Expert: Dr. Randolph Myerson - 6/14/2005

Question
Last thursday I went for a gross scaling. The dentist told me I had 2 cavities & needed to have my top 2 wisdom teeth removed since they were going into my cheek bones. In addtion to that he also refered me to an othodontist for a a corss bite I never knew I had. The only problems I had to complain about was my teeth clenching. He said that before I spent the money on a night gard that he'd rather I had the aforementioned problems fixed.   The next day my bottom left wisdom tooth started bothering me (sore). Monday they had me come in & found that I coincidentally had developed a small infection ont he bottom one. He wrote an RX to clear it up & reminded me about the top 2 wisdom teeth. I told him I had the appt set already.

My questions are:
1. what's the big deal about the wisdom teeth & the cheek bones. What kind of problems would occur?

2. The dental asst. said they have this gas stuff to make the removal easier for the patient. I had a bad experience removing my bottom right wisdom...with just a local. How will the gas help?

3. How do you fix a cross bite? my bottom jaw swings off to the left a little. I never noticed it till the dentist said something.

4. I called after the appts. about scheduling issues & asked why not just take the bottom left out too? & they said that if the top wisdom came out it would prob. fix itself... I didnt want to argue, but I really do NOT want to do this again.

Advice?

Thank you
shelly

Answer
When the wisdom teeth are in improper positions it can lead to discomfort, potential inflammation or infection of the gums, and disturbances in the bite which can affect the jaw joints.

The "gas" that you are refering to is nitrous oxide and oxygen which can provide a great deal of extra relaxation for you...similar to a one or two martini buzz.  There is no hangover and the effect is reversed in about five minutes after the procedure is completed.

The cross bite is corrected using braces.  The exact means of doing so really depends upon the rest of the bite.

I find it unusual that they would remove three wisdom teeth and not remove the fourth also.  Leaving this last tooth without it's antagonist in the opposite arch can lead to further bite problems if the tooth has nothing to bite against.  It is possible that this is not the case and leaving it in might be acceptable.  That really depends on your bite situation.