When is the Best Time to Extract Wisdom Teeth for Double Jaw Surgery?

Hello! This is Dr. Hee Jin Shin of EU Oral & Maxillofacial Surgery :D

Today we will discuss what should be done when performing double jaw surgery on patients with wisdom teeth.

We should be able to go over our general guidelines when approaching such cases.

Please keep in mind that the recommendation may differ depending on each individual.  

Generally speaking, it is not beneficial to remove wisdom teeth during double jaw surgery. 

Patients who receive preoperative orthodontic treatment in preparation for double jaw surgery usually have their wisdom teeth extracted during the orthodontic treatment period and ensure that the recovery period for wisdom teeth extractions does not overlap with the double jaw surgery. 

Removing the wisdom teeth creates an open socket inside the mouth, which makes it vulnerable to infection as it is an additional incision inside the mouth that would otherwise not be necessary.

If it is possible, we recommend extracting wisdom teeth prior to or after double jaw surgery. 

Wisdom teeth that are too deep in the skull can only be removed during surgery. 

In cases where the wisdom teeth are located beneath the eyes or at the posterior wall of the maxillary sinus, it would be advantageous to remove them during double jaw surgery. 

We also consider whether or not extracting the wisdom teeth during surgery requires additional incisions inside the mouth. 

In those instances, it is preferable to extract the wisdom teeth prior to or after double jaw surgery. 

If the wisdom teeth are fully impacted and are not visible above the gums, we can consider removing them during double jaw surgery. 

There are also instances where wisdom teeth must be extracted during surgery. 

We use the LeFort 1 Osteotomy as the surgical method for the upper jaw, and the wisdom teeth are usually located where we cut the bone. If this is the case, wisdom extraction before surgery would be beneficial.

In other instances, it can be the other way around. If removing the wisdom teeth leaves a sizable empty space in the mouth, it can have a negative effect on the healing of the bones, and it may be preferable to keep the wisdom teeth. 

Similarly, for the lower jaw, the wisdom teeth may be located where the SSRO cut line lies. If this is the case, the wisdom teeth have to be extracted. 

It is difficult to say definitively whether or not the wisdom teeth should or should not be removed, but we can definitively say the best choice is to consult your oral & maxillofacial surgeon.

For the lower jaw, there are more risks to consider compared to the upper jaw when extracting wisdom teeth. 

For the IVRO surgical method, the mouth is wired shut. Although the mouth is not fixed shut after double jaw surgery via the SSRO method, it is difficult to open the mouth with ease after surgery, and it is challenging to maintain oral hygiene in both cases. 

In addition, there will be an open socket left by the extracted wisdom tooth where food can collect and potentially cause an infection. 

There are special cases where wisdom teeth in the lower jaw have to be removed inevitably. 

Due to the fact that it is all dependent on the situation, it is necessary to consult with your oral & maxillofacial surgeon and orthodontist, but considering the multitude of variables involved, extracting the wisdom teeth in advance appears to be a relatively good choice. 

If you plan to undergo wisdom teeth removal prior to double jaw surgery, it takes at least 4 weeks for the gum tissue to cover the extraction site. 

After surgery, it takes at least 3 months for the bones to heal and for patients to be able to open their mouths wide enough. 

Today we covered how to approach wisdom teeth extractions for double jaw surgery.

At EU Oral & Maxillofacial Surgery, we are always striving to provide the most appropriate treatment for each patient :) 

More information can be found on our YouTube channel, EU Surgery. For any further clarification, visit us for an in-person consultation at EU Oral & Maxillofacial Surgery. Thank you!