At Coulee Region, Dr. Timm and Dr. Chuck are committed to helping you achieve a healthy smile that you love. Both surgeons provide quality care in wisdom teeth, tooth extraction, and bone grafting.  They sit down with their clients and go over the procedures to make sure everyone is on the same page. Appointment lengths will flux depending on the care they are providing, but Dr. Timm and Dr. Chuck want to make your experience as comfortable as possible. IV sedation is available for procedures and is a safe option for pain-free operations. With Coulee Region Implant and Oral Surgery Center, dental care can be simple and stress free.

Wisdom Teeth

Most people are born with twelve molar teeth which are used for chewing food. The first molar usually erupts at age six. The second molar eruptions are around age twelve. The third molar or Wisdom tooth will erupt from age 17-20 years of age. However, many people do not have adequate room for the third molars to grow into proper position for chewing or adequate cleaning. Because of this, nearly 85 percent of people have had their Wisdom teeth removed by adulthood. As a tooth begins to erupt into the mouth, they become exposed to the bacteria which can lead to decay and gum disease which are “silent” and do not cause pain or symptoms until the situation is serious. If the Wisdom tooth does not erupt into the mouth, this impacted tooth can develop cysts and/or tumors which may require advance procedures. If you still have your Wisdom teeth, we advise asking your dentist to examine the area and make necessary recommendations based on your situation or feel free to call CRIOS and make an appointment for a free consultation.

Reasons for Wisdom Tooth Removal

Periodontal Disease

Periodontal disease is an advanced condition of gum disease which will lead to local and systemic bacterial infection along with local bone loss of the jawbone.


Impacted or partially erupted teeth can have “deep pocketing” which can not be cleaned by a toothbrush or floss.  The bacteria in these deep pockets can be aggressive and lead to infection.


Pain is the most common symptom but only present after a tooth has been insulted by advanced decay, periodontal disease or infection.


Decay or caries is caused by bacteria and plaque which will lead to the tooth becoming soft and eventually nerve damage. Decay can “spread” to adjacent teeth.

Sinus Problems

Impacted teeth of the upper jaw can lead to sinus infections from decay or periodontal disease. Impacted upper teeth can also develop cysts or tumors that spread to the sinus cavities.


When people do not have adequate room for teeth crowding, this may develop and lead to crooked or mispositioning. Crowded teeth are more difficult to clean and will lead to a higher chance of decay.

What To Expect

At CRIOS, we typically will have you come in for an examination or consultation. During this appointment we will provide a diagnosis and individualized treatment plans, discuss the procedure, and review your anesthesia options. If you prefer, the examination and treatment can be performed on the same day if minimum health conditions are met.

The Wisdom tooth removal procedure will typically take 30-60 minutes with an extra 30-60 minutes if same day consultation and treatment with IV anesthesia is provided.

Click Here to Learn About IV Sedation Options

Tooth Removal

There are many reasons for the removal of a tooth or teeth. The most common include tooth decay, periodontal disease (gum disease), trauma and developmental problems. Most people believe that teeth should last an entire lifetime but this is not always the case. Teeth can wear and fracture from a course diet, grinding habits and out-lived restorations. Tooth removal is a common procedure and the providers at CRIOS are highly skilled at this procedure. The procedure can be performed with local anesthesia and Dental Nitrous Oxide, but our providers advise using IV sedation for your comfort.

Removal of a problem tooth is important and should never be put off. Delay of tooth removal can lead to extreme pain and serious infection. If you been having tooth pain, please call and speak with one of our skilled staff.

Reasons for Tooth Removal

Periodontal Disease

Periodontal disease is an advanced form of gingivitis where the bone supporting the tooth is lost and the tooth becomes loose. This disease can lead to bad breath and pain caused by bacteria. Periodontal disease has been related to heart disease and complications during pregnancy.

Dental Caries (Decay)

Decay is a term used to describe a condition where the tooth becomes stained and soft from bacterial attack. Advanced forms of decay will lead to tooth pain and damage of the tooth nerve.


Infection is related to advanced decay and periodontal disease. Luckily most oral infections are easily treated with tooth removal and antibiotics. However, when infection is not treated or addressed in a timely fashion, the infection can spread to the entire body. Fortunately, the providers at CRIOS have advanced training related to oral infections.

Sinus Pain

If you suffer from sinus pain, congestion and infections you may have a tooth with decay, periodontal disease, or nerve problems. Our providers work closely with Otolaryngologist (Ear Nose and Throat doctors) at Mayo and Gundersen in the treatment of patients with chronic sinus problems.

Impacted Teeth

When teeth do not erupt into the mouth completely or properly it is considered impacted and most likely needs to be removed. Impacted teeth can lead to periodontal disease, decay, sinus problems, cysts and in rare cases tumors.


Some people do not have adequate space for all of their adult teeth. We work closely with dentists and orthodontists to remove select teeth prior and during orthodontic treatment to enhance treatment success and a patient’s smile.

What To Expect

Length of Procedure

In most cases tooth removal can be easily accomplished in less than one hour. Tooth removal appointments may last up to 2 hours which would include consultation, procedure and in-office recovery. If more then one tooth is removed, we advise asking about IV sedation.

IV Sedation

Our providers have extensive training in IV sedation which is intended to provide relief of anxiety and induce sleep. You will be relaxed and sleepy during the procedure but breathing on your own and able to respond to commands. IV sedation aids in relieving procedure discomfort and induce forgetfulness. After your procedure you will be monitored by our skilled staff until fully recovered and ready to return home.

Avoiding Dry Sockets

  1. Avoid touching or brushing the wound at all costs other then changing gauze as instructed.
  2. Avoid smoking for at least 3 days after any oral surgery and tooth removal. We recommend permanent smoking cessation.
  3. Avoid hard or crunchy food that leaves small particles e.g. Nuts, Chips, Pretzels, Popcorn.
  4. Choose soft foods that can be mashed or cut with a fork.
  5. Avoid carbonated drinks.
  6. Please tell your doctor about any prescribed medications or herbals.
  7. Avoid vigorous sports or physical activity for 5 days.
  8. Avoid playing wind instruments for 5 days.
  9. Begin gentle salt/water rinses after three days.


Recovery Instructions
Home & Office Instructions