AboutJoel S. Teig, DMD, FABOMS Expertise I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.
Experience Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.
Organizations American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons
Education/Credentials BA
DMD
Awards and Honors National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude
I am a 28 year old female who still has her bottom two wisdom teeth intact. Both are above the gum line except for a small portion that is below as the teeth have grown in sort of sideways. My right wisdom tooth (my right) had a small cavity on the side of it closest to my cheek and one morning I woke up and the top of the tooth was gone. My tongue feels the hole is quite deep and when I look at it in the mirror it is ugly! It is an orangy color I guess I would call it, and sometimes it looks black. It doesn't hurt, only on occasion and on those occasions it feels like it is hurting due to the tooth moving as in teething like a baby getting new teeth. The pain lasts only a few hours and then subsides. It is not hot or cold sensitive, nor is it sweet sensitive. The only thing I have noticed food wise that bothers is when I have to chew something that takes a lot of energy, and then my jaw and neck hurt, but not my actual teeth. Behind the tooth on the back gums there is some swelling that I can visibly see with a flashlight while looking in the mirror, and there appears to be a small bubble that is white in the center. Is that an abscess? I am so scared also because I have been feeling tired lately, sick, and just a general feeling of not feeling well and I am not sure if that could be related to an infection within the tooth such as an abscess? I brush my teeth 4-5x a day and I also rinse with warm salt water just to make sure I am keeping my mouth clean. I do not have dental insurance and also suffer from acute panic disorder so getting me into a dentist office is like "pulling teeth" no pun intended. They scare me and have ever since I was a little kid. Could you please tell me what you think about this given the information I have provided you with? Do I have an abscess? Is my tooth making me feel sick and tired all the time? Could I possibly have an infection?
Thank you for your time.
-Misty
ANSWER: Misty - I hate to tell you this, but the tipping of the teeth as they grew is what has set you up for a future problem. Those teeth, even if you were extremely skilled at cleaning of the area and do it religiously, would have a troubled future. Those teeth need to be removed. Poorly aligned teeth are breeding grounds for bacteria and cannot be removed or even contained. I know the thought of the removal of these teeth scares you, but having a regular dentist remove these teeth would scare me also. What you describe would be a fairly straight forward and simple removal for a board certified oral and maxillofacial surgeon. Another major advantage of the surgeon would be the ability to give you give you a sedative before the surgery or even anesthesia in the surgery to relax you and make the experience much more comfortable.
So, it sounds like your tooth may be the culprit of you tired sensations and having the teeth removed by an oral and maxillofacial surgeon would remove the potential for a problem in the future and at the same time relax you during the procedure.
I wish you well and hope you feel better soon. If you have additional questions, feel free to contact me again.
---------- FOLLOW-UP ----------
QUESTION: Dr. Tieg,
Thank you for answering my question so promptly. I have had my upper two wisdom teeth removed and the surgery went well and there were no problems with them at all and they seemed to be worse off than my bottom two teeth. From what I described of this tooth, do you think I have an abscess? If I do not remove these teeth soon will they cause major medical problems? Will I be at risk for death or having my throat swell and close up? I have heard of those things happening in severe cases and want to know if, given the info I have given you, am I at considerable risk of those things happening?
And one other thing....given my age and the fact I still have both bottom teeth intact, is there a greater chance of me losing all feeling in my jaw and mouth by having them removed? That is another fear that keeps me out of the dentist chair.
How bad off am I from where you are sitting?
-Misty
Answer Misty - It does not sound like you have an abscess, but you might just have a chronic infection. Either way, the infection or early brewing infection needs to be taken care of. So you need to get these teeth removed before they produce other problems. You won't be at risk for any other related problems if you get those teeth out.
Age is not the factor with causing a loss of feeling. It is the position of the nerve relative to the roots of the teeth that is important. Age is not the factor, but the position of the tooth to the nerve.
You should not have a regular dentist remove these teeth. You do not want complications, then see an oral and maxillofacial surgeon. General dentists do not handle surgeries as well and they are not fully trained to avoid major complications.
If you have more questions, feel free to contact me again.
