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Oral Surgery/Method of Sedation with Wisdom Teeth Removal



Procedure/Cost/Insurance Summary
Is intravenous sedation with local anesthesia necessarily the best method of sedation for me?

I have attached photos of my insurance/cost summary and X-ray for reference if helpful.

I am 20 years old, and my wisdom teeth have been coming in for a long time. Three of four are fully exposed as you can see, with one coming in sideways (dummy). My orthodontist recently referred me to an in-house oral surgeon to get 3/4 of them extracted, as there's simply no room for them in my mouth. The fourth (lower left on X-ray) I am keeping because I lost a molar ( :'( ) a few years ago and it's replacing it.

The results of my consultation were mainly finding out all the (comically terrifying) risks associated with the procedure, during which I literally nearly passed out from the thought of it all. I also found out that the "recommended" (in quotes because it wasn't presented as a choice or option, though I found out it was) anesthetic/sedation was Intravenous Sedation with local anesthesia. Finally, I also found out after insurance, I would be due about $715 for all three extractions. I immediately felt that I should get more professional opinions due to my uncertainty.

My concerns are whether the degree of sedation is necessary, what the risks are (I know that all available methods are "safe and effective," but would like to know relative risk as compared to other methods available), how much a different method of anesthesia could reduce my out-of-pocket costs.

I was initially excited for my consultation as my mouth has been overcrowded for a long time, but after the lightning quick visit from the surgeon, during which he looked into my open mouth from two feet away, then said, "You see, there's no more room in your mouth, so your wisdom teeth have to come out. The girls will help you find an appointment for surgery with me. It was nice meeting you!" Then I was charged $56 (for the glance I guess..?). I've wondered whether a non-affiliated oral surgeon would be less apt to overcharge, if he's charging me too much.

Devin- from the pictures of the X-ray and the plan, I would agree that all three of those teeth need extractions. From what I see, I agree that they need extracting.  As far as the sedation, it can be done with just Novocaine, but be prepared for the pressure necessary for the surgeon to use.  That often provides signicanr discomfort.  That is why the sedation is probably a good suggestion.  

As far as the fees the upper teeth might be a little expensive but the lower seems fine.  Any more questions feel free to contact me again.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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