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Dentistry/wisdom tooth extraction

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Question
Hello,

I recently visited an oral surgeon for a preliminary meeting about having my wisdom teeth removed. After having a CT scan, it was revealed that the roots of one of the teeth appear to be wrapped around the nerve in my lower jaw. Although this tooth is currently not causing any problems, he said a "halo" was forming around it and that eventually it would need to be removed or a cyst would form. He said that there is a high probability of permanent nerve damage if it were fully extracted and recommended that only the upper half of the tooth be removed. Is this a good option and are there any unforeseen complications of this procedure?

Answer
Andrew -  I understand what you are describing and lower wisdom teeth that are not completely erupted of have their roots in a close position to the mandibular nerve.  This nerve is the one that when it is in contact with local anesthetic medication the lip and chin on that side get numb.  Well, during the extraction of a lower tooth near the nerve, there is occasionally trauma to the mandibular nerve, producing numbness of the nerve.  That numbness, if the nerve is not directly injured, but only traumatized from the extraction, often caused numbness for a while.  If, however, the nerve is damaged that numbness can be permanent.  For that reason, the doctor will advise the patient of the potential problem and leave it up to the patient if they want to have the extraction.    The upper extraction should produce no similar complications.  

My suggestion is that you get a second opinion.  Some doctors are not as skilled and avoid difficult procedures.  My suggestion is that you get that second opinion from a board certified oral and maxillofacial surgeon,  

If you have additional questions, feel free to contact me again,

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Joel S. Teig, DMD, Diplomate ABOMS, retired

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 -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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