WISDOM TEETH REMOVAL IN GRANADA HILLS
In-house wisdom tooth extraction, including fully impacted teeth and teeth sitting against the nerve, under IV sedation, by one clinician.
Not every wisdom tooth needs to come out. That's the first thing worth knowing, because a lot of people are told otherwise. At Viva Smile in Granada Hills, a wisdom tooth that's healthy and positioned so it can't harm the tooth in front of it is left alone and monitored, at any age. A wisdom tooth that's impacted, infected, or pushing against the second molar is removed here, in-house, with IV sedation for impactions, and with a protocol designed to make dry socket rare.
This page explains how the decision is made, what removal actually involves, and what recovery looks like day by day. Patients are seen from age 16; anyone under 18 is treated with a parent present.
Do your wisdom teeth actually need to come out?
Wisdom teeth are the third molars, and they usually arrive between the late teens and mid-twenties, when the jaw has finished growing and often has no room left for them. What happens next depends entirely on position, and position is what the decision is based on.
Left alone and monitored. A wisdom tooth that has come in fully, sits in line with the other teeth, can be cleaned, and isn't pressing on the second molar doesn't need removal. That's true whether you're 17 or 47, and whether or not the roots have finished forming. Removing a healthy tooth to prevent a problem it isn't causing is surgery without a reason, and we don't recommend it. These teeth are checked at regular visits, and if something changes, so does the recommendation.
Recommended for removal. A wisdom tooth is removed when it's causing a problem or positioned to cause one:
- It's impacted: stuck under the gum or bone, either fully or partway through.
- It's angled against the second molar, or pushing on it. Even with no symptoms, that position damages the root or the bone of the tooth in front of it over time, and the second molar is a tooth you need.
- It's partially erupted and the gum flap over it traps food and bacteria, causing recurring pain, swelling, or infection.
- It has decay or gum disease that can't be treated in a tooth that far back.
- A cyst has formed around it.
The distinction matters because the abnormal-position case is the one most people get wrong in both directions: patients wait because it doesn't hurt, and it's quietly damaging the molar beside it. An X-ray settles it.
Types of impaction, and why it changes the surgery
Impaction isn't one thing. On the X-ray, a wisdom tooth is classified by how deep it sits and how it's angled, and that's what determines how it comes out.
- Soft tissue impaction. The tooth has cleared the bone but is covered by gum. The simplest removal.
- Partial bony impaction. Part of the tooth is still within the jawbone. Some bone is removed to free it.
- Full bony impaction. The tooth is entirely encased in bone, often angled sideways or backward. It's sectioned into pieces and removed through a small opening in the bone.
All three are handled in-house, including full bony impactions. So are the cases many general practices refer out: lower wisdom teeth sitting on or wrapped around the nerve that runs through the jaw. Those are planned on a CBCT scan, a 3D X-ray that shows exactly where the nerve runs in relation to the roots, so the tooth can be removed without disturbing it. Coronectomy, removing the crown and deliberately leaving the roots, is rarely needed.
What removal involves
Sedation. For impacted wisdom teeth, IV sedation is routine here, not an add-on. You're deeply relaxed and breathing on your own, you can respond if spoken to, and most patients remember little or nothing of the appointment. Dr. Baghdasaryan trained in IV sedation at USC and serves as an evaluator for the Dental Board of California, conducting the site inspections and competency evaluations other dentists must pass to receive a moderate sedation permit. Someone drives you home, and the rest of the day is for resting. For a simple, erupted wisdom tooth, local anesthetic with The Wand is often enough; the choice is yours.
All four at once. When all four wisdom teeth need to come out, they're removed in one visit unless you'd rather not. One sedation, one recovery, done.
The procedure. Where an incision is needed, the Solea laser is used as the scalpel: a clean, nearly bloodless cut with less swelling afterward. Bone is removed with ultrasonic piezoelectric instruments that leave the surrounding tissue and nerve untouched. Once the tooth is out, the socket gets an antibacterial-impregnated hemostatic dressing to control bleeding and protect the site, and is closed with dissolvable stitches that disappear on their own. PRF, concentrated from your own blood at the appointment, is placed in the socket to speed healing.
A single erupted tooth takes minutes. Four impacted teeth take about an hour under sedation.
Recovery, day by day
The day of surgery. You go home and rest. Bite on gauze as instructed until the bleeding settles. Numbness fades over a few hours; as it does, soreness sets in, managed with the medication you're prescribed. Eat soft and cool that evening: yogurt, smoothies with a spoon, mashed potatoes, soup that isn't hot. No straws, no smoking, no rinsing.
Days one to three. Swelling peaks around day two and then starts to come down; a cold compress in twenty-minute intervals helps. Soreness eases steadily. From the morning after surgery, rinse gently with warm salt water after meals. This is the window most patients take off work or school: one to three days, depending on how many teeth came out and how you feel.
Days four to seven. Most patients are eating normally, with some care on the extraction side, and back to their routine. Stitches begin dissolving.
Weeks two and beyond. The gum has closed over. The socket fills in with bone over the following months, which you won't notice.
You'll get written instructions for all of this, a call from the practice within a day or two to check on you, and if anything worries you after hours, you can text the office and get a reply with a plan.
Dry socket, honestly
Dry socket is what most people fear about wisdom teeth: the blood clot protecting the socket is lost, exposing the bone, and the pain is real. Here it's rare, because the protocol is built to prevent it: the laser incision, the antibacterial hemostatic dressing packed into the socket, the PRF, and detailed instructions on the things that dislodge a clot (straws, smoking, forceful rinsing, hard or crumbly food).
On the rare occasions it does happen, it's almost always because food has packed into the socket, and it's treated predictably: one or two short follow-up visits to irrigate the site and dress it, and the pain resolves. It's not a complication that derails recovery, and you won't be left to manage it on your own.
Does insurance cover wisdom teeth removal?
Most PPO-type dental insurances cover wisdom tooth extraction when it's medically necessary, which impacted or problematic wisdom teeth generally are. We verify your specific benefits before treatment so you know where you stand.
The right answer is sometimes to leave them alone
And when it isn't, the right answer is a removal planned properly, done in one visit under sedation, with a recovery you can predict. Either way, it starts with an X-ray and an honest read. Book a dental exam online or call (818) 900-2800.
Frequently asked questions
Do wisdom teeth always have to be removed?
No. A wisdom tooth that has come in fully, sits in line with your other teeth, and isn't pressing on the tooth in front of it is left alone and monitored, at any age. Removal is recommended when the tooth is impacted, infected, decayed, or angled against the second molar in a way that will damage it over time. An X-ray tells you which.
Will I be asleep?
For impacted wisdom teeth, IV sedation is routine: you're deeply relaxed and most patients remember little or nothing, though you keep breathing on your own. It's not general anesthesia. Someone needs to drive you home. For a simple erupted tooth, local anesthetic alone is often enough.
Can all four be taken out at once?
Yes, and that's the usual approach when all four need to come out. One sedation and one recovery period instead of two or four. If you'd rather split them, that's fine too.
How many days off do I need?
One to three, depending on how many teeth are removed and how you feel. Swelling peaks around day two and then improves. Most patients are back to normal eating and routine within a week.
What if my wisdom tooth is on the nerve?
It's removed here. Nerve-adjacent teeth are planned on a CBCT scan, which shows exactly where the nerve runs relative to the roots, and removed with ultrasonic instruments that don't disturb soft tissue. These are the cases many offices refer out; here they're routine.
How do I avoid dry socket?
Most of the prevention is done for you: the laser incision, the medicated dressing in the socket, and the PRF. Your part is the first few days: no straws, no smoking, no forceful rinsing, and soft food. On the rare occasions dry socket does occur, it's from food packing into the socket and is resolved with a follow-up visit or two.
Do you see teenagers?
Wisdom teeth patients are seen from age 16. Anyone under 18 is treated with a parent present.
What's the first step?
A dental exam with a panoramic X-ray, which shows how each wisdom tooth is positioned and whether it needs to come out, be monitored, or be planned on a CBCT scan. Book online or call (818) 900-2800.
