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Oral Surgery/Wisdom Tooth Extraction

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Question
Hi, a few days ago I went to see an oral surgeon because I have a lower wisdom tooth on my right side that my dentist said needed to be extracted. When I went to the surgeon,they took an x-ray(the one that goes around your head) and when the surgeon came in and looked at the x-ray he said he wanted to not remove the tooth that day because he wanted me to go for a CT image of my mandible because he was concerned about where my nerve is in relation to the tooth. He told me that if he was to hit the nerve,my bottom lip would go numb and would probably never return back to normal. I am going for this CT X-ray tomorrow. My question to you is, that I believe he said that if he could not extract the tooth due to the nerve, that he would do something along the lines of a root canal instead. The tooth very rarely hurts me. I have never heard of anything other then an extraction being performed on a wisdom tooth. He also said the tooth has alot of decay. I was wondering if you could tell me anymore about this procedure. Is a root canal possible in a wisdom tooth? How does it compare to a root canal on a regular tooth? Is it a big procedure or painful? Thanks!

Answer
Matthew -  This new procedure that the surgeon spoke to you about is a fairly recent approach to treat wisdom teeth when the mandibular nerve is close.  This procedure just removes most of the crown of the tooth and then removes the nerve in the tooth, leaving it nonvital and hopefully passive.  

This approach is a development of malpractice insurance.  This approach has developed over the last few years when potential nerve damage is possible.  In that past, the wisdom tooth, if it was inflamed or causing pain, would be extracted.  Nerve injury warning is given before every tooth extraction and especially lower wisdom teeth.  

I have never performed this approach and yet I have not any patients with permanent numbness.  So if the doctor is concerned, then his approach is safe and should provide a positive result with minimal pain.

If youo have any 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 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 practicing for over 20 years. Assistant Clincal Professor at 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 Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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