Can Wisdom Teeth Be Removed by Only Extracting the Crown?

Q: Can Wisdom Teeth Be Removed by Only Extracting the Crown?

Hello： If you wish to address a general issue with a more complex procedure, it is recommended that you visit a medical center (which requires multidisciplinary collaboration) and discuss it with the attending physician in charge. <br>Thank you!

Can wisdom teeth be extracted by only removing the crown?

Hello Doctor, I am 20 years old.
My lower wisdom tooth is slightly exposed, and after an X-ray, it was found to be positioned vertically.
It is in the correct position, but there isn't enough space, causing it to be impacted against the bone and unable to erupt properly.
The tooth root is very close to the nerve, and the dentist at the clinic informed me that there is a higher risk of nerve damage, so they are hesitant to extract it.
After researching online, I found a procedure called "crown removal and root traction surgery" that can significantly reduce the risk of nerve injury, but it is too expensive out-of-pocket, and I am also afraid of the use of screws.
Can I first remove the crown and then wait for the remaining root to grow out before extracting it? Or will a partially cut wisdom tooth not erupt on its own without traction?

Lily, 20~29 year old female. Ask Date: 2019/09/28

Dr. Lin Jiayong reply Dentistry

Hello: If you wish to address a general issue with a more complex procedure, it is recommended that you visit a medical center (which requires multidisciplinary collaboration) and discuss it with the attending physician in charge.
Thank you!

Reply Date: 2019/09/28

More Info

When it comes to wisdom teeth, particularly those that are impacted or positioned close to nerves, the decision on how to proceed can be quite complex. In your case, you have a wisdom tooth that is partially erupted and positioned vertically, but due to limited space, it is unable to fully emerge. The proximity of the tooth root to the nerve is a significant concern, as this increases the risk of nerve damage during extraction.

The technique you mentioned, "crown removal and root traction," is indeed a specialized surgical procedure that aims to minimize nerve damage while addressing the issue of the wisdom tooth. This method involves removing the crown of the tooth while leaving the root in place, allowing for a more gradual and less invasive approach to extraction. However, this procedure can be costly and may not be covered by insurance, which is a common concern for many patients.

Regarding your question about simply removing the crown and waiting for the root to resorb or "grow out," it's important to understand that teeth do not typically "grow out" in the way you might hope. Once a tooth is partially erupted, the remaining root structure is unlikely to change significantly without intervention. If the root is left in place, it may lead to complications such as infection or the development of cysts, which could necessitate further surgical intervention down the line.

In general, if a wisdom tooth is not causing immediate problems, some dentists may recommend a watchful waiting approach, especially if the tooth is asymptomatic. However, in your case, given the potential for nerve involvement and the fact that the tooth is not fully erupted, it would be prudent to discuss all available options with your dentist or an oral surgeon. They can provide a thorough evaluation and help you weigh the risks and benefits of each approach.

It's also worth noting that while wisdom teeth can sometimes be left in place if they are not causing issues, they can also lead to complications later on, such as decay, gum disease, or crowding of adjacent teeth. Therefore, regular monitoring and dental check-ups are essential.

In conclusion, while the idea of only extracting the crown of the wisdom tooth may seem appealing, it is not a standard practice and could lead to more complications in the future. It is crucial to have a detailed discussion with your dental care provider about the best course of action tailored to your specific situation. They can help you navigate the complexities of wisdom tooth extraction and ensure that you make an informed decision that prioritizes your oral health.

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