How long can I put off getting my wisdom teeth pulled without ruining my teeth?

January 21, 2008 6:22 PM

How long can I put off getting my wisdom teeth pulled without ruining my teeth?

I'll apologize in advance if this has already been asked, but I searched pretty thoroughly through all the teeth posts and couldn't find exactly this question.

Basically, I'm in school, I don't have dental insurance, but (god willing) I will have a job with dental insurance by say September. Money is very tight right now (damn you Barbri....) and I don't have a job lined up so spending 2k or more to get my teeth pulled is horrifying and will probably require that I take out a loan to cover it.

However, I don't want to ruin my perfectly straight teeth. So I know you are not my dentist, but am I being a fool to even risk this for 7 months? Or is this the kind of thing I can put off? They've only recently really started to hurt (however I can live with the pain). Anecdotal stories of people putting off getting their teeth pulled welcome.

Also, does anyone have any experience as a patient with Howard Dental School?

posted by whoaali to health & fitness (38 answers total)

For what it's worth, dental insurance will not necessarily cover all or even some of this. Dental insurance is more of a discount plan for cleanings and some routine procedures. I'd ask your oral surgeon if you can start a payment plan and with all luck you can make do until your job starts without having to go with a loan - a lot of medical practitioners are flexible when it comes to no-fee no-interest payment plans, especially if you explain up front and are reasonable.
posted by kcm at 6:30 PM on January 21, 2008

My dentist told me to get mine pulled six years ago and I never did. I haven't experienced any pain because of it. The only downside so far is having to pry out bits of food from behind my back molars after eating. My teeth haven't gotten any crookeder, BTW.
posted by hjo3 at 6:31 PM on January 21, 2008

Basically, I'm in school, I don't have dental insurance...

Assuming you mean college/university, your school may have a health center where something like this might be covered. It's a longshot, but doesn't hurt to check. I had a shattered ankle covered via the health center, even though the shattered ankle didn't happen on school grounds and essentially had zero to do with the school. Covered via insurance built into the tuition/fees.
posted by Cool Papa Bell at 6:34 PM on January 21, 2008

Do you have $50 for a consultation? I had a consultation with an oral surgeon and think it cost about that. Seven months doesn't sound too long to my non-oral-surgeon ears, but a consultation with an actual one could put your mind at ease for relatively cheap. (My own experience is that I've been putting my wisdom teeth off for about 3 years, haven't noticed any changes in my teeth, and am having them out next Thursday now that I have insurance to cover it.)
posted by Meg_Murry at 6:35 PM on January 21, 2008

don't worry
posted by matteo at 6:37 PM on January 21, 2008

Some places (I know there is one in/near Austin, TX) will pay you to have them taken out for pain medication research.
posted by whycurious at 6:37 PM on January 21, 2008

spending 2k or more to get my teeth pulled

Just to clarify, the cost depends a lot on the variables; if you go with local anesthetic and your wisdom teeth aren't badly impacted (simple extractions vs. significant surgical action), the cost may be more in the neighborhood of a few hundred dollars. If you haven't gotten an estimate on the extraction, you might want to consider that to see what you'd be in for. Cost of a dental visit plus xrays, basically, and you'd have a better idea of what the full cost would be.
posted by cortex at 6:39 PM on January 21, 2008

If your teeth are actually starting to hurt, I think you should just get them pulled. It costs many more thousands of dollars and a lot more in time and pain to put your teeth straight again than it does to pull out the cause of the problem right at the beginning. And you won't ever get insurance to pay for it anyway, it's now a "preexisting condition." Get a loan, get it done.
posted by TeatimeGrommit at 6:40 PM on January 21, 2008

Consultation with an oral surgeon idea is good. Explain the situation and see what they think. And when I had mine pulled, it WAS a medical insurance thing, not a health insurance thing. But I had a justifyable reason for it (infections and I couldn't close my jaw). They may not cover it for cosmetic reasons.
posted by gjc at 6:40 PM on January 21, 2008

Oh, and cortex's post reminds me, the longer you wait, the more expensive it is to even do the extraction part. (impacted is worse than not impacted, and severely impacted is worse than "merely" impacted.)
posted by TeatimeGrommit at 6:41 PM on January 21, 2008

I strongly second Meg_Murry's recommendation to get a consultation with an oral surgeon. He or she will be able to tell you if you can put off the surgery for a few months.

When my wisdom teeth started hurting suddenly, I had no choice but to get them taken out pronto. This was not because of ruining my teeth alignment but because of the brutal impaction and infection (and unrelenting, unholy pain). When the oral surgeon took an x-ray, it turned out that my wisdom teeth were coming in sideways--they were all coming in at once, and all coming in the wrong way. YUCK. As it turned out, I still had to wait a week to get them taken out (that was the soonest they could fit me in for surgery) and it was a week of sheer hell. I was on alternating doses of Tylenol 3 with codeine and ibuprofen, along with powerful antibiotics to combat the infection. I'm not exactly stoic to begin with, but it was one of the only times in my life I can remember actually weeping from pain.

I don't mean to scare you, but be prepared that you might have to get them taken out if the reason they've started hurting is that they are impacted and infected. That's not something you want to let go for a few months.
posted by hurdy gurdy girl at 6:45 PM on January 21, 2008

Agreed that if you can get a consultation with an oral surgeon, that's the way to go. But for whatever anecdotes are worth, I had mine out nearly a year after my dentist first suggested it. Which itself was probably a good few years after I should have had it done, but I had a few years of not being able to swing regular dental care. The dentist gave me the go-ahead to wait the extra time, and it was not a big deal at all. But I wasn't in pain and there was no serious impaction; my understanding is that influences things a lot. So if you have any idea what shape your wisdom teeth are in now, that may influence your decision.

I'm guessing from your last question that you're already thinking about this, but just in case - my understanding is that dental schools can be a lot cheaper than other sources of dental care. If you decide you can't wait, that's something to look into. Maybe they could at least give you a cheap consultation.
posted by Stacey at 6:53 PM on January 21, 2008

Dental insurance can and does vary, so until you actually have a policy that spells out what's covered, ignore all the "oh, it won't be covered anyway" comments.
posted by sageleaf at 6:53 PM on January 21, 2008

Alright, to the oral surgeon I shall go, at the very least for a consultation. And hey when you already have 6 figure debt, what a little more, right?

I can't risk it suddenly getting bad and being incapacitated until I can get them out. Also, after looking extensively at my teeth in mirror, I think only one of them is really the problem, so maybe I'll get off easy.

Thanks for the advice everyone!
posted by whoaali at 6:53 PM on January 21, 2008

Don't just pick any oral surgeon either. Ask around. The oral surgeon that my dentist referred me to was 50% more expensive than somebody else that was also highly recommended. Rates seem to vary widely.

FWIW, my dentist told me at 21 that my wisdom teeth needed to come out. I finally did it when they started to bother me, about 12 years later. I didn't do any permanent damage.
posted by COD at 7:32 PM on January 21, 2008

If you are up for it you might see if there is a teaching hospital that has dentistry as a major. They may be able to give you a big break on the cost and you would probably be assured that, along with the student, a competent doctor would be on the sidelines making sure everything was done correctly.
posted by bkeene12 at 7:40 PM on January 21, 2008

Are you in excruciating pain? NO? Then forget about it. Pulling the wisdom teeth is one of the biggest dentistry scams around. Don't believe the hype. They do not need to come out unless you are in agony. They will not push your other teeth into grotesque configurations, they will not destroy your jaw. Pulling them will buy your dentist a new 100 inch plasma tv. If you are in pain, then everything changes.
posted by caddis at 8:04 PM on January 21, 2008 [2 favorites]

Also, after looking extensively at my teeth in mirror, I think only one of them is really the problem, so maybe I'll get off easy.

Let this be a vote for getting them all out at the same time. I know not one but TWO people who got them out in pairs and ended up with dry socket TWICE. Better to get that shit out of the way all at once.

(I had mine out all at once and yes, I was incapacitated for days, but hell, I am SO GLAD I don't have to go through that again.)
posted by fiercecupcake at 8:11 PM on January 21, 2008

This will mostly likely be covered by medical insurance, not dental insurance. I know, weird, but that's the way it works. Do you have any kind of medical insurance at all? Check and see what they say about surgery, though if it's "student" insurance, the may only cover emergency surgery.

Seven months is a reasonable gamble to take, in my opinion, unless the teeth are causing you pain on a regular basis. If they are causing you steady pain, get 'em out. Tooth pain gets increasingly stressful, and the risk of infection can get dangerous.

The surgeon will negotiate if he knows that you're uninsured. Though, if you can ask your folks/family for help, do it. It's not like it's a gambling debt, ya know?

Have you been to a dentist for the diagnosis of need-to-be-removed wisdom teeth, or are you just guessing based on where the discomfort is?
posted by desuetude at 8:12 PM on January 21, 2008

Do I just checked my crappy crappy school health insurance and they cover wisdom teeth!!!!! But only up to $75 per tooth??? But hey it's something and I'm guessing with insurance I'll get the reduced rate that they negotiate, so this maybe a lot more doable. It never occurred to be that medical insurance (and mine especially) would cover anything dental.
posted by whoaali at 8:28 PM on January 21, 2008

FWIW, here's my story: my wisdom teeth are only partially erupted so they get infected every couple years or so, at which point I always say, "if this pain gets any worse, I'm having them removed once and for all," but then the pain goes away and I say, "I'll wait 'til next time."

I went to an oral surgeon the first time it happened (because I didn't know what was causing the pain) and I got the consultation, the x-rays, etc. Basically, he recommended I have all four removed but it wasn't an OMG THEY NEED TO COME OUT situation. I was in my late 20s old so it's not as if I'm still growing and anything is moving, so it was kind of a matter of, do I want to risk further infections, etc.

So I've risked further infections for years (I'm 35 now), and I'm still not interested in having them removed for these two reasons:

1) it's expensive and I don't think my health insurance covers it (the insurance I had back then didn't cover it, and now I have pretty catastrophic/cheap insurance so I highly doubt it's covered)

2) my dad was born with too few teeth and has had many removed due to his own dental issues, so he has instilled this "never give up your teeth willingly!" attitude in me. ("Live teethed or die?")

I guess I'm waiting 'til it's an OMG situation. (And as I said, nothing's moving around; nothing's getting ruined in there. Your situation may vary.)
posted by iguanapolitico at 8:34 PM on January 21, 2008

I had three consecutive dentists, the third one being an oral and maxillofacial surgeon, tell me that wisdom teeth do not cause overcrowding at the front of the mouth.

In any case, I recommend that you get them pulled as soon as you can, or atleast get a dental xray to make sure that they're not impacted. Impacted wisdom teeth can destroy the adjacent molars if not pulled in time.

Further more, the longer you wait, the more developed the roots are going to be when you finally get them pulled. This results in a more difficult procedure that has a higher potential of permanently damaging the nerves responsible for sensation in your cheeks and lips. It also results in a more painful recovery.

To the poster above me, if you don't know whether your insurance covers it, don't automatically assume that it doesn't. At least go though the trouble of calling them and finding out. How long could that possibly take?
posted by BeaverTerror at 8:58 PM on January 21, 2008

I had my lower wisdom teeth pulled when I was 29 (didn't have uppers). They were quite impacted (laying horizontal pressing into the teeth in front of them). Had them done about 3 months after I started noticing pain. It didn't progress much but having to take an advil every night wasn't my idea of a good thing. I'm sure they had been sitting in that position for years, as I didn't go to the dentist from the time I was 18 until, well, when I started feeling this particular pain.

Obviously based on the posts here people's experiences vary a lot. Get x-rays done at a minimum along with professional advice. IIRC I paid $800 out of pocket and it would have been $3200 if I had no insurance. You don't want to end up on codeine pre-surgery like hurdy gurdy girl did.
posted by MillMan at 9:06 PM on January 21, 2008

If you can wait to get them out and it's not covered by your new employer insurance, don't forget to check out Flexible Spending Accounts. They stink for most everything but if you know in advance what you need to spend, they're great. Since you'll be starting a new job, you should be able to enroll at that time.
posted by chairface at 9:40 PM on January 21, 2008

And demand the best drugs possible. Triple cocktail for the surgery, Vicodin for the recovery.

I know I had all mine done and I know there was pain, but all I remember was a tremendous, legal, high. And being slightly addicted to Vicodin after the week was out.
posted by gjc at 10:45 PM on January 21, 2008

Do you even know if they need to come out? Don't assume all wisdom teeth must automatically come out. I know you say they hurt, but it's unclear whether they hurt just because they are coming in, the same way it hurts when a baby is teething.

I'm 33 and have all four of mine. They didn't affect the rest of my teeth at all.
posted by Violet Hour at 11:51 PM on January 21, 2008

Mine stayed in for a long time, two growing frontwards and impacting the teeth in front of them, one growing out sideways and poking into my cheek, fourth one *poof* non-existant. Went for several years noticing the pressure, but not in pain. Started working for a school with a Dental School, *bam* all three out one day by a prof and three students... meh, fine by me.
posted by zengargoyle at 3:58 AM on January 22, 2008

It only works if your wisdom teeth are angled forwards, as mine are, but I had the second molar removed in three quadrants of my mouth and the wisdom teeth then grew forwards into their place. This is a good strategy if your second molars are generally damaged or have been poorly treated (as mine were).
posted by wackybrit at 4:14 AM on January 22, 2008

Wisdom Teeth Removal Often Unnecessary
Study: Taking Out Symptom-Free Wisdom Teeth Neither Helps nor Hurts Health


Dentists warned removal of wisdom teeth 'unnecessary'

The Prophylactic Extraction of Third Molars: A Public Health Hazard

Consumer Reports Health: 12 surgeries you may be better off without

Some anecdotes and differing opinions on the matter in this previous askMe question on wisdom teeth removal.

Anecdote: I still have mine at 35. Have had no problems with them yet, even though my dentist told me they were all impacted and would need to come out ~20 years ago.
posted by syzygy at 4:38 AM on January 22, 2008 [3 favorites]

If you end up having them taken out, talk to the doc and/or his billing department about setting up a payment plan, where you agree to pay x amount per month instead of all at once. They'd probably rather have your money in installments than not at all!
posted by radioamy at 6:09 AM on January 22, 2008

If you're willing to go into debt on this - there are companies that provide financing specially for oral surgery. When I had an over-eager periodontist hot to do gum grafts on me one of the pamphlets they pressed into my hand was one for an option to finance it.

I don't think the rates are too great - they seemed to be operating on the "no interest if you pay in under 12 months" scam, which simple logic will tell you isn't how most people manage to pay off: if nobody paid interest there'd be no money in the business.

Never the less, whoever you get your consultation with will likely have this kind of information at hand.
posted by phearlez at 6:18 AM on January 22, 2008

Yeah I've been told for years by my dentists that my wisdom teeth were borderline whether they would need to come out and I always avoided getting it done. I think one for sure has to come out, looking in the mirror it's pretty clear there is a tooth coming up, but not really any gum left, more just cheek (sorry for the tmi). I'm fine after I take some advil, but definitely not so fine before.
posted by whoaali at 7:41 AM on January 22, 2008

MTANYT (my teeth are not your teeth) so YMMV, but the time elapsed between me being advised to remove my wisdom teeth by my Canadian dentist and the time they were actually removed by the Norwegian oral surgeon was >2 years and I was 35 years old by the time they came out.

Don't believe everything you hear about the Norway health system being particularly good - yes everyone gets health cover by the same crappy system, but even the British NHS is better. They had my X-rays for 18 months before they could see me.

Mine were removed because the danger was trapped food would lead to rot in the teeth in front and erosion of the enamel as the teeth pushed in. I wasn't in pain, so there was no imperative to remove them.

Get an oral surgeon, don't settle for a dentist who only does this kind of stuff occasionally. Mine came out as sweet as you please when done by a professional, but I have colleagues who had the dentist do it and suffered the consequences of broken bits of tooth left in the socket.
posted by arcticseal at 7:50 AM on January 22, 2008

I've got FIVE wisdom teeth. Every dentist I've been to since I was a child has said they'd have to come out. I'm 40 now and they're still all in there. They don't seem to be moving or changing, and they don't hurt, and I'm not wealthy, so they will stay.

Maybe I'll do it when universal health care pays for it. Ha ha ha. I should live so long.
posted by bink at 9:38 AM on January 22, 2008 [1 favorite]

Mine were impacted, and when one erupted it caused an infection and a cavity in the molar next to it. I was having migraines for 9 months before I got that one taken out. I was 27. Got the rest of them done six months later. I really wish I had gotten them out a couple years earlier.
posted by herbaliser at 12:07 PM on January 22, 2008

I was supposed to have my wisdom teeth out at 19. I only had the bottoms out, not the tops (because my dentist forgot to send the X Rays of the tops) and the tops were already said to be impacted. I'm 27 now. I pretty much fear the horror stories people are telling above, but I'm hoping for an outcome like bink's. I don't have the time or money to be sick right now, so, oh well.

Can you get dental care/oral surgery in either Canada or Mexico for less? I have a friend who goes to her dentist in Eastern Europe for crown replacements and root canals and such...
posted by onepapertiger at 4:34 PM on January 22, 2008

Also, re: Howard's Dental School. Howard is a toilet of a school. Go anywhere else. They just don't have normal standards for admission or graduation of professionals. Go to Baltimore if you have to. I think Johns Hopkins has a dental school.
posted by onepapertiger at 4:39 PM on January 22, 2008

Unless you're having a problem with them, they don't need to come out. I'm 42, still have them, and my teeth are straight. So does my sister, my parents, and my brother. None of us ever had braces. Our father is a dentist. If they're not impacted or causing problems, there's no need to remove them.
posted by FlyByDay at 5:45 PM on January 22, 2008