Dentists Refer Some Wisdom Tooth Extractions to Oral Surgeons

Post your comments about wisdom tooth referrals to our blog. Read the wisdom tooth survey press release.

Referring Wisdom Tooth RemovalsIn our most recent survey, we asked dentists what percentage of wisdom tooth removals they refer to an oral surgeon. Overall, half of our dentist respondents refer out 80% or more third molar extractions. Some dentists were grateful to be rid of most or all wisdom teeth cases, while other dentists prefer to refer only the most complicated cases.

Read the dentists’ comments for more insight into their thoughts on referring patients out to oral surgeons.

Click the graphs below for more data. Roll over to see exact percentages.

Not surprisingly, general dentists and specialists have very different profiles when it comes to referring patients. Specialists were sharply divided;
17% refer less than 20%, while 73% refer all extractions. Oral surgeons tend to treat wisdom tooth cases themselves, whereas specialists such as orthodontists or endodontists usually refer them all out.

General dentists were less polarized. Half refer out 80% or more. On the other hand, one in four (24%) treat most extractions, referring less than 20% of cases.

Geography was not a particularly significant factor. It is worth noting that rural dentists are especially likely to treat most wisdom teeth patients
themselves; in rural areas, there may not be a nearby oral surgeon.

Gender was also minimally significant. However, male dentists are twice as likely to report treating most wisdom tooth cases themselves.

For more insight into what our respondents are thinking, check out their comments!

Why not refer?

  • "That's what oral surgeons are for!" (California dentist who refers out all removals)
  • "Let those who do these procedures routinely, do them as they will do it better than I who used to do them occasionally. People do not rush to my office because I take out teeth really well!" (Trinidad & Tobago dentist who refers out all removals)
  • Better them than me! I actually have an oral surgeon come into the office and do impacted 3rds with oral/nitrous sedation." (Texas dentist referring 60-80%)
  • “All I needed was one 'numb' lip (and the tooth was barely on the nerve!). I'll stick to what I'm good at. They're not worth the risk." (Florida dentist referring more than 80%)

General dentists are fully qualified for most extractions

  • “I am glad they are there, but most surgical wisdom teeth are very easy and should be done by the dentist." (North Dakota dentist referring less than 20%)
  • “Cherry pick your cases, charge high fees, use dexamethasone to decrease inflammation and send them home with marcaine block and start with two Vicodin. They rarely need additional pain meds and you are a great dentist. Send the ones that are going to hurt later to the OS and he is the one that hurt them. Big plus you never have problems when you cherry pick. Never do a tough one for the money!" (Illinois dentist referring 40-60%)
  • "I know my limits, but I also enjoy Oral Surgery. I worked for an OS all thru Dental School, and he was a fantastic surgeon, and wonderful mentor." (Kentucky dentist referring less than 20%)

Sometimes, both the referring dentist and the surgeon win

  • "I refer all of them out because I don't enjoy doing them. The oral surgeon sends me some nice restorative/prosthetic/implant cases." (Florida dentist who refers out all removals)
  • “Better than periodontists; at least they'll send the patients back." (Tennessee dentist who refers out all removals)
  • "As an implantologist, I routinely do almost ALL of my surgeries including 3rds. One OS office in my town routinely refers their over-flow 3rds to me.
    Shared caring works out very well for all of us." (California implant dentist referring less than 20%)
  • “Much easier and more comfortable for the patient. Plus, our oral surgeon is next door so patients don't need to make another trip." (California dentist who refers out all removals)
  • "Patients feel comfortable knowing that I have a wealth of specialists I can count on." (California dentist referring 20-40%)

Some dentists only refer in extreme situations

  • “I only refer if I feel the likelihood of parasthesia is extremely high. I am proficient in exodontia, including difficult, full bony impactions." (Minnesota dentist referring less than 20%)
  • "Only extremely difficult cases. Patient management, complicated medical histories." (District of Columbia dentist referring less than 20%)
  • "Only extremely medically compromised patients, severely infected teeth, or very very difficult teeth to remove." (North Carolina dentist referring less than 20%)

In rural areas, you extract what you can

  • "The nearest oral surgeon is 150 miles away, so I do almost all of my third molar extractions." (Utah dentist referring less than 20%)
  • “With 20+ years experience at 3rd molar removals and IV sedation capability, we tend to only refer the obvious 'problem cases'… Especially with the nearest OS over an hour away." (Rural West Virginia dentist referring less than 20%)

Oral surgeons are good at what they do

  • They do it best…" (Indiana dentist referring more than 80%)
  • “I like having a good network of oral surgeons to refer my patients to." (Michigan dentist referring more than 80%)
  • “If someone can do something better and/or faster than me…I refer it." (New York dentist referring more than 0%)
  • "I want my patients to get thebest treatment." (India endodontist who refers out all removals)
  • "Less likely to have complications." (Missouri ortho technician who refers out all removals)
  • “Oral surgeons do this day in and day out, they have the expertise to extract third molars faster and with less trauma to the patient." (Texas orthodontist who refers out all removals)

Complications? See an oral surgeon!

  • “I am grateful to have a source to refer things that are more difficult than I am comfortable doing." (Mississippi dentist referring 60-80%)
  • "Better that the surgeon has to deal with any complications that may occur during the procedure!" (New York dentist referring more than 80%)
  • “If I'm not comfortable with an extraction, I have no problem sending my patient(s) to any of the oral surgeons in my area. I would even go to them if I needed an extraction." (Pennsylvania dentist referring more than 80%)
  • “I don't want to do a procedure that I am not comfortable with if complications arise." (Florida dentist referring more than 80%)
  • "I'm happy to refer out difficult cases. Patients deserve better care." (California dentist referring less than 20%)

Save money… refer extractions.

  • “It is not cost efficient to take teeth out." (Texas dentist referring more than 80%)
  • "The complications are not worth the fee." (New York dentist referring more than 80%)
  • “I think that I refer difficult cases to a specialist because of the cost time ratio, since surgical removal of a wisdom tooth costs the same as cl II filling of a molar tooth but not the same work duration." (Libya dentist referring 20-40%)
  • "I don't have time to deal with extractions." (South Dakota dentist who refers out all removals)
  • “Safer as they have much more experience. Not a practice builder: people don't come back to you if they have had a difficult time." (dentist referring 60-80%)
  • “Many great ones in the area, and lots of other things to keep me busy." (Virginia dentist who refers out all removals)

Save your sanity… refer extractions.

  • “Makes me sleep good at night!!!" (Florida dentist referring more than 80%)
  • “My practice is primarily adult and I don't do extractions that might give me a headache." (North Carolina dentist referring more than 80%)
  • “I thank the Lord that they are out there to refer to!!" (California dentist referring more than 80%)
  • "I refer because I don't want the patient getting swelling and pain from treatment I did for them. Let the specialist take the heat." (New York dentist referring 40-60%)
  • “It's less stressful for me and the patient to have the OS do them." (California dentist referring 60-80%)
  • “I'm glad they are available for the difficult patients." (South Dakota dentist referring 20-40%)
  • “Let them deal with it." (Kentucky dentist who refers out all removals)

It all comes down to anesthesia

  • "I believe it is a surgical procedure and it should be done under general anesthesia by the person best qualified. I treat my patient, not my wallet. Dentists who take out the upper and then send out for lower are the biggest frauds in the world. It makes no sense. If a patient is going to sleep why not let the oral surgeon do all four?" (Texas dentist who refers out all removals)
  • “Great service as it limits my legal exposure to complications, and IV sedation." (Oklahoma dentist referring 20-40%)
  • Litigation." (California dentist referring 60-80%)

What's wrong with some of these oral surgeons?

  • “Some are good, but too many talk about how fast they can do them. What good is that?" (Colorado periodontist who refers out all removals)
  • "We treat our patients better clinically and emotionally, and it seems Oral Surgeons like to 'go it alone.' They also do not have the big picture plan for treatment the way we do." (Massachusetts dental office worker)
  • "If needed, okay. Just be sure of the surgeon. Like in all fields of medicine, some are good, and some you just do not refer to." (Florida dentist referring less than 20%)
  • "Oral surgeons are a big help when needed…but they sometimes act as if they 'own' the patients and don't do what they are referred for. I have fired several oral surgeons for not following the treatment plan." (Georgia dentist referring less than 20%)

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