How is an Abscessed Tooth Diagnosed?

wisdom tooth abscessIn general, an abscess is a collection of purulence (pus), consisting of dead neutrophils and macrophages, that has accumulated in a cavity formed by the tissue (soft tissue or bone tissue) in which the pus resides due to an infectious process or other foreign materials. It is a defensive reaction of the tissue to prevent the spread of infectious materials to other parts of the body.

Relating to the mouth and dental structures, a tooth abscess is when an infection occurs either at the root apex or along the root surface of a tooth; or invasion of soft tissue by bacteria, fungus, etc.; or as the result of a foreign body left during dental treatment; or when the nerve of the tooth dies leading to necrosis. The infection process can sometimes be limited to the bone that surrounds the tip of the tooth’s root, or it may spread to involve the gum tissue, or soft tissue of the face.  The abscess can become dangerous if it spreads.

Any tooth can become abscessed, but wisdom teeth are notorious for causing these troublesome infections.  If you suspect that you have a wisdom tooth abscess, you may also experience swelling in the face, neck, and jaw regions. It is common to notice a bad taste or smell, difficulty chewing, temperature sensitivity, and even a fever as your immune system battles the infection. When the infection has progressed to include these symptoms, the swelling may be accompanied by pain and spontaneous discomfort. 

Your oral surgeon will employ a number of diagnostic tools to determine if your wisdom tooth has become abscessed.

Your oral surgeon will employ a number of diagnostic tools to determine if your wisdom tooth has become abscessed. Your evaluation will begin with the completion of a detailed health history questionnaire. It will be important that you disclose any underlying health conditions, prescription medications, non-prescription drugs, supplements, and allergies.

After learning about your health, a clinical examination will be performed to assess your condition. The teeth and gums near the affected area will be evaluated in order to determine which tooth is contributing to your discomfort. This visual examination will be important to confirm your diagnosis.

With digital x-ray technology, the anatomy in the affected area can be visualized. On an x-ray, an abscess often appears as a radiolucent (dark) area within the bone. An x-ray image will also provide valuable information as to the extent of the abscess. An acute infection can spread rapidly and cause destruction to the surrounding bone and the neighboring teeth.

To avoid prolonged discomfort and any unnecessary risk to your health, consult with Dr. Steven Koos, your dual-degree oral and maxillofacial surgeon serving Chicago Loop and surrounding Chicago suburbs, and have your abscessed wisdom tooth extracted as soon as possible. You can learn more by calling 312-328-9000 to schedule your individualized consultation today.

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On October 5th, 2012, posted in: wisdom tooth by

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How Much Does Wisdom Teeth Extraction Cost? Part 2: Fee for Service/Non-Insurance

wisdom tooth ChicagoThere are multiple factors that must be considered as you plan your wisdom tooth extraction in Chicago. That’s why it is important to schedule a consultation with your oral surgeon in order to position yourself for the best possible surgical experience and also the best possible final outcome.

During your consultation, your oral surgeon will determine the procedures that will be required to complete your treatment, and a detailed treatment plan will be outlined for you.  Your treatment plan will list all applicable procedure codes and their corresponding fees, enabling you to be informed and prepared for the out-of-pocket expenses that will be due at the time that services are rendered.

According to the guidelines set by the American Dental Association (ADA), the Current Dental Terminology (CDT) codes that relate to oral surgery and wisdom teeth removal include:

– 7210 Surgical Extraction $403

– 7220 Soft Tissue Impaction $440

– 7230 Partial Bony Impaction $549

– 7240 Complete Bony Impaction $661

– 7241 Complete Bony Impaction With Complicating Factors $780


– 9220 Deep Sedation first 30 minutes $575

– 9221 Deep Sedation subsequent 15 minute increments $238

– 9241 Moderate Sedation (Conscious Sedation) first 30 minutes $619

– 9242 Moderate Sedation subsequent 15 minute increments $254

– 9610 Parenteral Administration of Therapeutic Medication (Anti-inflammatory Steroid) $170

– 9910 Administration/Application of Desensitizing Agent (Hydrocolloid Analgesic) $115

The fees associated with each procedure code, otherwise known as “usual and customary fees” are based upon data that is compiled annually by the NDAS (National Dental Advisory Service). This national database is referenced by all dentists and specialists in order to set competitive, non-insurance fees for every dental procedure code (CDT).  These fees vary and are determined specifically for the zip codes of dental clinics in Illinois and throughout the country.  Based on zip code, the same extraction procedure may cost more in New York than in Chicago, or more in Oak Park than in Hyde Park.

Not all wisdom teeth extraction procedures are identical. The surgeon’s evaluation of your specific needs will determine which of these procedures will apply to your particular treatment.

Without the help of dental insurance, even necessary and beneficial oral surgery treatment can often be difficult to budget. To assist in meeting your needs, we offer financing through CareCredit. that are designed for dental and healthcare needs. To learn more, we invite you to call ORA® Oral Surgery & Implant Studio at 312-328-9000 for your appointment today.

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On September 20th, 2012, posted in: wisdom tooth by


Sedation for Wisdom Tooth Extraction: Will I remember anything?

sedation for tooth extractionIf you are feeling anxious about the thought of surgical dental treatment, you may want to speak with your Chicago oral surgeon about your options regarding sedation for tooth extraction.

With sedation, it is possible to calm your fears and achieve a peaceful state of relaxation as you have your wisdom teeth extracted. There are a number of sedation options, ranging from light to moderate intravenous sedation, to deep sedation and general anesthesia, in which the deepest levels of sedation can be reached.

For patients who elect lighter intravenous sedation, nitrous oxide (laughing gas) is also utilized concomitantly.  You may experience a peaceful, dreamlike state, a sensation of floating, or you may drift into a light nap. You will be able to hear and communicate with the dental team, though you’ll likely be inclined to daydream or simply rest comfortably. Once the procedure is completed, your recovery from anesthesia is a smooth transition into becoming alert and you may be able to recall some details of the procedure. 

With sedation, it is possible to calm your fears and achieve a peaceful state of relaxation as you have your wisdom teeth extracted.

When more comprehensive forms of sedation are utilized like deep sedation or general anesthesia, you will be soundly sleeping through the entire procedure. You will enjoy an ultimate level of relaxation, without being disturbed by the sounds and sights of dental surgery.  At the conclusion of your treatment, you will remember none of the procedure and you should expect to feel sleepy or somewhat groggy for a few hours.

With any type of sedation, a team of trained professionals will closely monitor your vital signs (heart rate, heart rhythm, oxygen saturation, blood pressure, end tidal carbon dioxide, and temperature) before, during, and after the procedure.  Furthermore, you will be instructed to enlist the assistance of a responsible adult to see that you arrive home safely.

The details of the procedure for wisdom teeth extraction will be different for each patient. Your oral surgeon will discuss your main concerns and review your medical history to determine the method of sedation that is most appropriate for you. Ultimately, you can expect to enjoy soothing comfort and absolute safety with the help of sedation dentistry carried out by an oral and maxillofacial surgeon.

To schedule your consultation, contact the wisdom tooth expert, Dr. Steven Koos DDS, MD, serving the Chicago Loop and surrounding Chicago suburbs.

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How Much Does Wisdom Teeth Extraction Cost? Part 1: Introduction

oral surgery ChicagoHaving an impacted wisdom tooth extracted is a procedure that has become more comfortable and more predictable thanks to the many exciting advances in dental surgery technology in recent decades. Still, the procedure shouldn’t be entered into lightly, because it is truly a surgical procedure, like surgery with any other part of the body.

Although we make every effort to create a soothing and comfortable dental experience, we realize that oral surgery is a serious medical procedure that requires experience, precision, and attention to detail only available from oral and maxillofacial surgeons.

Patients who plan to undergo oral surgery in our Chicago Illinois office should schedule an initial consultation with one of our dual-degree oral surgeons in order to gain a full understanding as to what the procedure involves. With a complete explanation regarding the details of your wisdom teeth extraction, you’ll be provided with an estimate for the costs associated with the procedure.

For each patient, the procedure is fully customized according to many important factors. Your health, comfort and safety are the most important priorities; therefore, you will be presented with the treatment recommendations that are most ideal for you. 

For your comfort, a full range of anesthetics and sedatives are available.

The status of each wisdom tooth will be considered individually. The extraction can range from simple to surgical, depending upon the position of each tooth. Wisdom teeth can be fully erupted, impacted within the soft tissue (gums), or completely surrounded by bone; each scenario requiring varying levels of expertise and corresponding fees.

For your comfort, a full range of anesthetics and sedatives are available. The fees for deep sedation dentistry can vary, according to the time involved for the surgery, which is dictated by the level of difficulty for each individual’s case.  Typically forty-five minutes to an hour of general anesthesia is required for the removal of four impacted teeth.

Dental insurance can be applied to the oral surgery estimate, and may provide a helpful discount for the services that are recommended. Each insurance plan is different, and the limitations for each plan will influence your out-of-pocket expenses. Once you have received your treatment estimate, you may want to refer to your insurance benefits booklet for a more detailed explanation of your allowances.  When insurance is involved there can be a huge range of co-pay requirements and yearly maximums, as every insurance plan is different, even within the same company.  Our patient care coordinators will do their very best to make the claims process as trouble-free as possible for you.

Although our field of expertise is surgical in nature, we understand the challenges of budgeting for healthcare, both for patients with insurance and for those without coverage. We can provide information for third-party, no interest financing, and we are always available to answer your financial questions to the best of our ability.

We look forward to providing you with the oral surgery that is best for your health, and we invite you to contact ORA® Oral Surgery & Implant Studio today to schedule your appointment.

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Wisdom Teeth Pain: It’s not your average toothache

wisdom tooth pain ChicagoA toothache is never fun, but the pain and discomfort associated with a wisdom tooth can be far more complicated than mere sensitivity. Whenever abnormalities involving the wisdom teeth can be identified, the teeth should be removed before pain or discomfort becomes a problem. Waiting until the painful symptoms become unbearable can sometimes pose an unnecessary and inconvenient health risk. In addition, at that point, significant damage to surrounding bone and neighboring teeth can already have occurred that is beyond repair.

Patients who are experiencing even mild wisdom teeth pain in Chicago should immediately contact the office of Dr. Steven Koos DDS, MD experienced oral and maxillofacial surgeon, at once for a proper diagnosis and treatment recommendation. With the assistance of sophisticated 3D medical digital imaging and a clinical examination, troublesome third molars (wisdom teeth) can be identified and safely removed before damage and abscess occurs. 

Waiting until the painful symptoms become unbearable can sometimes pose an unnecessary and inconvenient health risk.

For many patients, it can be helpful to be familiar with the signs and symptoms of a problematic third molar. These teeth are located in the very rear of the mouth, and are often only partially visible to the naked eye. They may be partly or completely concealed by the gum tissue and jaw bone, and may be unable to develop properly due to the size and shape of the jawbone.

Wisdom tooth pain sometimes occurs when the tooth is unable to move into its proper position. You may notice jaw pain, pressure, or throbbing radiating from the ear and extending towards the chin. Recurrent headaches in the temple region, as well as pain in front of the ear can also be directly related to impacted wisdom teeth.  In some cases, patients are unable to determine if the pain is originating from the upper or lower jaw, due to its sometimes inconsistent nature.

Even wisdom teeth that have moved into position can present a problem since they are often difficult to access, crammed against the neighboring molar and cannot always be cleaned thoroughly to clear bacterial accumulations. They can create a trap for food and plaque, becoming the source of inflammation, infection, gum tenderness, bleeding, foul odor, and tooth decay. The surrounding tissue may become especially painful during chewing and eating as the gums and cheeks tend to become caught between the teeth.

The uncomfortable challenges associated with a bad wisdom tooth may be constant or periodic, and can sometimes be managed temporarily, but cannot be completely resolved without help from an experienced oral surgeon. To schedule a consultation, or to plan your wisdom tooth extraction, contact our wisdom teeth experts serving the downtown Chicago Loop at 312-328-9000 for your appointment today.

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On August 7th, 2012, posted in: wisdom tooth pain by


Can you ever keep your wisdom teeth?

Chicago oral surgeonHaving the third molars—“wisdom teeth”—removed is so common and necessary that it has almost become one of the rites of passage along the road to adulthood. For many patients, the decision to visit an oral surgeon to have the wisdom teeth removed is prompted when those teeth cause pain or become infected.

The main issue with the wisdom teeth is that most people don’t have enough room in their dental arch or jaws for those teeth to erupt properly. As a result, they often become impacted, or stuck in the bone or gum tissue.

Impacted wisdom teeth can cause a host of problems, such as abscesses, tumors and infections. The wisdom teeth can also knock the other teeth out of alignment as they continue to try to push through the gums.

Dr. Steven Koos, your downtown Chicago oral and maxillofacial surgeon, removes impacted wisdom teeth as a protective measure against those issues.

However, not all patients experience problems with the wisdom teeth. People who have qualms about oral surgery may question the need to extract teeth when they aren’t causing any symptoms.  But hypertension (high blood pressure) doesn’t usually cause symptoms either, until end organ damage occurs.  Should high blood pressure not be treated either until it is symptomatic?  So that line of thinking isn’t the best line of thinking.

For most patients, wisdom tooth extraction is recommended and necessary. It’s impossible to predict when problems will occur, and it’s best to have the third molars removed before they can do any damage. Furthermore, the procedure is routine and remarkably safe, if skilled oral and maxillofacial surgeons perform the surgery.

It is the exception, when the wisdom teeth are expected to emerge fully and in the proper alignment, and it is only in these instances where patients may not need to have them removed.

Our oral surgeons use sophisticated, state-of-the-art, 3D digital CT radiographs to help determine if you have enough room in your jaw for the wisdom teeth to erupt. Having this knowledge can help you make a better-informed decision.

Ideally, patients should have their wisdom teeth removed before age 23. But this can vary from person to person based on wisdom tooth maturity.  After that point, the roots of the wisdom teeth are more solidified and longer, which makes the extraction procedure more difficult. Older patients also take longer to heal from the surgery.

Nonetheless, patients who put off the procedure can still have the third molars safely extracted at a later age.

When making this decision, patients weigh a number of factors. If you are considering whether to have your wisdom teeth removed, contact ORA® Oral Surgery & Implant Studio, serving Cook County Chicago, to learn more about this valuable procedure.

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On July 20th, 2012, posted in: oral surgeon by

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What are some potential complications associated with the removal of wisdom teeth?

wisdom tooth removal ChicagoPatients gain a number of benefits when they have their wisdom teeth removed, including reduced risk of infection and abscesses and a lower likelihood of misaligned teeth.

To take advantage of those benefits, and avoid some serious problems, a large number of patients decide to have their wisdom teeth extracted each year.  Before doing so, though, it’s important to be adequately prepared for the process.

After all, wisdom teeth removal is actually a surgical procedure, not a dental one, and any appointment with an oral surgeon raises the possibility, however remote, of complications.  The fact that surgery is being performed makes it even more important to have the procedure performed by a highly trained oral and maxillofacial surgeon, rather than just a regular dentist, who is incapable of handling any potential complications and who is not skilled in the procedure. 

Patients gain a number of benefits when they have their wisdom teeth removed, including reduced risk of infection and abscesses and a lower likelihood of misaligned teeth.

As is the case with any surgery, patients who pursue wisdom teeth removal do face certain risks. One of the main concerns following wisdom teeth extraction is dry sockets. If everything goes as expected, the patient will develop a blood clot at the extraction site that offers an extra layer of protection during the first few days of the healing.

If that blood clot is dislodged prematurely or never fully forms to begin with, it can lead to the painful inflammation of clotless – dry sockets.

Other potential complications of wisdom tooth extraction include excessive pain, bleeding or swelling, infection, sinus perforations and ongoing numbness in the area of the mouth. Additionally, the sedation aspect also holds a minute associated with that treatment. None of these issues are necessarily common in wisdom tooth extraction, but the patient should be aware that they may occur.

Older patients face a higher risk of complications than those who have their wisdom teeth extracted in their late teens or early twenties. The surgery tends to be more complex for patients beyond their mid-twenties. The roots are longer and more integrated with the jawbone, creating more challenges in removing the teeth.

Although patients can face complications following wisdom tooth extraction, they can also take steps to help prevent those bad outcomes. Our Chicago oral and maxillofacial surgeons can recommend a post-surgical regimen to decrease your chances of developing a problem. For example, patients are encouraged to avoid drinking through straws for the first few days after the procedure. This helps cut down on the risk of dry sockets.

For more information on wisdom teeth removal in Chicago Illinois, and the potential risks and complications associated with extraction of a wisdom tooth, please visit our website and refer to the informed consent forms within the patient resources section.  Also feel free to contact ORA® Oral Surgery & Implant Studio at 312-328-9000.

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What is a Full Bony Impacted Tooth?

oral surgery ChicagoIf you have ever been informed that your wisdom teeth are fully bony impacted, you may have thought that your dentist was speaking another language.

The term actually describes the position of the wisdom teeth and may also provide a hint about the health of the teeth. Of course, for a definitive diagnosis and a recommendation for treatment, you’ll need to schedule an appointment with a specialist to discuss your options for oral surgery in Chicago. Your oral & maxillofacial surgeon will utilize advanced 3D digital imaging to gain a complete perspective as to the position of the teeth and the threat they pose.

When a tooth is completely surrounded by bone, it is said to be full bony impacted. The tooth will be unable to erupt into the proper position and may also present complications for the neighboring teeth. 

With today’s sophisticated dental technology, a full bony impacted tooth can be evaluated and successfully treated in a relaxing and comfortable environment. 

Fully impacted teeth can often press against the roots of the neighboring teeth. This constant, abnormal pressure can contribute to pain in the teeth and the resorption (dissolving) of the roots, which will lead to the loss of the neighboring teeth.

In some instances, a cyst or pocket can form around the impacted tooth, contributing to bone loss and damage to the jaw bone and any surrounding structures.

With today’s sophisticated dental technology, a full bony impacted tooth can be evaluated and successfully treated in a relaxing and comfortable environment. 3D CT imaging enables your oral surgeon to visualize the exact location of the teeth as well as the location and position of the neighboring nerve pathways and sinus cavities.

Although some bone will need to be removed in order to expose and extract the impacted tooth, the procedure can remain conservative in nature when advanced radiography is used as a guide.

Comprehensive forms of sedation/anesthesia are also available to provide you with the most comfortable and relaxing surgical experience possible. During your initial consultation, a review of your health history will help to determine the form of sedation and post-operative pain management that is best for you. At that visit, the surgical team will also explain the details of the procedure and review post-operative instructions.

The state of your impacted teeth is impossible to evaluate on your own. Most dentists unfortunately ignore the problems as well, until it is too late and neighboring tooth damage has been done or cyst formation has occured.  Make plans for a discussion with our dual degree Chicago oral surgeon in Illinois today for an examination and a recommendation for treatment. Call ORA® Oral Surgery & Implant Studio at 312-328-9000 to schedule your visit.

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On June 22nd, 2012, posted in: oral surgery by


What is a Partial Bony Impacted Tooth?

toothache ChicagoWith such easy access to advanced dental care, there is no longer a need to suffer with a toothache in Chicago. Although a toothache can stem from a number of sources, pain in the very back of the mouth can typically be caused by an impacted wisdom tooth. Having your wisdom teeth extracted by an experienced oral surgeon is the most effective way to relieve the discomfort and protect your health.

Not all wisdom teeth will need to be removed. Your oral surgeon will perform a clinical examination and should use an advanced 3D CT film to determine the health and prognosis for each of your teeth. If a tooth is determined to be impacted, meaning it is unable to grow into its proper position, extraction is often the best alternative.

One common scenario is a partial bony impacted tooth. In this instance, the tooth is partially surrounded by dense jaw bone. The tooth may have the proper orientation as the neighboring teeth, or it may be positioned at a severe angle.  The remainder of the tooth may be covered by a thin layer of gum tissue, or the tooth may have broken through the gums, partially visible in the mouth.

A tooth in this position can pose a risk to the neighboring teeth in a number of ways. If the partially impacted tooth is pressing against the adjacent tooth, it may be difficult to clean properly. Tooth decay and periodontal disease may develop, compromising the health of both the wisdom tooth as well as the neighboring tooth.

If the partially impacted tooth has broken through the gum tissue, bacteria and food particles may become trapped beneath the soft tissue. Bad breath, localized infection, and inflammation are the common result since it may be impossible to access and clean the area. Unless the immune system is able to contain the infection, pain and swelling often ensue, making the need for treatment much more urgent.

To find out if your wisdom teeth are impacted, contact the office of Dr. Steven Koos, serving Downtown Chicago, for your appointment today. For your health and for your comfort, try not to wait too long. Call 312-328-9000 to schedule your visit.

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On June 8th, 2012, posted in: toothache by

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Wisdom Tooth Removal: Will I remember anything?

Anesthesia for Tooth Extraction ChicagoWhen facing a wisdom tooth extraction, the last thing you want to worry about is an enduring negative memory of the procedure. Anesthesia or sedation can help patients avoid such a negative outcome.

Anesthesia and sedation wipe out any memory of a wisdom tooth extraction. When patients awake from a peaceful rest, they’ll have no recollection of the procedure.

For this reason, as well as to ensure comfort during the procedure, nearly all patients will choose some form of sedation or anesthesia beyond a local anesthetic for tooth extraction in Chicago.

Deciding between full general anesthesia or a conscious sedation is an important consideration in the process of planning your wisdom tooth extraction. Familiarize yourself with the options offered by your oral surgeon so that you can decide which one you prefer. 

Anesthesia and sedation wipe out any memory of a wisdom tooth extraction.

Most patients feel more comfortable with general anesthesia and our surgical assistants and anesthesia assistants are trained, certified, and experienced in the safe administration of this method, as well.

Sedatives are delivered intravenously, and the two basic levels are moderate and deep sedation.

Regardless of whether patients are under moderate sedation or full general anesthesia, they are closely monitored with advanced operating room equipment for signs of distress throughout the procedure.

Keep in mind that you will need to take steps to prepare for your sedation or anesthesia. You will need to fast from food and drink (even water) for a minimum of six hours prior to the procedure, for example.

Additionally, patients are in no condition to drive after a wisdom tooth extraction under sedation or anesthesia. Be sure to arrange for a responsible adult to escort you to the appointment and to make sure you get home safely.

Do you have questions or concerns about the experience of a wisdom tooth extraction? Talk to our experienced oral and maxillofacial surgeons, serving Cook County Chicago, in advance so you’ll know what to expect. Call 312-328-9000 for more information.

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