-6725 or by filling out the schedule appointment form on this page.


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Especially with the younger crowd, this is a question we get time and time again in our office! And understandably so! To some, removing the wisdom teeth seems like it should be an elective procedure, not a necessary one.Woman with a tooth pain You have probably heard the statistic that 85% of people have to have their wisdom teeth (also called “third molars”) extracted at some point during their life. But you may be wondering “Why?” (As in “Why fix it if it isn’t broken?”)

Well, as it turns out, naming these teeth “wise” demonstrates a very questionable use of vocabulary. “Wisdom” teeth actually turn out to be more like “trouble makers” for most people, and the common removal of them during the young adult years is done as a necessary preventative measure to avoid much bigger problems down the road.

What kind of problems are we preventing?

One of the problems wisdom teeth present is that often there is no place for them to grow. The average mouth is designed to accommodate 28 permanent teeth, not 32. What ends up happening is that the third molars start to grow horizontally, inward or outward or even into the jaw bone, eventually crowding the nerves and causing pain.

In the case of impacted teeth, they may be “stuck” in the jawbone, only able to partially erupt through the gums. This can create an inlet for bacteria with the potential to cause serious infection inside the mouth and jaw area. Furthermore, brushing and flossing becomes a problem, which leads to more problems with decay and infection.

Still not convinced as to why we would perform the procedure now instead of just waiting to see if you develop problems later in life? Great question! As it turns out, we have a very good reason for that as well: In a teen or young adult, the removal of wisdom teeth is much easier to perform with less pain and complications simply because the roots have not fully formed yet. Once those roots set in the surgery becomes more complicated.

We understand your hesitations about wisdom teeth removal, and we’d be happy to answer any other questions you have about your wisdom teeth, give us a call today!

To learn more about Wisdom Teeth removal, please visit Dr. Cohen’s article in the Huffington Post, “How To Know If Wisdom Teeth Really Need To Be Removed