Getting My Wisdom Teeth Removed

In January of last year I got my wisdom teeth removed. In December of 2018 I saw my dentist for a routine checkup and cleaning. He took some X-rays and told me that my wisdom teeth were coming in and my mouth did not have enough room to hold them. He gave me the name of an oral surgeon. I’d known for a while that I would probably have to get them removed and that I was at about the age when they usually come in.

I had a consultation with the oral surgeon. He looked at my mouth, took some panoramic X-rays and told me what I already suspected – I didn’t have enough room in my mouth for the teeth to fully come in. That if they did break through the surface of my gums they wouldn’t fully crown. Also, they could damage my other teeth or make them crooked. And I had spent too much time, energy, money and pain on braces to let it all go to waste because I didn’t want to get my wisdom teeth removed. Also, not so much for the top teeth, but for the bottom, the roots get longer and grow deeper into your jaw. They can fuse to the jawbone and grow into the nerves, which can make removal at a later date more painful, expensive and complicated.

Another detail, which concerned me as I was going into the consultation, was whether I would get a local or general anesthetic. I always prefer a local if at all possible. But I knew that doctors prefer patients to have generals because it makes it easier for the doctors. The oral surgeon urged me to go with a general. He noted that the vast majority of people go with generals and that some number of people who go with a local back out halfway through. But I made it clear that I strongly preferred a local.

We scheduled the removal in early January. In the end it was really no big deal. When getting the teeth removed I showed up and signed a waiver. Then they asked me what music I wanted played while I was under the knife. I chose classical. Then I lay back and started breathing laughing gas (which made me feel drunk). Then they gave me eight injections of lidocaine. They needed two per tooth; the first numbs the outside of the tooth and the second numbs the inside. They needed this they needed to cut the bottom teeth in half to remove them. The injections were just a giant pinch and then almost immediately numb. Right after the doctor did the last injection I saw him take the knife to my bottom left. I felt nothing.

I don’t know exactly how long it was – somewhere between a half hour and an hour of pulling and pushing. Then I was done. He sewed me up. I couldn’t really talk because I was still numb. I went home to recover. I was prescribed some antibiotics and Tylenol with codeine. I was extremely careful not to create any suction, as that could lead to dry socket. I was sore and swollen for about a week. I kept getting swollen until about the fourth day, which is when the swelling started to go down.

Just over a year earlier I had gotten riboflavin-based corneal crosslinking in my left eye. That involves, essentially, getting your eye skinned while you are fully conscious. You’re numb during the procedure, but the anesthetic wears off very quickly. And, remember, your eye is one of the most pain-sensitive parts of the body. Your gums, on the other hand, do not have a lot of pain receptors. After experiencing that, in comparison the oral surgery was nothing. And I’m glad I got it done.

Why Dental Insurance Isn't Insurance

What is insurance? The defining feature of insurance is paying a third party to take on catastrophic risk. Health insurance’s main and original purpose was to protect you from incurring the expense of a catastrophically expensive disease or injury. Homeowner’s insurance protects you from the catastrophic risk of your house burning to the ground. Auto insurance protects you from the catastrophic risk of a car accident. Those are all uncertain events, hence there is a risk. You don’t pay to have your car insurance cover tire rotations or oil changes. Your homeowner’s insurance does not cover house-painting.

Not all forms of insurance are catastrophic, of course. When I buy a $60 video game from GameStop they offer insurance on the game. For $3 they will replace the game if it breaks or gets damaged within a year. That is clearly not catastrophic or traditional insurance. But there is clearly not a need for catastrophic insurance for video games sold by GameStop.

Health insurance provides protection against the financial risk of facing huge medical expenses which, in rare cases, can go into the millions of dollars. Typically, the amount a policy pays is defined by deductibles, coinsurance percentages and out of pocket maxima. If you suffer an illness or injury, the amount that you have to pay for treatment is limited.

For some reason dental care is not generally covered by health insurance. Therefore there are standalone dental policies. That would be fine, except for the fact that dental insurance doesn’t provide the risk protection that people want with insurance. A typical dental insurance plan has a maximum benefit of $2,000 (or less) per person per year. One of the biggest problems with this is that it will cover regular checkups, cleanings and fillings, but once you need anything serious it gets maxxed out quickly and won’t cover anything. Crowns, root canals and implants can all run into the thousands of dollars -- each. So if you need a lot of dental work it can run into the tens or even hundreds of thousands of dollars. That – and not the $250 checkup and cleaning -- is what dental insurance should be for.

That’s not to say that there are no benefits to having a dental insurance policy. It can save you money in at least three ways:

• If you go to dentists who are in the insurance company’s network you pay discounted “in network” rates;
• If you are a “heavy user” of dental care, you may get more in benefits that you pay in premiums; and
• You pay premiums on a pre-tax basis and get benefits on a post-tax basis, thereby saving in tax.