Central New Hampshire Oral Surgery, P.A.

Wisdom Teeth and Summer ! 5 items to know about them

June, 2015

Wisdom teeth! School and college are out, and your dentist tells you to “get your wisdom teeth looked at”…… Great!

As a Harvard-trained and Board certified Oral Surgeon, I certainly don’t tell folks that wisdom teeth need to be removed just because they’re there! I treat my patients in the same way that I’ve treated my family for a long time. So:

Points which are important, and which I discuss with you at our initial Consultation meeting:

1- Some wisdom teeth simply don’t need to be removed. They’re so deep that the chances of infection are very small.

2- Wisdom teeth DO frequently become infected, however. That can become serious. Wisdom tooth infections can enter the throat and neck.

3- Wisdom teeth develop right near the nerves in your lower jaw, and near  your upper jaw sinuses. An Oral Surgeon should deal with these. Oral Surgeons have the training and skill to delicately treat quite challenging teeth. We also have the advanced training and experience to  provide General Anesthesia for you, if that’s your wish.

4- Checking them before you’re 20 years old is sensible.  Wisdom teeth can become much “harder” or more challenging as you age.

5- Wisdom teeth DO NOT cause your front teeth to crowd. Multiple studies confirm this . Studies do show that wisdom teeth CAN add to back-tooth crowding and movement.

Well, that’s five wisdom tooth factoids which you probably didn’t know. Be assured that we’ll treat you like family. Most of my patients elect General Anesthesia after we’ve spoken. That will be your choice, with my assistance.  See you/ your child this summer!

Dr. Levy 


“Doc, will the tooth be hard to pull?”

April 25, 2014

MANY of my patients ask me questions before I treat them which show that they’ve had some pretty negative experiences in the past. My “job” is to have you feel that “Gee, that wasn’t so bad after all” when we’re finished.

Usually, my patient tells me about a well-intended Dentist who tried his/her best. But, it turned into a 1 or 2 hour extraction. That would be pretty tough on anyone !

I am very good at what I do. With my training, and my years of experience, I should be ! And, odd for most patients to understand, my staff and I really like what we do. So, a broken down painful tooth that looks really hard is usually pretty routine to us. That means that although I’m never in a rush, the tooth (or teeth) seems to be “easy” compared to what you were expecting. I know that you don’t want me in your mouth for too long! And I really try to describe just how “hard” the tooth may be for you beforehand.

If my accurate description makes you “sweat”, then I stop and we discuss whether you wouldn’t do better if you had it removed under General Anesthesia. Many of our patients simply know that they want to “be asleep”. My Residency training in Anesthesia permits me to make that happen. I’m not going to tell you that” it’s just a little pressure” if it’s clear that you had a very negative previous extraction where the Dentist told you just that !

Often, I can see that a procedure is going to be challenging under “novocaine”. Like a set of infected Wisdom Teeth in a teenager who has had almost no “dental work” except for cleanings in his life. I’ll question to that person (and his parent) if he should be expected to put up with many “shots” , pressure, noise, etc. I once had a rugged police officer tell me that “You can break a bat on my head, no problem. But if I’m having a tooth pulled, I’m going to sleep”.

So, it’s usually not how hard the tooth is.  For me, it’s whether for YOU, what I can do pretty “slick” will be ok for you, when you’re sitting in my chair. Sharing my experience and advice, and then listening to what you think about it, is what I offer my patients, aside from my technical skill.

In closing, patients often ask me how many stitches  I put in. Since I like to close your surgical sites really nicely, I’ll often let a bit of my Brooklyn origin come through.” Quite a few, but I don’t charge by the stitch, so I didn’t count.” Then, if you really want to know, I’ll give you my best estimate. After I’ve taken off my gloves, and you know that it wasn’t that bad after all !

Welcome to Dr. Levy’s Helpful Info “Blog”

April, 2014

I’m pleased that we have the chance to chat. After 25-plus years in my specialty, there are questions which many of my patients have. I may be able to help you with some FAQs which you find useful.

Since finishing my surgical residency at the Massachusetts General Hospital, I’ve served the people of N.H. My experiences with patients clearly shows:

Almost everyone  is anxious about their needed oral surgery care. Some are just about “terrified”. This could be based on a bad previous experience with a dentist, or what they’ve heard from others about oral surgery. For many, the mouth is a private place, and doing necessary care is much more scary than many other types of surgery.

I very much respect patients’ fears as being real to them. I begin our visit by finding out how YOU feel about what needs to be done. Most patients appreciate that I “experimented” on myself. I’ve had two wisdom teeth removed awake with novocaine. Separately, the other two were removed while I was “asleep”, with General Anesthesia. So, when you tell me about how you feel, I can relate.

You can expect honesty from me about what you’ll experience.  A tooth may not be “hard” to me, as I’m quite good at what I do. However, you may find the thought of novocaine, and the sensations of pressure and some noise to be more than you can handle.  We’ll then discuss whether General Anesthesia would help you. Many patients choose Anesthesia, including some who admit that they have a special anxiety about “dentists doing stuff in my mouth”.

My training included months as an Anesthesia Resident. So, for example, I did anesthesia care for abdominal, orthopedic and urology procedures, as well as for removing teeth.

Our Anesthesia Care is very similar to what you’d receive in a hospital-but at a fraction of the cost. General Anesthesia is very different from those dentists who give you a pill to “relax you”, or Conscious Sedation, where you are awake, and usually aware. I can, of course, use these forms of “relaxation” for the right patients. Basically, my concern is your care and comfort, and which works best for you. That’s why we chat at length before I treat you. It’s also why I have advanced medical training and certifications. 

So, my “agenda” is to help you by whichever method you and I agree will work best for you. Your medical well-being as well as your emotions is what I’m advising you on, before you’re cared for.

Dr. Paul E. Levy