Wisdom Teeth: Risks, Nerve Damage, and Dental Imaging Concerns

Wisdom teeth

Hello Dr.
Liu,
I apologize for bothering you with more questions.
On June 7th, I went to see about my wisdom tooth, which is the one on the lower right side.
This tooth is somewhat encased in gum tissue, so initially, two X-rays were taken, but the doctor said they weren't sufficient and took four more.
He mentioned that this tooth is difficult to extract because it might be close to the inferior alveolar nerve or even entangled with it.
He warned that in severe cases, after the extraction, I could experience permanent numbness on the right side of my face.
He explained everything very clearly and used many technical terms, so I can only describe a little of it.
Hearing this made me very scared (I didn't sleep well that night), and he also suggested that I go to a larger hospital.
1.
Dr.
Liu, can a severed nerve recover? Is it really that serious? Are there patients who have experienced this?
2.
If the nerve is severed, will it affect cognitive function?
3.
I had six X-rays taken for this tooth; could too many X-rays be fatal or increase the risk of localized cancer?
I’m really sorry to trouble you with these questions.
Thank you very much.

Miss Ou, 20~29 year old female. Ask Date: 2003/06/08

Dr. Liu Tiancai reply Dentistry

Hello! Wisdom teeth often fail to erupt properly due to insufficient space, resulting in what is known as "impacted teeth." In some cases, the roots of these teeth may be very close to the mandibular nerve canal, which poses a risk of nerve injury during extraction if not handled carefully.
However, very few teeth actually "hook" onto the nerve.
1.
If the nerve is severed, it can recover and will not cause permanent numbness.
2.
It will not affect cognitive function.
3.
The radiation exposure from dental X-rays is extremely low and does not significantly increase the risk of cancer.
Best wishes for your health from Dr.
Liu Tian-Cai, Director of Dentistry, Taoyuan Hospital, Department of Health, Executive Yuan.

Reply Date: 2003/06/08

More Info

Dear Patient,
Thank you for your questions regarding wisdom teeth, nerve damage, and dental imaging concerns. It's understandable to feel anxious about dental procedures, especially when there are potential risks involved. Let's address your concerns one by one.

1. Nerve Damage and Recovery: When it comes to wisdom teeth extraction, particularly for teeth that are positioned close to the inferior alveolar nerve (which runs along the lower jaw), there is indeed a risk of nerve damage. This can lead to symptoms such as numbness, tingling, or even a loss of sensation in the lower lip, chin, or tongue. In some cases, this nerve damage can be temporary, and patients may experience a gradual return of sensation over weeks or months. However, in more severe cases, the damage can be permanent. The likelihood of recovery depends on the extent of the nerve injury and individual healing factors. There are documented cases of patients experiencing nerve damage during wisdom tooth extraction, but many do recover fully or partially.

2. Impact on Cognitive Function: If the nerve is damaged during the extraction, it primarily affects sensation in the areas supplied by that nerve. It does not directly impact cognitive function or brain health. The inferior alveolar nerve is responsible for sensation in the lower jaw, and while its injury can be distressing, it does not affect the brain's cognitive abilities. However, the psychological impact of experiencing nerve damage can lead to anxiety or depression, which may indirectly affect one's mental well-being.

3. Dental Imaging Concerns: Regarding your concern about the number of X-rays taken, dental X-rays, including panoramic and cone beam computed tomography (CBCT), are generally considered safe when used appropriately. The radiation exposure from dental X-rays is quite low compared to other medical imaging procedures. The risk of developing cancer from dental X-rays is extremely minimal, especially when the procedure is justified by clinical need. Dentists take these images to ensure they have a comprehensive view of the teeth and surrounding structures, which is crucial for planning a safe extraction, particularly in complex cases like yours.

4. Choosing the Right Facility: Your dentist's recommendation to seek treatment at a larger hospital is prudent, especially if there are concerns about nerve proximity. Larger hospitals often have more resources, including specialists who have experience with complex extractions. They may also have advanced imaging technology that can provide a clearer picture of the relationship between the wisdom tooth and the nerve, which can help in planning the extraction to minimize risks.

In conclusion, while there are risks associated with wisdom teeth extraction, especially regarding nerve damage, many patients do recover well. It's essential to discuss all your concerns with your dental provider, who can provide you with tailored advice based on your specific situation. If you feel anxious, consider seeking a second opinion or consulting with an oral surgeon who specializes in these types of procedures. They can offer reassurance and a detailed explanation of the risks and benefits involved.

Take care, and I hope this information helps alleviate some of your concerns. If you have further questions, feel free to ask.

Best regards.

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