Brady J. Semmel DMD, MD

Map Icon1422 Commonwealth Drive, Wilmington, NC 28403

Map Icon910-509-1422
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What Are Wisdom Teeth?

Impacted Wisdom Teeth

Wisdom Teeth Removal

Wisdom Tooth Surgery Pre- and Post-Op Instructions

After Extraction of Wisdom Teeth

What Are Wisdom Teeth?

Wisdom teeth are the final adult teeth to emerge and usually finish growing by a patient’s teens or twenties. They are located behind the last teeth and are also known as “third molars.” Because their development can cause impaction or other dental issues, wisdom teeth removal is a common procedure all across the U.S.

If you would like to schedule a consultation or an appointment for wisdom teeth removal in Wilmington, North Carolina, call 910-509-1422.

Impacted Wisdom Teeth

What are impacted wisdom teeth?

Impaction happens when there isn’t enough room in the jaw for teeth to erupt correctly from the gumline. While any tooth can become impacted, it commonly happens with wisdom teeth. While it is common to develop all 32 adult teeth, often there is not enough room for the wisdom teeth to come in and function properly.

Types of Teeth Impactions

We recommend that you come in for a consultation with Dr. Brady J. Semmel. At Semmel Oral and Facial Surgery, he will use our advanced X-ray imaging to determine whether or not you are a good candidate for wisdom teeth extraction in Wilmington, North Carolina. The following are common types of impactions our office treats.

Soft Tissue Impaction:

This happens when the tooth fails to emerge fully from the soft tissue of the gums. This can make it difficult to clean the site and can lead to decay or infection.

Partial Bony Impaction:

This happens when the tooth becomes impacted within the bone of the jaw and only partially appears above the gumline. Like with soft tissue impaction, this can make it difficult to clean the site, as well as prevent chewing and functioning properly.

Complete Bony Impaction:

This happens when the tooth is not able to emerge due to lack of space and needs surgery to be removed.

Wisdom Teeth Removal

Oral Exam

At your oral exam, our oral surgeon will examine the wisdom teeth to determine if they have the potential to cause issues. We recommend that parents bring their children in by their mid-teens for early evaluation and more successful treatment.

With wisdom teeth removal and all other oral surgeries performed outside of the office, our experienced oral surgeon and office team will use anesthesia to help patients feel comfortable throughout the procedure.

Why would I need to have my wisdom teeth extracted?

We recommend removal of wisdom teeth before their roots develop, during early teens or twenties. If they are not removed early, they can cause a host of problems, including:

  • Infection, when a partially emerged tooth irritates the surrounding gum tissue and causes an infection called pericoronitis.
  • Cysts, which are fluid-filled formations that can cause damage to the surrounding tissue. This becomes more difficult to treat in older patients. Rarely, tumors can also develop due to unremoved wisdom teeth.
  • Crowding, when the impacted tooth pushes other teeth out of alignment. This can interfere with orthodontic work and the proper bite and function of the teeth.
  • Damage, if the position of the impacted tooth prevents proper dental hygiene, it can lead to tooth decay and gum disease.

What happens if I don’t have them removed in my teens or twenties?

The longer wisdom teeth are allowed to develop, the more difficult it becomes to remove them. As the roots lengthen and the jawbone’s tissue strengthens, it can complicate the extraction and slow down healing. However, if you are past your early teens or twenties and the teeth are completely impacted, we may not recommend surgery unless other issues appear.

What happens during the appointment?

During your appointment, our office will provide you with safe sedation and anesthesia options. These will help you feel comfortable and help our oral surgeon effectively complete the procedure. Our office is trained and licensed, and we have the experience to provide these services using modern, up-to-date techniques and tools. Our practice is also inspected by the Board of Dental Examiners regularly to ensure optimum safety.

On the day of your wisdom teeth extraction, patients will be given medications to take to help with post-surgery recovery. Patients should be escorted by a responsible adult to drive the patient home and monitor them throughout the day. Wisdom teeth extractions usually take anywhere from a half hour to an hour, and most appointments last about an hour and a half. Our office’s current techniques keep our office sterile and help patients recover quickly with minimized overall discomfort.

In the six hours before their surgery, patients should avoid food and drink, taking in only sips of water with their medication. Patients should also avoid heavy meals before this six-hour period, as they may cause nausea or vomiting. Our oral surgeon can arrange for pain medication prescriptions to be filled in advance. Once patients are seated, an IV will be inserted if they are receiving sedation. With all tooth extractions, anesthesia will be given to help you feel at ease during the procedure. Anesthesia effects will last for the rest of the day. The patient will need to be taken home and monitored until they wear off.

If sutures were used during the surgery, there is no need to come in for removal, and they will disappear within three to five days. The gums may also swell and pull away from the teeth. This is normal and should start to go away within a few days.

After the affects of anesthesia wear off (usually after a day), patients can try taking over-the-counter anti-inflammatories like ibuprofen. If this is not enough, patients should take any prescribed pain medication. The affects of anesthesia may cause numbness and should not be confused with nerve damage.

To avoid nausea, we recommend not ingesting dairy products until the anesthetic and pain medications wear off. In addition, if you are given antibiotics, take in mind that these can interfere with the effectiveness of birth control medication.

How much will this procedure cost?

Depending on the position of the teeth and the anesthesia used, the price of treatment will vary. When patients come in for a consultation, our oral surgeon can examine X-rays of the teeth and give an accurate estimate of the procedure. Each insurer has different coverage for wisdom teeth extractions, but our team will do their best to get you the most coverage possible.

Who do I contact if I have questions?

Patients can contact our office at 910-509-1422 if they have any questions following their consultation or surgery.

Wisdom Tooth Surgery Pre- and Post-Op Instructions

Before your operation:

  • Diet: Do not ingest any food or drink in the six hours before your procedure. Only take in medications and sips of water and ask our oral surgeon about insulin issues.
  • Supervision: A driver must take you home following your surgery, and you must have someone to supervise you for twelve hours until the anesthetic wears off. We ask that your driver accompany you during your check-in.
  • Medication and Prescriptions: For patients who did not receive their pain medication or other prescriptions during their consultation, we recommend that they call in a week before surgery. This will give the pharmacist time to prepare the prescription and for you to pick it up before your appointment.

*Our office does not allow photos or video of patients in the clinical or recovery areas.


  • Diet: Keep to a liquid diet on the day of your surgery while avoiding hot drinks. Keep to soft foods and avoid crunchy or hard foods for the first week. Be sure to remove any gauze pads before you eat.
  • Bleeding: After your surgery, keep the gauze in place, covering the surgery site, for twenty minutes. If the site is still bleeding, patients can replace the packs until the bleeding has stopped. While bleeding may occur for up to two days, patients can use a wet tea bag, applying pressure for another twenty minutes. If heavy bleeding continues, get in touch with Semmel Oral and Facial Surgery.
  • Swelling: Alternate applying ice every 20 minutes to help reduce swelling during the first 2 days.
  • Pain: Your discomfort should start to lessen after two to three days. Be sure to take any medication and avoid drinking alcohol.
  • Smoking: Do not smoke in the weeks following your surgery.
  • Dental Hygiene: Patients should still brush their teeth though they should avoid touching the surgery sites during the week after their surgery. Patients can also rinse with salt water and flush the site using an irrigation syringe. (We usually recommend using the syringe three days after the initial procedure.)
  • Sutures: Avoid disturbing the sutures and do not pull at the lips or cheeks. The stiches should dissolve on their own over the course of the week.
  • Fever: Following the extraction, patients may experience a slight fever. If this lasts more than a few days, contact our practice.

If you have any questions concerning your recovery, call 910-509-1422 to speak with our office.

After Extraction of Wisdom Teeth

Before your appointment, our oral surgeon will go over any risks associated with the surgery, sedation or anesthesia methods. After removal, the gum will be sutured and gauze will be placed over the site. After our office discharges you, you will be given a kit including post-surgery instructions and prescriptions for antibiotics or pain relievers, as well as a follow-up appointment if necessary. Call 910-509-1422 if you have questions following your appointment.

How will I feel following surgery?

The day following your appointment, many patients will have some pain, bleeding and swelling. We recommend applying ice the first day to reduce swelling. The swelling should start to reduce by the third day, and the jaw may become stiff, and it may be hard to fully open the mouth. We recommend applying a warm, wet towel or other compress to help relax the muscles of the face. Refrain from strenuous activity in the three to five days following your surgery.

What issues can develop after surgery?

While our office does everything we can to ensure proper recovery, some patients may develop the following:

  • Dry sockets
  • Infection
  • Nerve damage
  • Sinus communication (an opening between the sinuses and the mouth)

We advise patients to follow any post-surgery instructions to avoid these issues and to help ensure healing. However, our oral surgeon can help patients recover from any unexpected treatment complications.

Dry Sockets:

The most common complication for patients is dry socket, which can cause pain around the ears and chin. Our oral surgeon may recommend changing your prescription or applying a dressing to help protect the site from discomfort. Until the site has been pain-free for two to three days, patients will need to switch out the dressing every day or every other day. A dressing is not always necessary to help with pain, and the socket will heal on its own without it.


If an infection occurs, patients will come in for an additional exam. Most often, a week of antibiotic medication can resolve the issue. If necessary, our oral surgeon may recommend that the site be drained and cleaned. Some stiffness, chafing, bruising and bleeding may take some time to heal. Please call our office if you have questions not answered by the post-surgery sheet given to you.

Nerve Damage:

The nerve that runs along the lower jaw can occasionally become damaged during removal, especially when treating older patients. After the effects of anesthesia have been given time to wear off, patients should let our oral surgeon know if they experience any lingering numbness or tingling in the face. Most often, this will wear off in a few weeks or months.

Sinus Communication:

Some teeth in older patients fuse to the bone that separates the oral cavity from the sinuses. The removal of these teeth can result in a space connecting the two openings. This will usually close on its own, but we recommend not putting any pressure on the space and avoid blowing your nose or sneezing with the mouth closed. Very rarely, our oral surgeon will recommend a second procedure to repair this opening.


Map Icon1422 Commonwealth Drive, Wilmington, NC 28403