Should I Extract My Wisdom Teeth with Cavities or Try Filling First?

Q: Should I Extract My Wisdom Teeth with Cavities or Try Filling First?

Hello： 1. <br>The decision to extract wisdom teeth primarily depends on the individual's level of oral hygiene. <br>Even if one brushes their teeth after meals, food particles may still remain, indicating that wisdom teeth are inherently difficult to care for. <br>If they are wel

My wisdom tooth is decayed~~~

Hello Dr.
Liu,
I have cavities in both of my upper left and right wisdom teeth.
All four of my wisdom teeth are quite intact, not very tilted, and there are no occlusion issues; I do experience some food retention at times, but I brush my teeth after meals.
The upper left wisdom tooth has a cavity on the occlusal surface and a small cavity on the side.
The dentist mentioned that filling it would be unnecessary and suggested extraction instead.
However, if I extract both upper wisdom teeth, would I also need to extract the lower ones? Additionally, the dentist said that the side cavity is difficult to fill and recommended extraction.
Is that true? Shouldn't we try filling it first before deciding to extract? I would prefer to fill it first and make a decision later if it causes issues, as I am hesitant to extract without attempting a filling first.
Moreover, extracting all four would result in four separate wounds.
What is your advice on this matter? I look forward to your response.

Xiao Dong, 20~29 year old female. Ask Date: 2006/04/17

Dr. Liu Tiancai reply Dentistry

Hello: 1.
The decision to extract wisdom teeth primarily depends on the individual's level of oral hygiene.
Even if one brushes their teeth after meals, food particles may still remain, indicating that wisdom teeth are inherently difficult to care for.
If they are well-maintained, then cavities are less likely to occur.
2.
The difficulty in filling cavities on the side teeth is related to the degree of mouth opening; based on experience, it is generally challenging to perform such procedures.
No dentist can make the decision to extract a tooth; they can only provide recommendations.
If you prefer not to have an extraction, then seek out a dentist who is willing to perform the filling.
Sincerely, Dr.
Liu Tien-Tsai, Dentistry.

Reply Date: 2006/04/17

More Info

When considering whether to extract your wisdom teeth or attempt to fill cavities first, it's essential to weigh several factors, including the condition of your teeth, potential complications, and your overall dental health.

From your description, it sounds like you have cavities in both upper wisdom teeth, with one having a cavity on the occlusal (biting) surface and another on the side. The recommendation from your dentist to extract the teeth rather than fill them may stem from a few considerations:
1. Cavity Severity: If the cavities are extensive, filling them might not provide a long-term solution. In some cases, if a tooth has significant decay, it may be more beneficial to extract it rather than risk further complications, such as infection or abscess formation.

2. Wisdom Teeth Position: Since you mentioned that your wisdom teeth are relatively straight and not impacted, this is a positive factor. However, if they are still prone to cavities and food retention, it may indicate that they are not functioning well in your mouth. Wisdom teeth often do not have enough space to erupt properly, leading to decay and potential gum issues.

3. Future Dental Work: If you extract your upper wisdom teeth, it does not necessarily mean you must extract the lower ones. Each tooth should be evaluated based on its condition. If the lower wisdom teeth are healthy and not causing problems, they can often remain in place.

4. Filling Challenges: Your dentist's comment about the difficulty of filling the side cavity is valid. Cavities on the sides of teeth can be challenging to fill effectively, especially if they are deep or if the tooth structure is compromised. If the filling does not adhere well or if the cavity is too large, it may lead to further decay, necessitating extraction later.

5. Personal Preference and Anxiety: It’s understandable to feel anxious about multiple extractions. If you prefer to try fillings first, discuss this with your dentist. They may agree to fill the cavities, but it's crucial to set realistic expectations about the longevity of the fillings, especially if the cavities are significant.

6. Long-term Considerations: If you choose to fill the cavities, ensure you maintain excellent oral hygiene to prevent further decay. Regular dental check-ups will be essential to monitor the condition of your wisdom teeth and surrounding structures.

In conclusion, while attempting to fill the cavities may seem like a less invasive option, it’s crucial to consider the long-term health of your teeth. If your dentist believes extraction is the best course of action, it may be worth considering their expertise. Ultimately, the decision should be made collaboratively with your dentist, taking into account your comfort level, the condition of your teeth, and the potential for future complications. If you decide to proceed with fillings, ensure you have a follow-up plan to monitor the situation closely.

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