Does Wisdom Tooth Extraction Always Risk Nerve Damage?

Is it certain that removing wisdom teeth will damage the nerves?

Is it true that removing wisdom teeth will always damage nerves? I have a horizontally impacted wisdom tooth that I want to have extracted, but I've read a lot of information online stating that it can injure nerves, which makes me quite anxious! Could you please explain this, doctor?

Tangguo, 20~29 year old female. Ask Date: 2008/12/22

Dr. Cao Guoqing reply Dentistry

If the position of the wisdom tooth is very close to the inferior alveolar nerve canal, the dentist will be very careful during extraction.
For the rest, you can rest assured that the nerve will not be harmed.
Of course, if a nerve block anesthesia is used, there is a possibility of injuring the nerve.

Reply Date: 2008/12/22

More Info

When it comes to wisdom tooth extraction, particularly for horizontally impacted wisdom teeth, concerns about nerve damage are quite common. The fear of nerve injury is understandable, especially given the potential complications that can arise from dental procedures. However, it is essential to understand the context and the actual risks involved.

Firstly, the inferior alveolar nerve (IAN) is the primary nerve of concern during the extraction of lower wisdom teeth. This nerve runs through the mandible (lower jaw) and provides sensation to the lower lip, chin, and teeth. If a wisdom tooth is positioned close to this nerve, there is a risk of nerve damage during extraction. This damage can manifest as numbness, tingling, or pain in the areas supplied by the nerve, and in rare cases, it can lead to permanent changes in sensation.

However, it is crucial to note that not all wisdom tooth extractions result in nerve damage. The risk of injury largely depends on several factors, including:
1. Position of the Tooth: Horizontally impacted wisdom teeth are often more challenging to extract and may pose a higher risk of nerve damage compared to teeth that are vertically positioned.

2. Proximity to the Nerve: Dentists often use imaging techniques, such as X-rays or cone beam computed tomography (CBCT), to assess the relationship between the wisdom tooth and the IAN. If the tooth is situated very close to the nerve, the dentist may discuss the risks with you and consider alternative approaches.

3. Experience of the Surgeon: An experienced oral surgeon or dentist will have a better understanding of the anatomy and the techniques required to minimize the risk of nerve injury. They can also provide you with a more accurate assessment of your specific situation.

4. Surgical Technique: The method used for extraction can also influence the risk of nerve damage. Surgeons may employ techniques that reduce trauma to the surrounding tissues and nerves.

5. Patient Factors: Individual anatomy can vary significantly, and some patients may have anatomical variations that increase the risk of nerve injury.

While the fear of nerve damage is valid, it is essential to weigh this risk against the potential benefits of having the wisdom tooth removed, especially if it is causing pain, infection, or other dental issues. If you are particularly anxious about the procedure, consider discussing your concerns with your dentist or oral surgeon. They can provide you with detailed information about the risks and benefits specific to your case, and they may also offer reassurance based on their assessment.

In summary, while there is a risk of nerve damage during wisdom tooth extraction, it is not a certainty. Many factors influence this risk, and with proper evaluation and an experienced surgeon, the likelihood of complications can be minimized. If you have further concerns, it may be beneficial to seek a second opinion or consult with an oral surgeon who specializes in such procedures. They can help you make an informed decision based on your specific dental health and the potential risks involved.

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