Richard S. Nemes Jr., DDS in Baltimore: Extraction and Implant Surgery Near Federal Hill
Richard S. Nemes Jr., DDS operates an oral surgery practice in Baltimore focused on tooth extractions, wisdom tooth removal, and implant placement and restoration. The practice sits on the edge of Federal Hill, drawing patients from across the city and surrounding counties who need surgical-level dental intervention that general dentists refer out.
What the practice does
Oral surgeons differ from general dentists in scope and training: they complete four additional years of surgical residency after dental school and hold hospital privileges. Nemes's practice handles procedures general practitioners cannot perform or do not perform in-office. This includes surgical extractions of impacted teeth, bone grafting ahead of implant placement, and extraction of teeth broken below the gum line. Wisdom tooth removal, whether routine or complicated, is a substantial portion of the caseload. Unlike some oral surgeons who focus exclusively on implants or orthodontic support, this practice covers the full surgical range.
Sedation and anesthesia options
Most Baltimore-area oral surgeons offer local anesthesia, nitrous oxide, and IV sedation; Nemes's practice provides all three. Local anesthesia alone suits simple extractions; nitrous oxide (laughing gas) reduces anxiety without rendering the patient unconscious. IV sedation, managed by a nurse anesthetist or anesthesiologist, is standard for complex cases and patients who prefer to sleep through the procedure. The specific sedation provider and cost adjustment for anesthesia services should be confirmed at consultation, as rates and in-office vs. hospital-based anesthesia vary by case complexity and patient medical history.
Wisdom tooth removal and extractions
Wisdom tooth removal represents a high volume for most oral surgeons in Baltimore. Nemes handles routine impactions (teeth that fail to erupt normally in the jaw) as well as severely angled or deeply embedded teeth. Surgical extraction differs from a simple extraction in that the surgeon may need to remove bone, section the tooth, or use elevators rather than forceps alone. Recovery from surgical extraction typically runs one to two weeks for swelling and pain to subside, with complete bone healing extending months. General dentists remove teeth that are fully erupted and mobile; oral surgeons intervene when the tooth is trapped or its removal risks nerve or sinus damage if attempted without proper training.
Implant planning and placement
Dental implants require bone volume. When a tooth has been missing for years, or when extraction leaves insufficient bone, a surgeon performs bone grafting to create a foundation for implant placement. Nemes's practice provides the surgical phase; the restorative phase (crown, abutment) typically occurs with the patient's general dentist or a prosthodontist after the implant integrates (three to six months). This split workflow is standard across Baltimore and costs money and time, though some practices coordinate closely to streamline the process. Implant placement itself is outpatient surgery under sedation, completed in one to two hours depending on bone quality and implant quantity.
How Nemes compares to other Baltimore oral surgeons
Baltimore has multiple oral surgeons: practices like Towson Oral and Maxillofacial Surgery and several independent surgeons in Canton and Fells Point. Differentiation often hinges on location, specific equipment (3D cone-beam CT scans reduce guesswork during planning), anesthesia staffing, and whether the surgeon accepts insurance. Practices that accept Delta Dental, United Healthcare, and CareFirst BlueCross (the dominant carriers in Maryland) reduce out-of-pocket cost for covered procedures. Practices in medical office parks sometimes offer ample free parking, whereas downtown and Federal Hill locations often require street parking or paid lots. Lead times also vary: some surgeons book routine extractions within two weeks; others carry six-week waits. Call ahead to understand wait time and parking reality for your specific procedure.
Who this suits and who it does not
Nemes's practice suits patients requiring complex tooth removal, implant surgery, or bone grafting. It suits people who want sedation because anxiety blocks them from dental care. It does not suit patients seeking cosmetic gum contouring or jaw realignment; those are subspecialty services requiring an oral and maxillofacial surgeon with additional fellowship training. It does not suit someone seeking a second opinion on whether extraction is necessary (that decision typically belongs to the referring dentist). It suits urgent cases where a tooth fractured and the referring dentist cannot extract safely; some oral surgeons keep same-day slots for emergencies.
The first visit
Most referrals arrive from general dentists. If self-referring, call to ask whether the practice accepts new patients directly or prefers a referral letter. At the first visit, expect a clinical exam, imaging (X-rays or CT scan), and a detailed discussion of options, risks, and cost. Insurance verification happens before or at the visit. A surgical plan is drafted, sedation is discussed, and a surgery date is scheduled. Budget 60 to 90 minutes for this appointment alone.
Hours, parking, and location
The practice operates in Federal Hill. Hours typically follow a Monday-through-Friday schedule; many oral surgeons close weekends and holidays. Street parking on Federal Hill fills quickly; nearby paid lots exist. Call to confirm current hours and parking details, as schedules change with surgeon availability and seasonal demand.
Oral surgeons are essential for complex tooth removal and implant surgery that general dentists cannot handle safely. This practice serves that role across Baltimore.
