Do Impacted Wisdom Teeth Need Removal? Risks and Considerations

Q: Do Impacted Wisdom Teeth Need Removal? Risks and Considerations

Hello： According to the theory, impacted wisdom teeth should be extracted because the cyst surrounding the crown may undergo adverse changes. <br>Additionally, there may be a periodontal pocket between the wisdom tooth and the second molar, which can lead to periodontal disease o

Do impacted wisdom teeth need to be extracted?

Hello Doctor: The day before yesterday, during my dental check-up, an X-ray revealed that I have impacted wisdom teeth on both sides of my lower jaw, which are growing almost horizontally and are very close to the nerves.
The dentist recommended surgical extraction, but mentioned that there could be a risk of facial nerve paralysis, which really frightens me (the extraction procedure may take 1 to 1.5 hours).
I am not experiencing any discomfort at the moment.
I have two questions: 1.
Is it necessary for me to have my wisdom teeth extracted? What problems could arise if I choose not to have them removed? Will the situation worsen in the future? 2.
If I do decide to have them extracted, what risks are involved? Is there a possibility of significant bleeding or nerve damage? 3.
The dentist mentioned that after the wisdom teeth extraction, I would need to have bone grafting with artificial bone powder, which would cost NTD 8,000.
Is this procedure necessary? Thank you!

Kaiwen, 30~39 year old female. Ask Date: 2006/05/04

Dr. Liu Tiancai reply Dentistry

Hello: According to the theory, impacted wisdom teeth should be extracted because the cyst surrounding the crown may undergo adverse changes.
Additionally, there may be a periodontal pocket between the wisdom tooth and the second molar, which can lead to periodontal disease or decay of the second molar.
As for the extraction of the wisdom tooth, there is a possibility of compressing the inferior alveolar nerve during the procedure or post-operative hematoma compressing the nerve, which may result in temporary numbness for a few weeks that should resolve.
The use of bone graft material is considered a selective treatment that can accelerate bone healing and prevent exposure of the roots of the second molar, which could lead to post-operative sensitivity.
It is recommended to consult with an oral and maxillofacial surgeon.
Sincerely, Dr.
Huang Chih-Cheng, Dentistry.

Reply Date: 2006/05/04

More Info

When it comes to impacted wisdom teeth, the decision to remove them is often based on a combination of factors, including their position, potential for future complications, and the patient's overall dental health. Let's address your questions one by one.

1. Do I need to remove my wisdom teeth? What happens if I don't?
In your case, since your wisdom teeth are horizontally impacted and close to the nerve, it is generally advisable to consider removal. While you may not currently experience discomfort, impacted wisdom teeth can lead to several issues over time. These include infection, cyst formation, damage to adjacent teeth, and even potential misalignment of your bite. Additionally, as you age, the risk of complications can increase, making the extraction more difficult and potentially more dangerous. Therefore, while you may feel fine now, not addressing the issue could lead to more significant problems in the future.

2. What are the risks associated with removal?
The risks of wisdom tooth extraction, especially for impacted teeth, include bleeding, infection, and nerve injury. The latter is a particular concern when the teeth are close to the inferior alveolar nerve, which runs along the lower jaw. If this nerve is damaged during extraction, it can result in temporary or, in rare cases, permanent numbness or tingling in the lower lip, chin, or tongue. However, it's important to note that experienced oral surgeons take precautions to minimize these risks. While the thought of potential complications can be frightening, the majority of wisdom tooth extractions are performed without serious issues.

3. Is bone grafting necessary after extraction?
The need for bone grafting after wisdom tooth extraction depends on several factors, including the condition of your jawbone and the specifics of your extraction. Bone grafting is often recommended if the extraction site is expected to heal poorly or if there is a need to preserve bone for future dental work, such as implants. If your dentist has suggested this, it is likely because they foresee a benefit in maintaining the integrity of your jawbone. However, if you are not planning on any future dental implants or procedures, you might discuss with your dentist whether this step is essential for your situation.

In conclusion, while the idea of having your wisdom teeth removed can be daunting, especially with the potential risks involved, it is important to weigh these against the possible complications of leaving them in place. Consulting with an oral surgeon who specializes in these procedures can provide you with a clearer understanding of your specific situation and help alleviate some of your fears. They can explain the procedure in detail, discuss the risks, and outline the benefits of removal, allowing you to make an informed decision about your dental health. Remember, taking proactive steps now can prevent more serious issues down the line, ensuring your long-term well-being.

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