General dentist or oral surgeon for decayed wisdom teeth extractions

Joined
Nov 11, 2021
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Hello! I'm posting to get some input about my situation. I am 31 and scheduled to have all four of my wisdom teeth removed next Friday. I do not drink or smoke cigarettes but I do vape (D8 THC). Here is a link to my xrays.

I went to the dentist this week for the first time in over five years. I have a major dental phobia I'm working through. In that time my wisdom teeth have decayed and obviously need to be removed. The dentist I saw is not the one who will be removing the teeth, he was in the middle of a procedure while I was there so I wasn't able to ask questions. I would like to know if there are any reasons I should use an oral surgeon instead of a general dentist for the removal, like proximity to a nerve or sinus, etc. The codes on the estimate for the removal are all surgical extractions, does this mean the teeth are impacted? They seem to be fully erupted to me. Just looking for some other opinions on if I need a surgeon or not. I am also scheduled to have two cavities filled in December - does this look about right based on my bite wings? And last question, what's up with my front tooth looking black in the panoramic xray? Thanks for any advice you can provide!
 

honestdoc

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Jun 14, 2018
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General dentists have varied skill sets and experience levels. I've been fortunate to recognize which cases I will pursue and those I will refer. Looking at your x-rays, the top wisdom teeth should come out fairly quick with minimal trauma. I usually code D7140 simple extractions since many of them come out less than 5 min. The bottom ones will be tougher due to the jaw bone being more difficult and many times removal of bone (surgical) and sectioning the top crown may be needed. The tooth appear to tip and will exit distally (away from the midline) which can be more difficult as well. The dentist (or surgeon) may code soft tissue impaction (more expensive) but should not code partial bony or fully bony impactions. If they do, they are ripping you or your insurance off.
 

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