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Comment by seanmcdirmid | Hacker News Reader

Dentists don’t remove wisdom teeth, they just refer you to an oral surgeon. The problem with wisdom teeth is that they increase maintenance requirements, it’s hard to clean back there and they can affect adjacent teeth if they do go bad. So I get why many dentists default suggest to remove them (I still have mine but recently started running into problems at 47).

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Yes, there is a risk of complications with wisdom tooth removal. I was lucky twice, but when I had the lower ones removed, I got an infection blowing up the side of my face with a racketball-sized lump.

The oral surgeon had to prescribe anti-biotics and follow up with a "debridement", reopening the site, draining and flushing it. No fun at all. Also not something that's normally done at a dentist's office.

No way would I have done lower wisdom tooth removal without total-knockout anesthesia (Propofol). For me it's as much about the sensory input, sounds, and visuals of the hardware tools used. With the Propofol, it was a painless "30-minute time-travel" experience but I still felt exhausted for a couple days after the procedure. It's like my body knew what it went through even though I have no memory of it. Apparently this is a common feeling.

The upper wisdom teeth come out easier and heal faster. I had those out with just local anesthetic injections, nitrous oxide, tightly shut eyes, and headphones blasting music.

I had all of my wisdom teeth removed with just local anesthetic and nitrous oxide. It is certainly an interesting experience as you listen to your teeth being broken up by what amounts to a large ice pick. It didn't really bother me though.

The worst part of the entire procedure was that they wouldn't call my prescriptions into the pharmacy in advance, so I could just go home and not run errands after the procedure. I guess people will schedule fake wisdom teeth removal so they can get a 3 day supply of Tylenol with codeine? I remember being very annoyed waiting around for a half hour in some grocery store with my mouth full of gauze and the pain setting in. Would have preferred to be at home in bed. Sigh! At least I don't have any more wisdom teeth.

> they just refer you to an oral surgeon

Perhaps in the US where they drug you down? Here the dentist just gives you a local anesthetic and pry them out, unless there is something extraordinary. Or perhaps it's a different person? But still the same company getting the money.

I'm in the US. I've had one out and I just got novocaine and elbow grease.

It was honestly an awful experience. Trying to pry that thing out while I couldn't feel a thing, but I felt incredibly drained afterward. Not sure if it was from adrenaline/anxiety or if you still respond to the trauma despite no immediate pain or sensation.

Then I had the pleasure of little shards and chips working their way out as I healed over the next several months. It really did take a good 3-4 months before I felt remotely healed back there.

The US usually has both options - and the dentist will usually recommend the surgeon, especially since some medical insurance will cover that but not the yank and jank.

Oral surgeons in the US are usually found in larger hospitals; most dentists are just dentists.

It would also depend a lot on what's going on with your wisdom teeth. If they haven't erupted at all and are causing trouble, that's oral surgery time. If they're fully erupted, a regular dentist may do it. In between, it depends.

I was referred to a oral surgeon at the university of Washington (but there are oral surgeons affiliated with Swedish hospital also), my dentist is the typical private practice. Financially they are completely unrelated.

> Dentists don’t remove wisdom teeth, they just refer you to an oral surgeon

Bit of a meaningless distinction if they're in the same office.

In the US, that would be rare.

Pointless nitpick, especially because providers pay referral fees.

"Payment by or to a physician or health care institution solely for referral of a patient is fee splitting and is unethical. Physicians may not accept: Any payment of any kind, from any source for referring a patient other than distributions of a health care organization's revenues as permitted by law."

https://www.ama-assn.org/delivering-care/ethics/fee-splittin...

I had a wisdom tooth removed by a dentist within the last 5 years. This was in the United States, for what it’s worth.

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