Do Impacted Wisdom Teeth Require Treatment or Extraction?

Does a horizontal tooth need treatment? It has decayed very deeply, and brushing it causes a lot of pain. Is the dental nerve exposed?

I have a severely decayed wisdom tooth with a large cavity that hurts a lot when I brush my teeth, as the bristles touch the cavity.
Is it possible that the dental nerve is exposed? The dentist said they would treat it and used a machine to clean the wisdom tooth.
However, the pain was unbearable, causing my body to shake and cry; it felt like the machine was grinding the nerve, which was much more painful than nerve inflammation.
Now, they have filled the cavity with a white medication that smells and tastes very strong.
I am not in pain right now, but I am really scared about the follow-up appointment in a week.
Should I proceed with treatment for the impacted tooth, or should it be extracted? The two teeth in front of the wisdom tooth were also extracted due to decay and being unable to be treated.

vivi, 20~29 year old female. Ask Date: 2015/09/26

Dr. Huang Zhicheng reply Dentistry

Dear Vivi,
Hello.
Wisdom teeth, especially those that are impacted, often need to be extracted as they can trap food and promote bacterial growth, leading to periodontal disease and pulpitis.
In more severe cases, this can result in facial cellulitis.
Wishing you safety and health.
Sincerely,
Dr.
Chih-Cheng Huang
Director of Dentistry
Taoyuan General Hospital, Ministry of Health and Welfare

Reply Date: 2015/09/26

More Info

When it comes to impacted wisdom teeth, the decision to treat or extract them often depends on several factors, including the extent of decay, the position of the tooth, and the potential for future complications. In your case, it sounds like you are experiencing significant pain and discomfort due to a large cavity in your impacted wisdom tooth, which may indeed be affecting the nerve.

Impacted wisdom teeth can lead to various dental issues, including decay, infection, and damage to adjacent teeth. If the cavity is deep enough to expose the nerve, it can cause severe pain, as you have described. The pain you felt during the cleaning procedure could be attributed to the proximity of the dental instruments to the nerve or the inflammation caused by the decay.
In many cases, if a wisdom tooth is severely decayed and cannot be adequately restored, extraction is often recommended. This is especially true if the tooth is impacted, as it may not erupt properly and could lead to further complications, such as infection or damage to neighboring teeth. Since you have already had two adjacent teeth extracted due to decay, it may be wise to consider the extraction of the impacted wisdom tooth as well.

The treatment options for an impacted wisdom tooth generally include:
1. Monitoring: If the tooth is not causing any pain or problems, some dentists may recommend monitoring the tooth over time. However, given your current symptoms, this may not be the best approach.

2. Restorative Treatment: If the tooth can be restored, your dentist may attempt to fill the cavity. However, this is often not a long-term solution for impacted wisdom teeth, especially if they are difficult to clean and maintain.

3. Extraction: If the tooth is severely decayed or impacted, extraction is usually the best option. This can prevent further complications and alleviate pain.

Regarding your fear of the upcoming follow-up appointment, it is important to communicate your concerns with your dentist. They can provide you with options for pain management during the procedure, such as local anesthesia or sedation, to help make the experience more comfortable for you.

In summary, while some impacted wisdom teeth can be treated, the presence of significant decay and pain often indicates that extraction may be the more prudent choice. It is essential to have a thorough discussion with your dentist about your symptoms, treatment options, and any concerns you have regarding the procedure. They can help guide you to the best decision for your dental health and overall well-being.

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