Second opinion about extracting healthy teeth

khan86

Hi,

I went to the dentist a couple of weeks ago with a recurring infection on my bottom left wisdom tooth (second time in 8 months, and had a mild case two years previous). Dentist discovered that the top wisdom tooth was down on the same side and as it was over-erupted it was damaging the lower gum where the bottom wisdom is trying to erupt (she said I was 'canibilising' it ) and this was causing inflamation and infection. I was prescribed two antibiotics and given an appointment to return yesterday to have the top wisdom tooth out under local anaesthetic. She did a full xray of all my teeth and it seems both my lower wisdoms are impacting. She suggested I have the teeth beside them extracted (sevens I think) to give the wisdoms the space to come up and she recommended the same for my top right wisdom tooth. Is this something that is usually recommended by dentists? I am a bit sceptical about having perfectly healthy teeth removed but I acknowledge that I am not the expert here, I would just appreciate some reassurance. Is there a chance that I could get the sevens removed and the wisdoms may still cause me hassle and then have to be removed anyway, which if that were the case would seem like an awful lot of teeth to lose and a waste of time removing the sevens? To be honest I found getting the top wisdom removed yesterday quite traumatising (not pain, but did not like the pressure sensation I'm still getting shivers thinking about it) and would prefer not to have to go through that again to get three healthy teeht removed if it is not guaranteed they will solve the problem. My OH had his bottom wisdom removed under sedation/local anaesthetic by a specialist in his local dental clinic and had stitches and could not eat for 6 days and went through a painful recovery so I know how invasive this procedure is and what to expect but I would still prefer this than being conscious for a normal extraction of healthy teeth.

Sorry about the (possibly unnecessarily) lengthy post, but I would appreciate any help with this.

coylemj

khan86 wrote: »

Hi,
My OH had his bottom wisdom removed under sedation/local anaesthetic by a specialist in his local dental clinic and had stitches and could not eat for 6 days and went through a painful recovery so I know how invasive this procedure is and what to expect but I would still prefer this than being conscious for a normal extraction of healthy teeth.

You are jumping the gun in saying that you 'know how invasive this procedure is and what to expect' when getting a wisdom tooth out based on your OH's experience.

I had my bottom wisdom teeth removed with no bother at all. The dentist did them a week apart and apart from some tenderness from the raw nerves and a dull pain, I survived. I had to pop two Neurofen to kill the pain just before going to bed that night and I avoided cold and hot drinks for a couple of days but apart from that it was a piece of cake. I had hardly any pain the following day so I was able to eat sandwiches and cooked food that wasn't too hot.

You can't compare the views of anonymous (and accountable to nobody) people on boards with the professional opinion of a dentist who's actually examined your teeth. If you want a second opinion, go to another dentist.

Oral Surgeon

Hard/impossible to give a second opinion without seeing you or your xray but...
In general;

I see a lot of impacted wisdom teeth....

I would consider extracting the 7s if the patient was young and the 7s were badly decayed and the wisdoms looked likely to erupt into a useful position... The end result would hopefully be healthier wisdom teeth more or less in the position of the decayed 7s... Good result

I would not consider removal of the 7s if they were not or mildly restored and likely to remain, or if the impacted wisdoms looked likely to remain impacted and not come into a functional relationship with the upper teeth. Then the wisdoms should be removed.

Infection around a wisdom tooth is often caused by impaction allowing stagnation of food and plaque and then gum inflammation and infection pain swelling... Removing the tooth in front does not always remove this stagnation area, gingival inflammation and pain infection can remain...

Impacted Wisdom teeth are often more difficult to remove than other molars but this should not sway the decision making process...

Sounds like you need to discuss this again...;)..
OS

khan86

coylemj wrote: »

You are jumping the gun in saying that you 'know how invasive this procedure is and what to expect' when getting a wisdom tooth out based on your OH's experience.

I had my bottom wisdom teeth removed with no bother at all. The dentist did them a week apart and apart from some tenderness from the raw nerves and a dull pain, I survived. I had to pop two Neurofen to kill the pain just before going to bed that night and I avoided cold and hot drinks for a couple of days but apart from that it was a piece of cake. I had hardly any pain the following day so I was able to eat sandwiches and cooked food that wasn't too hot.

You can't compare the views of anonymous (and accountable to nobody) people on boards with the professional opinion of a dentist who's actually examined your teeth. If you want a second opinion, go to another dentist.

Thanks for your input coylemj, I will get the opinion of another dentist if necessary, I just thought I would throw it out to the boards forum first to see what feedback I would get, I assumed that's what the Dental Issues forum is there for. Make no mistake, I am not second guessing my dentist but it is the first time I have seen this dentist as I always used to attend my home-town dentist during college therefore I am unfamiliar with her and just wanted to see what others would think. Like I said, I know I am not the expert here.

Futhermore, I am not basing my decision by comparing my potential experience of having my wisdoms out with the experience of my OH as I know everyone's experience is different. His for example was very different to yours as he was IV sedated and had to have his jaw bone pared back (I'm sure that is not exactly the correct term), had stitches for 6 days and could not eat at all. The reason I said I knew it was invasive was because my dentist said this is why she recommends just having the sevens out as she thinks too many dentists recommend people have the wisdoms surgically removed when there is other ways to deal with the problem than putting yourself through a more invasive procedure.

Besides, my question was more about the removal of the sevens which are in perfect condition. If anything I'm more in favour of having the wisdoms out as I can be sedated/anaesthetised for that!:D

khan86

Oral Surgeon wrote: »

Hard/impossible to give a second opinion without seeing you or your xray but...
In general;

I see a lot of impacted wisdom teeth....

I would consider extracting the 7s if the patient was young and the 7s were badly decayed and the wisdoms looked likely to erupt into a useful position... The end result would hopefully be healthier wisdom teeth more or less in the position of the decayed 7s... Good result

I would not consider removal of the 7s if they were not or mildly restored and likely to remain, or if the impacted wisdoms looked likely to remain impacted and not come into a functional relationship with the upper teeth. Then the wisdoms should be removed.

Infection around a wisdom tooth is often caused by impaction allowing stagnation of food and plaque and then gum inflammation and infection pain swelling... Removing the tooth in front does not always remove this stagnation area, gingival inflammation and pain infection can remain...

Impacted Wisdom teeth are often more difficult to remove than other molars but this should not sway the decision making process...

Sounds like you need to discuss this again...;)..
OS

Thanks for your reply Oral Surgeon, very helpful and useful information. I think that is what my dentist is expecting, that the wisdoms will replace the sevens and do the same job. I am 25 and there is nothing wrong with my sevens, they are in good condition.

If this was not the outcome and I had to have the wisdoms removed anyway after having the sevens extracted would I miss my teeth back there? i.e would there be any implications down the line not having my sevens or wisdoms? I know I should have discussed all this with my dentist at the time but I was in a bit of a haze after the extraction I wasn't really thinking about it.

At the minute I still have some pain that comes and goes on my bottom wisdom mainly going up into my ear and there is still a bad taste and smell even though I am just finished two antibiotics for the infection so I need to make a decision soon about what to do.

Oral Surgeon

Op, I don't like to second guess anyone and I don't have the benefit of looking at you or your xrays but again, I speak in general terms and from the experience of many- not you but...:

In a 25 year old you would not expect any further eruption of a wisdom tooth (they erupt from 18-21 approx)...

Therefore, I fear that you will have 2 good 7s removed to accomodate 2 wisdom teeth that most likely will not erupt into a good alignment with the upper 7s and most likely will continue to cause gum inflammation and pain and therefore will need to be removed in time aswell.
This will leave you a little short on molars for chewing etc unnecessarily...
There are of course downsides to wisdom tooth removal- most notably the fact that they lie close to sensory nerves etc but that should not push you towards the treatment plan above if it will not work...
Have a chat to your dentist again, maybe there are other factors involved that we both are not aware of...
Good luck,
OS;)