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Oral Surgery/Tooth extraction and wisdom teeth


Hi Dr. Teig,
Thank you for taking the time to help out all of us who visit this forum. You are providing a great service.

I have a complex case. First I need 2 teeth extracted, numbers 13 and 30. My general dentist has offered to do the extractions one at a time along with a bone graft after each extraction. He has told me both extractions are going to be somewhat difficult. Both extractions are going to be done using Novocaine. What can I expect in terms of recovery time and pain afterwards?

Also I have 2 lower impacted wisdom teeth. Both lie right on the nerve and have cysts. I first had the wisdom teeth looked at years ago and the oral surgeon told me the risk outweighed the benefit of extracting them.

In Feb. 2012 I was seen at Tufts Dental School for the wisdom teeth..... a many weeks process. One resident wanted to extract 1 of the wisdom teeth to in his words"see how things go" ..which didn't sound too appealing to me. I was also seen by a couple of people from the oral surgery department who told me the surgery was risky for someone in my age group.

After thinking things over I consulted with an oral surgeon in a private practice. He looked at the x-rays and told me the extractions were going to be a real bear for someone my age. Plus he told me the risk for complications were high....meaning slow healing,nerve damage and a potential broken jaw. And please note I have had issues with the facial nerves after several dental procedures.

My general dentist feels the risks outweighs the benefit of having the wisdom teeth extracted. Have you had patients where you thought the risks outweighed the benefits of extraction?

I am looking forward to your reply. Thank you.


Bob - What you are experiencing is not unusual.  Many of us have wisdom teeth developing close to the nerve or in a position that the extraction might produce excess forces on the tooth.  You did not state you age, but the older we get, the more dense our jaw bones become, making the extraction more difficult. Without seeing xrays of the area, it is a little difficult for me to be more informative.  

As far as the use of a bone graft for the extractions of teeth #13 and 30, if done correctly I don't see the need for the bone grafting.  Sure it fills the opening, but if the extractions are done properly, especially with those teeth, rapid healing and new bone formation should be expected.

I wish I could help more about those wisdom teeth.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon 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 practicing for over 20 years. Assistant Clincal Professor at 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 Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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