Oral Surgery Insights
Oral Surgery Insights is your front-row seat to real conversations between two of the Pacific Northwest’s leading oral and maxillofacial surgeons—Dr. Russ Lieblick and Dr. Brandon Rehrer of Beacon Oral Surgeons. This podcast is designed for patients, dental professionals, and anyone interested in learning more about oral surgery, dental implants, wisdom teeth removal, and the evolving science behind surgical dental care.
Each episode tackles essential topics like the dental implant process, bone grafting, sedation options, jaw surgery, facial trauma treatment, and post-operative care. Russ and Brandon break down complex procedures with clarity, humor, and deep clinical experience—sharing real patient stories and expert perspectives on what works, what doesn’t, and what’s coming next in the world of oral surgery.
Whether you’re considering a procedure, supporting someone who is, or simply want to demystify topics like TMJ surgery, oral pathology, or digital surgical workflows, Oral Surgery Insights helps you feel informed and empowered. Tune in weekly for trusted advice, practical tips, and a refreshing take on what it really means to restore oral health and confidence—one conversation at a time.
Oral Surgery Insights
Signs and Symptoms of Impacted Wisdom Teeth
When it comes to wisdom teeth, silence doesn’t always mean safety. In this episode of Oral Surgery Insights, Dr. Russ Lieblick and Dr. Brandon Rehrer uncover the early signs, subtle symptoms, and potential complications of impacted wisdom teeth.
From dull jaw pain to gum inflammation and even “silent” damage to neighboring teeth, they explain how to recognize the body’s warning signs before serious issues arise. You’ll also learn why early evaluation—starting around age 12—is key to preventing infection, cysts, and long-term dental complications.
Whether you’re a parent, a teen, or an adult curious about wisdom tooth removal, this conversation will help you understand what to watch for and when it’s time to consult an oral surgeon.
🎧 What You’ll Learn:
- The most common warning signs of impacted wisdom teeth
- How pain, swelling, and gum infections develop
- “Silent” issues that can damage healthy teeth and jawbone
- Why early X-rays and dental checkups are critical
- The importance of proactive oral surgery evaluation
🦷 Listen now to learn how early detection can make all the difference in preserving a healthy, pain-free smile.
Dr. Lieblick: Brandon, one of the things we try to help our patients understand is how to listen to their own bodies. Our bodies have ways of signaling that something isn't quite right, and those signs can range from being very obvious to incredibly subtle.
Dr. Rehrer: That’s a great point, Russ. And that's especially true in dentistry and oral surgery. A classic example is the impacted wisdom tooth, a condition that can announce itself with a wide variety of signals. Sometimes it's a loud, clear problem, and other times it's a quiet issue that can only be found with a careful examination.
Dr. Lieblick: And being able to recognize those signals is so important for a patient's long-term health. Welcome, everyone, to Oral Surgery Insights. I’m Dr. Russ Lieblick, and I’m here with Dr. Brandon Rehrer. Today, we’re going to be talking about the common signs and symptoms that can indicate a problem with your wisdom teeth.
Dr. Rehrer: Our goal is to provide clear, practical information to help listeners better understand these signals. Recognizing these signs early can often lead to simpler interventions and prevent more significant complications down the road.
Dr. Lieblick: First off, we really need to be evaluating patients early…. Starting at age 12. While most patients are ready for wisdom tooth removal at age 14 to 16, we don’t want to be late! Complications are greatly increased with late identification.
Dr. Rehrer: Yes! Ask your dentist for an xray to check early and often. If they aren’t sure it’s time, they can check with an oral surgeon. We get radiographs from dentists all the time asking if it’s time for a consultation.
Dr. Lieblick: I think the most common symptom, and the one that usually prompts a person to call us, is pain or discomfort. But this pain can show up in a lot of different ways.
Dr. Rehrer: It can. It’s not always the sharp, severe toothache people might imagine. Frequently, it starts as a dull, persistent ache in the very back of the jaw, behind the last molars.
Dr. Lieblick: Patients often describe it as a feeling of pressure, or a general soreness that might seem to come and go. It can also be a more acute pain, especially when they're chewing or if food gets packed into that area.
Dr. Rehrer: And that pain isn’t always just in the immediate area of the tooth. Because of the complex network of nerves and muscles in the face and jaw, the inflammation from an impacted wisdom tooth can cause referred pain.
Dr. Lieblick: That’s a key point. We see many patients who come in complaining of earaches, frequent tension headaches, or even neck pain, and they're surprised when we trace the source back to a problematic wisdom tooth. Any persistent, unexplained pain in that general region is worth investigating from a dental perspective.
Dr. Rehrer: Another very common set of signs involves inflammation and infection of the gum tissue, particularly with wisdom teeth that are only partially erupted.
Dr. Lieblick: This is when the tooth has broken through the gums but hasn't fully emerged into a normal, cleansable position. This often leaves a flap of gum tissue partially covering the chewing surface of the tooth.
Dr. Rehrer: And that flap, which we call an operculum, creates a deep pocket that is a perfect trap for food debris and bacteria. It's almost impossible to clean effectively with a toothbrush or floss.
Dr. Lieblick: This can lead to a localized infection called pericoronitis. For the patient, this usually means the gum tissue in that area becomes red, swollen, and very tender to the touch.
Dr. Rehrer: It can be quite painful. They might also notice a bad taste or bad breath coming from that area, or in more advanced infections, there might even be some pus that drains from under the gum flap.
Dr. Lieblick: A significant pericoronitis can be very disruptive. The swelling can sometimes be visible on the outside of the cheek, and it's common to have swollen, tender lymph nodes under the jaw, just like when you have a sore throat.
Dr. Rehrer: In some cases, patients may even feel generally unwell or develop a low-grade fever as their body works to fight the infection. Because the underlying anatomical problem—the partially erupted tooth and the gum flap—is still there, these infections can be recurrent, flaring up every few weeks or months. This is a very clear sign that the wisdom tooth is causing an ongoing health issue that needs a definitive solution.
Dr. Lieblick: It's also so important for people to understand that an impacted wisdom tooth can cause serious problems for the other teeth, often silently, without any initial pain.
Dr. Rehrer: This is one of the most significant risks we look for when we evaluate diagnostic X-rays. A wisdom tooth that is impacted and angled forward can disrupt the attachment of the gum tissue on the adjacent tooth.
Dr. Lieblick: This allows regular mouth germs below the gumline which can cause lots of damage including infections or cavities on the neighboring tooth.
Dr. Rehrer: An area that is impossible to clean effectively. Over time, this can lead to a severe cavity on the back surface of that second molar, which is one of the most difficult places for a general dentist to see and restore properly.
Dr. Lieblick: We have seen many cases over the years where a perfectly healthy second molar ends up needing a root canal or even being lost, not because of a problem with the tooth itself, but as a direct result of irreversible damage caused by the neglected wisdom tooth right behind it.
Dr. Rehrer: The other, more insidious issue we see is root resorption. The pressure from the crown of the impacted wisdom tooth can literally cause the root of the second molar to dissolve or wear away over time. This is a slow, painless process that can only be detected on an X-ray.
Dr. Lieblick: And that damage is permanent. If it progresses too far, it can severely compromise the stability of that important second molar. This is a prime example of why a lack of pain does not mean a lack of a problem.
Dr. Rehrer: While less common, there are other, more significant signs that can be associated with impacted wisdom teeth. One of these is the development of a cyst.
Dr. Lieblick: A cyst is a fluid-filled sac that can form in the jawbone from the tissues that are supposed to form the tooth. These are almost always benign, but they can grow quite large over time without causing any initial symptoms.
Dr. Rehrer: As a cyst expands, it can silently hollow out the jawbone. This can weaken the jaw significantly and sometimes damage the roots of nearby teeth by displacing them. Often, the first sign a patient might notice is a gradual, painless swelling of the jaw. In very advanced and rare cases, a large, untreated cyst can weaken the jaw to the point where it could lead to a fracture from even minor trauma.
Dr. Lieblick: It's so important to bring this all together with a final crucial point: many of the most significant problems caused by wisdom teeth are discovered on a routine X-ray before the patient experiences any symptoms at all.
Dr. Rehrer: That’s absolutely correct. We can identify a horizontal impaction that is destined to damage the adjacent tooth, or we can see the early formation of a cyst on a panoramic X-ray in a patient who feels completely fine and has no idea anything is wrong.
Dr. Lieblick: This really underscores the value of those routine dental checkups and screening panoramic X-rays, especially during the late teenage and early adult years when wisdom teeth are in their most active phase of development and eruption.
Dr. Rehrer: That proactive monitoring allows us to identify these high-risk situations early. This gives us the opportunity to intervene in a planned, controlled way at an optimal time, rather than waiting for an emergency situation to develop after the patient is already in pain or has an infection.
Dr. Lieblick: So, to recap for our listeners, the signs and symptoms of impacted wisdom teeth can range from the very obvious to the very subtle.
Dr. Rehrer: On the obvious end, you have things like pain in the back of the jaw, recurrent swelling and redness of the gums, a bad taste, and difficulty opening your mouth. These are clear signs that you should seek an evaluation promptly.
Dr. Lieblick: On the more subtle end are the problems that might not cause any initial symptoms, like silent damage to adjacent teeth or the slow growth of a cyst, which are typically found during a dental examination and on X-rays.
Dr. Rehrer: The most important message is to listen to your body and to not ignore persistent or unusual symptoms in the back of your jaw. And equally important is to maintain your regular dental checkups, as they are the key to early detection.
Dr. Lieblick: A professional evaluation is the only way to get a definitive diagnosis and understand the best course of action for your specific situation. We hope this discussion has been helpful in clarifying what to look out for. Thank you for joining us on Oral Surgery Insights.
Dr. Rehrer: We appreciate you spending your time with us and trust this conversation has provided valuable information.
Dr. Lieblick: We wish you good health.