Concerns About Nerve Damage When Extracting Wisdom Teeth

Q: Concerns About Nerve Damage When Extracting Wisdom Teeth

Hello： It is recommended that you schedule an appointment with the oral surgery department at a medical center to have your lower right wisdom tooth extracted. <br>Once the extraction is completed and confirmed to be without complications, you can return to your original clinic f

There is a concern that extracting wisdom teeth may permanently damage the nerves?

Hello Dr.
Lin, I am 20 years old and recently had my lower left wisdom tooth extracted for orthodontic treatment (it had not yet erupted).
Before the extraction, the doctor reviewed my full mouth X-ray and mentioned that there was a possibility of nerve damage, but reassured me that if it did happen, it would heal in a few days and told me not to worry.
Fortunately, everything has been fine since the extraction (it has been over a month).
However, I am concerned about the upcoming extraction of my lower right wisdom tooth.
What if it causes permanent nerve damage? Additionally, this clinic only has X-ray equipment and does not have a CT scanner.
I am undergoing orthodontic treatment here, and I feel uncomfortable going to another clinic with a CT scanner for the extraction, as I fear the doctor might think I do not trust him.
Therefore, I would like to ask the doctor: 1) Based on the notes below regarding the X-ray description, should I be concerned about the possibility of nerve damage during the extraction of my wisdom tooth that could lead to permanent injury? (I am not worried about temporary damage that heals in weeks or months.) 2) Do I need to go through the trouble of finding another clinic with a CT scanner to have my wisdom tooth extracted? 3) Is it common for the roots of wisdom teeth to adhere to nerves, potentially causing the nerve to be severed during extraction? Thank you, doctor.
Note: The clinic provided me with a full mouth X-ray, and the roots of my wisdom tooth do not appear to be distinctly separated; it is not very clear that there are two roots.
However, they overlap with the first nerve but do not overlap with the second nerve.
The roots of my wisdom tooth are growing smoothly, without any significant hooks, and my wisdom tooth is tilted approximately 30-45 degrees towards the front teeth.

Yang, 20~29 year old female. Ask Date: 2024/02/16

Dr. Lin Jiayong reply Dentistry

Hello: It is recommended that you schedule an appointment with the oral surgery department at a medical center to have your lower right wisdom tooth extracted.
Once the extraction is completed and confirmed to be without complications, you can return to your original clinic for orthodontic treatment.
Orthodontics is not considered essential medical care, so delaying or even forgoing it will not have any negative impact.
First, address the wisdom tooth issue, and once you feel more stable, you can begin the subsequent treatments.

Reply Date: 2024/02/16

More Info

When it comes to concerns about nerve damage during wisdom tooth extraction, it's understandable to feel anxious, especially when you've been informed about the potential risks. Let's address your questions one by one, and I will provide some additional context regarding the relationship between wisdom teeth and nerve damage.

1) Should you worry about permanent nerve damage from wisdom tooth extraction?
While there is a risk of nerve damage during the extraction of wisdom teeth, particularly if the roots of the teeth are close to the inferior alveolar nerve (the nerve that runs through the lower jaw), the majority of extractions are performed without complications. The risk of permanent nerve damage is relatively low, especially if the extraction is performed by an experienced oral surgeon. Temporary nerve damage, which can result in numbness or tingling, is more common but usually resolves within weeks to months. If your X-rays show that the roots of your wisdom teeth are not significantly intertwined with the nerve, the likelihood of permanent damage is further reduced.
2) Should you seek another facility with a CT scan for your extraction?
While a CT scan can provide more detailed imaging and help assess the proximity of the tooth roots to the nerves, it is not always necessary for every extraction. If your current dentist is experienced and has assessed the risks based on your X-rays, it may be reasonable to proceed with the extraction at their office. However, if you feel uncomfortable or if the roots are particularly close to the nerve, seeking a second opinion or consulting with an oral surgeon who has access to more advanced imaging could provide peace of mind. Communication with your dentist about your concerns is crucial; they should understand your need for reassurance.

3) Is it common for the roots of wisdom teeth to adhere to nerves?
In some cases, the roots of wisdom teeth can be close to or even envelop the inferior alveolar nerve. This anatomical relationship can increase the risk of nerve injury during extraction. However, not all wisdom teeth have this issue, and many can be removed safely without affecting the nerve. Your description indicates that while the roots are not clearly separated, they do not appear to be significantly entangled with the nerve, which is a positive sign.

In summary, while there are risks associated with wisdom tooth extraction, the likelihood of permanent nerve damage is relatively low, especially with proper assessment and technique. If you have concerns, it is always best to discuss them openly with your dentist or consider a consultation with an oral surgeon. They can provide you with a thorough evaluation and help you make an informed decision about your treatment options. Remember, your comfort and confidence in the procedure are just as important as the technical aspects of the extraction itself.

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