Can 3D Dental CT Reveal Wisdom Teeth and Nerve Relationships? - Dentistry

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Can dental computed tomography visualize the three-dimensional relationship between wisdom teeth and nerves?


Hello Dr.
Lin, I have a wisdom tooth that is growing at a 45-degree angle towards my front teeth.
My dentist has recommended that I have it extracted, but I am concerned because I know people who have experienced nerve damage after having their wisdom teeth removed, and it took them months to recover.
I would like to ask you, since a regular X-ray only shows a 2D view of the wisdom tooth and the nerve, does a 3D cone beam computed tomography (CBCT) scan provide a better view of the spatial relationship between the wisdom tooth and the nerve? If a doctor assesses that there is a higher risk of nerve damage based on the 3D imaging, does that mean the likelihood of nerve injury is lower when having the extraction done at a major hospital? If so, could you explain the main differences in tools and techniques used for wisdom tooth extraction between major hospitals and smaller clinics? Thank you, Dr.
Lin.

Zhong, 20~29 year old female. Ask Date: 2024/02/07

Dr. Lin Jiayong reply Dentistry


Hello: If there is a CBCT (Cone Beam Computed Tomography) image, it is indeed easier to assess the risk of nerve injury during and after tooth extraction, and it also helps the dentist to better understand how to avoid nerve disturbance during the extraction process.
The advantage of having the procedure done in a large hospital is that there are many experienced doctors available to address any issues that may arise.
On the other hand, the benefit of having the extraction done in a clinic is that general conditions can be resolved promptly and conveniently.

Reply Date: 2024/02/07

More Info


3D dental CT scans, also known as Cone Beam Computed Tomography (CBCT), provide a comprehensive view of the dental structures, including the relationship between wisdom teeth and surrounding nerves. Unlike traditional 2D X-rays, which can only show a flat image of the teeth and jaw, 3D imaging allows for a detailed three-dimensional representation. This capability is particularly beneficial in assessing the position of wisdom teeth, especially when they are impacted or tilted, as in your case where your lower wisdom tooth is angled towards your front teeth.

The 3D imaging can help dentists and oral surgeons visualize the proximity of the wisdom tooth roots to the inferior alveolar nerve, which runs through the lower jaw. By accurately assessing this relationship, the risk of nerve injury during extraction can be evaluated more effectively. If the 3D CT scan indicates that the wisdom tooth is very close to the nerve, the dentist may take extra precautions during the extraction process or refer you to a specialist with more experience in complex extractions.

Regarding your concern about the likelihood of nerve damage during extraction, it is true that larger hospitals often have more resources and experienced staff. They may have access to advanced imaging technologies and specialists who can perform the procedure with a higher level of expertise. In contrast, smaller clinics may not have the same level of resources or experience, which could potentially increase the risk of complications. However, many general dentists are well-trained in performing extractions and can do so safely.

The tools and methods used in larger hospitals versus smaller clinics can differ significantly. Larger hospitals may utilize more advanced surgical tools, sedation options, and post-operative care facilities. They often have a team of specialists, including oral surgeons and anesthesiologists, who can manage more complex cases. In contrast, smaller clinics may rely on standard extraction tools and local anesthesia, which can be effective for straightforward cases but may not be ideal for more complicated extractions.

In summary, if you are concerned about the extraction of your wisdom tooth and the potential for nerve damage, a 3D dental CT scan can provide valuable information to help your dentist make an informed decision. It is advisable to discuss your concerns with your dentist, who can explain the findings from the imaging and the planned approach for your extraction. If necessary, seeking a consultation at a larger hospital or with an oral surgeon may provide additional peace of mind and ensure that you receive the best possible care. Remember, it is essential to communicate your fears and concerns with your healthcare provider, as they can help address them and guide you through the process.

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