Hi Dr. Hall,
About a year ago my lower wisdom tooth cracked and a corner fell off. Over the course of the past year little pieces have been falling out leaving me with just the back wall left and the inner pulp. Now the pulp is disappearing fairly rapidly and the tooth is super sensitive. Will it eventually just fall out or should I go in to the dentist? Since I’m dirt broke it’s kinda a hard choice.
– Tanner B.
(See Dr. Hall’s answer below.)
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Yes, your decaying wisdom tooth will eventually decay away completely and fall out. But of course it’s best to have the dentist take out the tooth. There is a chance that infection could get into the bone and cause a serious abscess, and to avoid that you should have the tooth taken out.
But then there’s your money circumstances, and my sympathies for that begin to kick in, so I need to tell you some of the mitigating factors in your situation. I’m going to have to make some assumptions here, because it’s a little fuzzy to me what is going on with your tooth. I’m not sure what you mean by the pulp disappearing. If the pulp of your tooth has been exposed, then it became infected and is pulp no longer. Is that what you mean? And then I’m unsure what you mean by your tooth being super sensitive. Sensitive to what? If the pulp is infected, it is dead, and your tooth could only be sensitive to biting. But when people say their tooth is sensitive, they usually mean sensitive to cold or air. In that case the pulp would have to still be alive. So there’s some confusion in my mind about how far along the damage is to your tooth.
Here’s my advice, given the uncertainties about the condition of your tooth, and out of sympathy to your financial situation. As long as there is no swelling around your jaw, this isn’t an emergency, you could just wait this out and hope that the tooth just decays away. But if you start to have swelling, you need to get to a dentist.
With this being a lower tooth, it makes things a little easier because once infection starts, that won’t get in the way of getting the tooth numb. The nerves to the lower teeth are accessible in the back of your mouth, so novocain can be administered without having to inject into infected tissue. For upper teeth, that isn’t the case. If this were an upper wisdom tooth, it’s much more risky to wait until it’s infected.
Another option you might consider, though, is calling around to find a free dental clinic for emergencies. In many cities there are such charity clinics where they will do extractions or other simple dental emergencies for free for people with no money. You could call around to local charities or dental offices to see if anyone knows of such a clinic in your area.
Oh, and I should add for the sake of other people who may want to extrapolate what I am advising to apply to other teeth. If this tooth were a first molar, say, my advice would be totally different. For a first molar, you have a potential complication of the surrounding teeth tipping into the space and ruining your bite. But that won’t happen with a wisdom tooth.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.