The Cosmetic Dentistry Blog

Dr. Hall, I was searching online with the statement “wisdom teeth piece left in gumline” and I found a post of yours. You stated that the dentist makes a choice of whether or not he should leave the piece left in the gum. What are the actions that can occur if something does go wrong later on. I am asking because I had this happen to me and I am trying to figure out what I should do. I have seen two other dentists and they said they will not do the surgery to go in and remove the piece because they are scared of nerve damage in my face. Is there any legal responsibilites by my old dentist? I appreciate you time and any information you can give me.
- Chris from Virginia

Chris,
You didn’t say whether or not you are having trouble with this piece of tooth left in your jaw. If you aren’t having any trouble, then that is the end of the issue.

Even if you are, though, I don’t think the dentist is responsible for anything. And here is the reason: It seems to me that if you have two other dentists who are afraid to go after this piece for fear they will damage your nerve, then the dentist was reasonable to leave it in. If the piece is bothering you a great deal, then you can make a decision that you will take the risk of damage to your nerve, absolve the dentist or oral surgeon of any responsibility, and have it taken care of. But you will need to sign away your rights to complain later.

If your inferior alveolar nerve is severed in the process of getting this piece out, then your lower lip on that side will be permanently numb. While it feels weird for several months, eventually people get used to this and forget that it’s numb. You do have to be forever careful, though, because you can’t feel it if you bite your lip or burn it. I think you need to decide whether or not you want to take that risk.

Dr. Hall

Related links:
Read about the post-operative complications possible with wisdom tooth removal.

Dr. Hall,
My name is Kim. About a year ago I had my wisdon teeth pulled on the right side.

I had it done by a military dentist who did a terrible job. Afterward, my entire mouth was in a large amount of pain for months. I thought the pain would never go away. It slowly did but now I have a constant irritating feeling on the lower right side of my lip and the right side of my chin. When I push down on it, it tingles and gives an irritating tender feeling. Everytime I kiss my husband I flinch and pull away because it does’nt feel good. That’s one of the reason it botters me so much. I want to be able to kiss my husband without issues.

After almost a year is this damage considered permanent? What is wrong with it? Will it ever go away? Is there something I can do to make it better? Please help me so that I can kiss my husband again.
- Kim in Virginia

Dear Kim,
When you had your wisdom teeth out, the nerve that goes by the roots of your lower right wisdom tooth was apparently damaged.

Because you are having strange sensations and your lip is not completely numb, it will probably fully recover in time. The strange sensations indicate that the nerve was damaged but not severed. Nerve tissue is very slow-growing and takes a number of months to fully recover. Usually it recovers in a year, but it can take longer.

There’s nothing we know of that you can really do to make it get better any faster.
- Dr. Hall

Related links:
Wisdom tooth removal
Tooth extraction
Tooth infection

Dr. Hall,
Thank you for this service. I am a male age 63 male, and need my upper second molar (#15) extracted, which concerns me. I have a 2 1/2 year history of taking Fosamax, though I haven’t taken any the past six months. The oral surgeon insists that he should also remove the neighboring wisdom tooth, because it is a “vertical impaction” that is resting against the side of the #15 tooth and should also be removed to lesson the risk of infection. The wisdom tooth has never caused me problems and more jaw bone work increases my fosamax-related concerns. I’m thinking if a problem develops from there I can later deal with that. Please respond ASAP.

Thanks,
Larry from Missouri

Dear Larry,
I’d have the oral surgeon take out the wisdom tooth also.

If #15 didn’t have to come out, then I’d leave the wisdom tooth alone. But with #15 being extracted, that is going to open up a passageway from your mouth directly to the wisdom tooth, and the chance of getting infection in your wisdom tooth could be pretty high. And waiting until it bothers you would be a bad idea. Once it’s infected, it could be very difficult to get you numb for the extraction, plus extracting an infected wisdom tooth could cause a general septicemia. Plus, with the socket open after the extraction of #15, the wisdom tooth will be much, much easier to take out. Like maybe five times easier.

While you are taking Fosamax, you have increased chances of osteonecrosis after an extraction, or from any tooth infection. This risk, in my opinion, is only an additional reason for getting the wisdom tooth out. In other words, I believe you are at greater risk in taking out just #15 than if you did as your oral surgeon recommends and have both teeth out.

Bottom line – save yourself some misery and just get the wisdom tooth out at the same time. Less chance of infection, less chance of osteonecrosis, less pain, fewer appointments, happier patient. I don’t see any downside.

Dr. Hall

Related links:
Wisdom tooth removal
Tooth extraction
Wisdom tooth
 

Dr. Hall,
I am a 31-year-old woman and my lower right wisdom tooth started to bother me a few days ago. I made an appointment with an oral surgeon for a consult. I was wondering what are the risk of extraction surgery for my age? Can my jaw bone get damaged or even break? I had my upper left wisdom tooth removed in emergency about 4 years ago but i was never told that the others needed to be removed. I hope I am not ” too old ” to get this done. And my last questions is can they remove all 3 remaining teeth at the same time? Thanks in advance for your help
Fran in Virginia

Fran,
No, I wouldn’t say you’re too old at all to have the rest of your wisdom teeth out. And, if the wisdom tooth is bothering you, that means it’s probably infected, and you don’t have much choice anyway. An infected wisdom tooth can become life-threatening if it isn’t taken care of, so I wouldn’t put off getting it taken care of.

Yes, it would have been better to have had them out at age 18-25, but the chances for complications still aren’t a lot. I didn’t start to get concerned until people were over 40. You’re very unlikely to have your jawbone get damaged or break. Now they will give you a scary consent form to sign with a list of absolutely every possible thing that could go wrong, but this is because they have to protect themselves in today’s legal climate. The chances of any of these bad things happening are pretty remote.

And yes, I would have the rest of them all out at the same time. It’s so much easier that way, and then you have them done. Don’t wait any longer–it doesn’t get any easier. The next time one of these bothers you, you may be over 40 and then the chances for complications will be that much worse.

Dr. Hall

Related links:
Wisdom teeth removal
Dry socket
Tooth infection

Dr. Hall,
I’m 19 years old and am experiencing pain from what I thought were my wisdom teeth. The pain is severe and causes migranes. I went to my dentist and the x-ray showed my bottom wisdom teeth growing in sideways, the lower right one was sitting on a nerve. My dentist said that the pain wasn’t coming from the tooth but from a cavity. He filled it and said the pain should go away, and that I didn’t have to worry about my wisdom teeth at all. I am insecure about it and think, despite what he said, he should have them taken out immediately because of their position. What do you think?
- Lavelle in Kansas

Dear Lavelle,
Many dentists are uncomfortable with taking out wisdom teeth, and their advice is colored by this attitude. I suspect your dentist just doesn’t do wisdom teeth extractions. Most don’t. 

I would say absolutely that if you are 19 and your wisdom teeth are sideways, there is no chance of them ever coming in normally, so they will need to come out sooner or later. And it is incredibly simpler to take them out now rather than to wait until they bother you. Any dentist who has taken out a lot of wisdom teeth will tell you that. The risks, complications, and difficulty quickly escalate as you get older. But the timing to take them out would be perfect for you now. They will never be easier to take out.

And I’d say that it’s entirely possible that your pain is coming from your wisdom teeth.

I’d get a recommendation for an oral surgeon and just make an appointment to get your wisdom teeth looked at. And I’d do it soon. It’s possible that you have an infection there.

Dr. Hall

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Dr. Hall,
I am 61 and my dentist feels I should have my #1 upper wisdom tooth removed. He says it is dropping down into space created by an earlier lower wisdom tooth removal. It could be a problem later if interferes with other teeth. What should I do?
- Mark in Florida

Mark,
You need to have that wisdom tooth taken out. Your dentist is right. It’s useless, and it could disrupt your bite and contribute to tooth decay or gum disease in other teeth.

It’s a good idea to take out wisdom teeth in pairs, at least, so I would have taken it out when the lower was removed. What good is the upper wisdom tooth with no lower to chew against? And usually, if the wisdom teeth on one side are trouble, the same is true of the other side of your mouth, so I generally removed them all at the same time, unless one pair was not going to cause any trouble.
- Dr. Hall

Dr. Hall,
I have a severly impacted wisdom tooth with a large cyst over it for some time now. It never bothered me until about 3 weeks ago. I’ve seen a dentist and am planning to have it removed, he explained the procedures to me which I can deal with. My question is what other alternative is there besides wiring my jaw shut. I am a smoker for over 50 yrs now and have difficulty breathing at times.

One dentist told me they could screw a piece of plastic brace type thing to the outside of the jaw. In this day and age there must be a few alternatives to wiring. I would appreciate any info you can give to help me.
- John from Connecticut

John,
I suspect there really isn’t an alternative to wiring your jaw shut. I don’t know your particular situation, but I’m guessing from your e-mail that, since you’ve been a smoker for over 50 years that your age is over 60. And I’m going on faith in your surgeon. I’m guessing that there must be some serious risk that your jaw will break because of the difficulty of the surgery. And after being there for many years, the cyst has very possibly grown to where much of the bone in that spot is gone. Which means that your jaw has to be wired shut to stabilize it while it heals. That’s the only way to insure that all your teeth will come together like they’re supposed to when you’re all done.

But your question provides a great illustration of the desirability of getting wisdom teeth out, the sooner the better. Don’t put this off–it will only get worse.

There are some voices that say, “Why worry about wisdom teeth? Don’t get them out until they start bothering you.” But those who do this surgery know that the risks and complications multiply quickly once patients pass their mid-twenties. If you had had this wisdom tooth out when you were young, this would have been much, much easier. But now it could become life-threatening.

Get this done and over with, because the risks will only increase the more you delay.

- Dr. Hall

Further information on wisdom tooth removal.
Read about tooth infection.

Dr. Hall,
My daughter, age 21, had all 4 wisdom teeth removed 4 days ago. She says that she feels so tired all of the time, even though the pain is easing up. She states she doesn’t “feel like herself”, but can’t put her finger on it. Is this tired feeling normal after 4 days?
- Suzanne in Indiana

Suzanne,
I wouldn’t worry about any tired feelings. Those feelings vary from patient to patient, and it’s not uncommon for that to last even up to a week.

The pain should be gradually going away, and the swelling should be going down each day starting usually with the third day.
- Dr. Hall

Related topics:
Dry socket after wisdom teeth extraction
Tooth infection
Nerve damage from wisdom teeth removal