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 lessen 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. You say you are not taking Fosamax right now, so that will only be a factor if you start taking it again. So that, in my opinion, is only an additional reason for getting the wisdom tooth out now, while you aren’t taking it. 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
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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.
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