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Dentistry/Is an extraction really needed?



I am 30 years old, female, and have been without dental insurance (and care) since I was 18. I recently picked up insurance, and had several problems taken care of. My wisdom teeth were not removed as a teenager, as my pediatric dentist felt my jaw had enough room, and the teeth came in straight.

However, in the years after, cavities occurred, and eventually rotted away the wisdom teeth. The nerves are completely dead, and 3 of the 4 teeth have broken in pieces, to the point there's the gumline in spots. The fourth tooth is completely gone, with a small indent where I suspect the pulp was.

The dentist is very firm that I need an extraction on all 4 teeth, or the root may abscess. Given the damage done, and the total lack of any sensation in that area, I suspect that the root is already dead. Do I really need an extraction? I hate the thought of being anesthetized for anything, as I've never had that done, and it's really freaking me out. I'm not sure why an extraction has to be done if the nerve is already completely dead?

Amanda - without directly examining you or viewing xrays of the areas it is a little difficult for me to define what is present and what has occurred.  Saying that, with the extent of decay in the wisdom teeth, a nerve inflammation or infection is ahead.  Just because you don't have pain does not mean the nerve is dead, rather, the nerve has not yet been invaded by the decay and the bacteria in the decay.  It sounds, from your description, that a problem with the wisdom teeth is inevitable.  Your dentist is probably trying to help you by preventing a problem.  So extracting the wisdom teeth sounds correct.  

If you have proof that the nerves have not been affected and the teeth are not alive it might better help me arrive at a diagnosis to help you.  So get back to me with other information, but for now, extracting the wisdom teeth seem appropriate and will prevent a future problem.


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Joel S. Teig, DMD, Diplomate ABOMS, retired


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.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

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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