Wisdom Teeth Removal
At Carolina Oral & Facial Surgery, PA, Dr. Bart D. Williams III, has over 25 years of experience performing wisdom teeth extractions every day in the offices of Greenville, South Carolina and Brevard, North Carolina. It is this experience that our patients and families can trust to provide the highest standard of care with a calm and comfortable experience.
Wisdom teeth, also known as third molars, are the last set of teeth to develop and typically emerge between the ages of 17 and 25. Because there’s often not enough space in the mouth, these teeth may grow in at an angle, sideways, or remain impacted beneath the gums.
While wisdom teeth are not necessary for speaking or chewing, they can cause several problems if left untreated—such as crowding, pain, infection, gum disease, and damage to nearby healthy teeth. Early removal can help prevent these complications and support a healthier, more comfortable smile.
Why Extract Wisdom Teeth Early?
Prevent Infection and Gum Disease — Impacted or partially erupted wisdom teeth can trap food and bacteria, leading to painful infections, swelling, and gum disease.
Protect Adjacent Teeth — Removing wisdom teeth reduces the risk of decay, bone loss, or damage to neighboring molars caused by crowding or difficulty cleaning the area.
Reduce Risk of Cysts or Tumors — Extraction prevents the development of cysts or other lesions in the jawbone that can cause long-term damage to bone and surrounding teeth.
Preserve Your Smile, Avoid Future Dental Crowding — Early removal can help preserve the alignment of your smile, especially for patients who have undergone orthodontic treatment.
Early Age Extraction — Younger patients often experience quicker healing and fewer complications after wisdom tooth removal compared to patients in their thirties, forties, and beyond.
Minimize Chronic Discomfort — Extraction can relieve recurring symptoms such as jaw stiffness, pressure, swelling, or sinus pain linked to impacted teeth.
What Is the Wisdom Tooth Removal Process?
1. Initial Consultation
Your journey begins with a comprehensive evaluation by Dr. Williams. All patients are required to complete their new patient paperwork online or by mail prior to their appointment. During your initial visit Dr. Williams will:
- Perform a thorough review of medical history
- Perform an oral examination
- Assess required diagnostic imaging (such as a panoramic X-ray or 3D scan)
- Discuss your symptoms
- Explain the risks and benefits of removal
- Answer any questions, and discuss concerns or anxiety regarding surgery and care
Together, we will develop a personalized treatment plan, including anesthesia options, to ensure your comfort and safety. Our patient financial coordinator will also review your insurance coverage (if applicable) and provide a clear outline of your financial responsibility for surgical services. Each patient receives a surgery folder with detailed preoperative and postoperative instructions, along with a full explanation of surgical fees to ensure transparency every step of the way.
Non-Narcotic Pain Medication Options
Our office strongly supports the use on non-narcotic options for postoperative pain management, including the use of alternating ibuprofen and Tylenol every 3 hours, while awake. In addition, If you are concerned about your child taking narcotic pain medication and want to look at an additional option, we offer a long-lasting local anesthetic medication called Exparel that can last up to 72 hours. There is an additional cost for Exparel.
Some patients may still need narcotic pain medication even with the use of Exparel. However, less pain medication is usually required to relieve discomfort. If you want to know more about this option, please discuss this with Dr. Williams during the initial consultation and visit the Exparel website for more information.
Together, we will develop a personalized treatment plan, including anesthesia options, to ensure your comfort and safety. Our patient financial coordinator will also review your insurance coverage (if applicable) and provide a clear outline of your financial responsibility for surgical services. Each patient receives a surgery folder with detailed preoperative and postoperative instructions, along with a full explanation of surgical fees to ensure transparency every step of the way.
2. Preoperative Preparation
We follow the same hospital safe anesthesia rules requiring nothing to eat or drink after midnight preceding the morning before your surgery (excluding discussed prescription medications with a sip of water). Having anything in your stomach can increase the risk of serious anesthetic complications.
Your procedure will be rescheduled for your safety if you cannot follow these instructions. Our clinical team will reach out to each surgery patient or family 2 days prior to surgery to:
- Review pre-operative instructions
- Discuss specific patient medical history elements that impact your surgery
- Answer other surgery related questions
Patients should review all preoperative Instructions, located on this website or found within your surgery folder, at least 2 days prior to surgery.
3. Day of Surgery
Caregiver: If the patient is under 18, a parent / legal guardian, if over 18 a responsible adult must accompany the patient the day of surgery, remain in the building for the entire time of the surgical procedure, and drive the patient home.
The caregiver must be able to drive since the patient will be unable to drive for at least 24 hours after sedation. The adult responsible must be present for surgery to begin, and the vehicle must remain on the premises. Patients are typically with us for approximately an hour.
4. Wisdom Teeth Anesthesia Options
All in office wisdom teeth surgeries take place in a private surgical suite at our Greenville, South Carolina or Brevard, North Carolina locations. These personalized, comfortable environments are designed to ensure both safety and efficiency during your procedure. To help you feel completely at ease, all surgeries are performed using the appropriate anesthesia.
In most cases, wisdom teeth removal is done under intravenous (IV) sedation. Once you are comfortably sedated, we administer local anesthesia to keep the area numb during and after your procedure.
Although sedation medications wear off fairly quickly, everyone responds a little differently—so it is normal to feel drowsy for a few hours afterward.
For more details about your options, please visit our Anesthesia Options page.
5. Immediate Postoperative Care
The effects of local anesthesia typically last two to four hours, but in some cases may continue into the following day. For patients who choose to include EXPAREL®. Today, many patients find they manage well without the need for narcotics, even after more complex extractions.
Most patients should plan to take a few days off from work or school and follow a soft-food diet while avoiding strenuous activities, including sports. Keeping your mouth clean is especially important to reduce the risk of complications.
Recovery & Follow-Up
With proper care, healing typically progresses quickly. A follow-up appointment will be scheduled to monitor your recovery and ensure everything is healing as expected.
Our office strongly supports the use of non-narcotic options for Postoperative pain management.
If you have any questions please don’t hesitate to reach out.
Greenville Office
Brevard Office
Frequently Asked Questions
What if I do not have my wisdom teeth removed as a teenager or young adult?
In general, you will heal faster with fewer complications when wisdom teeth are removed in your teens or early twenties. As wisdom teeth develop, the roots may grow near anatomically important structures like sinuses or nerves. In an older teenager or adult, the jawbone becomes denser and tighter around impacted teeth. When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the procedure and postoperative course may have increased risk for complications. We are here to help you make the best surgical choice for you and respect each patient’s decision.
What do I do if my stitches come out?
If you receive lower socket stitches during surgery, these usually dissolve or work out in 3 to 5 days and do not require removal. If they come out early, they are helpful but not mandatory and do not need to be replaced.
I feel a bump on my gums, near the extraction site, what do I do?
In the first couple of days following surgery, with swelling in the area, you may feel a bump, or the gums may feel like they pull away from your teeth. This is all part of a normal recovery and will subside in a few days so try not to use your tongue to play with the site as this can prolong recovery.
If you notice a bump develop after two weeks or more, this may be due to trapped food or debris. Please contact our office for a follow-up visit and to discuss management.
Why are my jaws sore and tender in the morning after surgery?
Occasionally, some of your remaining teeth may feel sore or have a loose sensation after a couple of days. This is most common when someone may tend to clench or grind their teeth after surgery. Typically, waking up with pain in the morning or during the night is also classic for grinding one’s teeth in their sleep. Since most people are unaware of this while sleeping, it may not be immediately obvious. With time, this gets better but may require calling the office for some medication to relax the jaw muscles at night if this persists.
How long does wisdom teeth surgery take?
Wisdom teeth extraction typically takes 45 minutes to an hour, but the exact time depends on your treatment plan, the number of teeth removed, their level of impaction, and Postoperative recovery.
How long are you sleepy or groggy after wisdom teeth removal with IV sedation?
Immediate effects:
After the procedure, you might feel drowsy, tired, and disoriented.
Shorter-term recovery (within a few hours):
The initial grogginess should start to wear off, but you may still feel tired or lightheaded.
Full recovery (up to 24 hours):
It is recommended to avoid strenuous activities, making important decisions, or operating machinery for the next 24 hours.
Individual variation:
The exact duration of the effects can vary based on factors like your age, weight, overall health, the specific medication used, and the length and complexity of the procedure.
Are there any complications after the extraction of wisdom teeth that I should be aware?
As with any medical procedure, there can be recovery complications or an unanticipated result. Some complications that patients undergoing wisdom tooth extraction may experience, from most common, include:
Dry sockets
Dry sockets are the most common concern after wisdom teeth are removed—especially in the lower jaw (mandible). This condition occurs when the healing process in the empty tooth socket is disrupted, often due to poor oral hygiene, smoking, or, in some cases, the use of birth control pills.
Dry sockets typically develop between the third and fifth day after surgery and are more frequently seen in the lower jaw than the upper. Patients often experience a deep, dull, continuous ache on the affected side, with pain that may begin near the ear and radiate down toward the chin.
Our team will provide you with detailed aftercare instructions to help reduce your risk, and we are here to support you if any symptoms arise.
Symptoms of a dry socket often begin suddenly and may not respond well to your usual pain medications. In some cases, it may be helpful to place a medicated dressing inside the empty socket. This dressing can significantly reduce discomfort and shield the area from food particles.
Relief typically lasts 24 to 48 hours, and some patients may require the dressing to be replaced every day or two. Since the dressing provides pain relief but can slow the natural healing process, it is usually removed once your discomfort can be managed with medications alone.
After the dressing is no longer needed, we may provide you with an irrigation device to gently rinse the area and help prevent food from becoming trapped in the socket as healing continues.
Other temporary issues that may occur during recovery include:
- Jaw stiffness
- Chafing or soreness at the corners of your mouth
- Facial bruising
- Mild bleeding from the extraction sites, especially after meals
These are common and typically resolve on their own. Our Postoperative instructions cover these topics in detail, but if you have questions or concerns, please do not hesitate to call our office at 864-458-9800. We are here to help you every step of the way.
Hygiene Issues Causing Potential Infections
Occasionally, postoperative infections can develop a couple of weeks after surgery. These are most often linked to Postoperative hygiene compliance. Most commonly as the socket heals, food and debris can become trapped deep in the site.
While this might not cause immediate discomfort, it can eventually lead to swelling, drainage, and irritation. Antibiotics may help reduce these symptoms temporarily, but they will not remove the underlying debris. If symptoms persist, the area may need to be cleaned out to promote proper healing. We offer postoperative evaluations at no charge to our surgical patients and encourage you to contact us immediately if you have any concerns.
Sinus Considerations After Upper Wisdom Tooth Removal
The upper wisdom teeth are located close to the sinus cavities. In rare cases, their removal may create a small opening between the mouth and the sinus. This is much less likely to happen when wisdom teeth are removed at an earlier age before the roots are fully formed.
If a sinus opening does occur, it often closes on its own without the need for further treatment. However, we may provide you with special postoperative instructions to protect the area and support healing. These include:
- Do not blow your nose for at least 2–3 days after surgery.
- You may gently wipe your nose but avoid creating pressure in the sinus area.
- If you feel a sneeze coming, try to sneeze with your mouth open into a tissue to prevent pressure buildup.
Creating pressure in the sinus area too soon may disrupt the healing blood clot and delay recovery. If you notice any unusual sensations, such as air or fluids passing between your nose and mouth after surgery, please contact our office right away. On rare occasions, a minor additional procedure may be required to close the opening.
Damage to the sensory nerve that supplies sensation to the lips and tongue
A primary concern is a nerve within the lower jawbone that supplies feeling to the lower lip, chin, and tongue. This nerve is frequently close to the fully developed roots of the lower wisdom teeth. Dr. Williams will review imaging and discuss the nerve location during your consultation and associated risks. Having wisdom teeth out between the ages of 12 and 18 before full root development, usually provides shorter roots so that the nerve is not so close.
Occasionally, when the teeth are removed, and especially in older patients, the nerve can be injured. When local anesthesia wears off, you may experience a tingling or numbing sensation in the lower lip, chin, or tongue. This does not affect the patient’s ability to move the lip, chin, or tongue. This will resolve gradually over a period of days, weeks, or months. On rare occasions it can result in a permanent alteration of sensation like having local anesthesia. Although rare, this is strongly correlated to a patient’s anatomy and proximity of roots to the nerve.
We believe in providing you with all the information necessary to make an informed decision—and that includes being aware of this rare, but possible, complication before proceeding with surgery.
Anesthesia Options Available for Surgery
Local Anesthesia
Patients who have undergone fillings or other minor dental procedures may have previous experience with local anesthesia. Local anesthesia is a numbing medication that is injected directly around the area to be treated.
IV Sedation
IV sedation allows patients to enter a deeply relaxed, sleep-like state during a procedure. It is commonly used for more complex surgical treatments or for individuals with significant dental anxiety.
General Anesthesia
Some people are best managed in a hospital or surgery center. This may be due to the complexity of the surgery, health of the patient, or in cases of severe anxiety, emotional immaturity, or developmental delay.
We Are Here to Help You Prepare
At Carolina Oral & Facial Surgery, we are committed to providing the highest level of care and treatment for every patient. See helpful information to guide you before and after your surgery.
Parent Resources
Our goal is to create a safe, welcoming environment where your child feels comfortable and cared for from the moment they arrive. These resources are designed to help parents understand what to expect before and during surgery, and how to best prepare children of all ages for a positive experience.
Our Locations
Conveniently providing care to patients throughout South Carolina and North Carolina.
Greenville SC • Simpsonville SC • Greer SC • Powdersville SC • Easley SC • Liberty SC • Pickens SC • Seneca SC • Clemson SC • Five Forks SC • Taylors SC • Mauldin SC • Fountain Inn SC • Brevard NC • Hendersonville NC • Asheville NC • Highlands NC • Cashiers NC • Arden NC • Flat Rock NC • Mills River NC
Greenville, SC
39 Brendan Way
Greenville, SC 29615
Mon - Thu: 8am - 5pm
Fri: 8am - 2pm
Sat - Sun: Closed
Brevard, NC
4 Market Street #4204
Brevard, NC 28712
Mon - Thu: 8am - 5pm
Fri: 8am - 2pm
Sat - Sun: Closed
We will always schedule your appointment as promptly as possible. If you have pain or an emergency situation, every attempt will be made to see you that day. For information on how to get to our offices, visit our map and directions page for our Greenville, SC Office or our Brevard, NC Office.