Wisdom Tooth Removal

Wisdom teeth can stay in place if the jaw is long enough for them to come up straight and fully clear of the gum around them. They also need space around them so they can cleaned well enough to prevent decay and gum disease to the wisdom tooth and also the second molar in front of it.

If the wisdom tooth is buried in bone and never breaks the surface of the gum, it can also be left in place. If the lower jaw is too short, the wisdom tooth will try to come through but at an angle and if it is impacted against the back of the second molar it will be stuck in this position of being only partially through the gum. Bacteria and plaque can now get down between these two teeth causing decay and gum disease to these two teeth (see periconitis in oral pain section).

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Risks Associated with Wisdom Tooth Removal

Removal is often the only long-term option for impacted wisdom teeth. However, there are risks involved in removal of lower wisdom teeth.

  1. The roots may be into or near the nerve trunk, which passes through the lower jaw and up to the lower lip on that side. If this nerve trunk is bruised or damaged, the lower lip may stay partially or fully numb for a period of time or even permanently.
  2. Similarly, the roots may be close to the lingual nerve, which supplies the tongue and if disrupted during removal, can cause numbness to the side of the tongue, which in rare cases, can be permanent. A numb tongue can be worse than a numb lip as it interferes with eating and talking.

An OPG scanning x-ray of the teeth in the jaws is a good starting point to assess the proximity of the nerve trunk to the roots of the wisdom teeth. If not too close, the wisdom teeth can be removed at a dental surgery with minimal risk.

If too close, we will refer you to a specialist oral surgeon, who if necessary will order a CT scan to check the exact proximity of the roots to the nerve, and will surgically manage your case from there.

In extremely close cases, sometimes he will remove almost all of the tooth but leave the root tips.

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