Hi! I was hoping to get some advice or opinions on an extraction I'm due for tomorrow (I wish I'd found this place sooner!).
Here's my situation:
A few months ago, part of my lower right backmost molar (#31) broke off. It started to hurt, so I went to the dentist. She offered me a choice between extraction and root canal. I went with the root canal because I don't like the idea of extraction, and I don't want to do it unless medically necessary.
The root canal procedure went beautifully, and my mouth is feeling much better. The problem started when I returned to get my post and crown.
The post itself went right in with no issue, and I got the filling, but the crown wasn't happening. In fact, the dentist couldn't even take an impression of the tooth because the wisdom tooth right next to it (#32) is interfering. The dentist recommened I have an OS extract it, or at least grind it down enough for her to get a crown placed on the root canal tooth.
I'll take a moment to explain that I'm 37 years old and all of my wisdom teeth are under the gum. A panoramic x-ray showed that they're all straight except for #32. It's heavily angled forward, and one corner is in physical contact with the root canal tooth. It also may or may not be attached to a nerve in my jaw.
Fast forward to 2 weeks ago, when I was originally scheduled for extraction or grinding. It turned into a consult, instead. The OS said that grinding may or may not work because of the postion of the wisdom, and extraction would probably be the better choice, though it would be complex. He explained that the bone was very hard and awkardly postioned and would be difficult to remove.
He then addressed the nerve, telling me that it might just be near the tooth and wouldn't present a problem. If the nerve is touching the tooth, he can leave part of the root intact. I asked how he would know if the nerve was touching. He said, "I'll know if I pull on the tooth and you start 'singing opera'." At which point I started having a mild panic attack and asked him to repeat that. He assured me there would be no pain, but pressure. I told him that I would want to be knocked out for the procedure, so how would he know in that case (I chose IV and I know that's not really being nconscious). He told me I would wake up. That sounds like my body could go into some kind of shock! Is there validity to what he said? Is there no other way to know if the nerve is touching? I've been fixated and rather frightened at the thought. I had the presence of mind to ask "if not for the root canal tooth, would you consider pulling the wisdom tooth?" He said it was my choice, but there didn't seem to be a medical need at present.
So I got thinking - and yes, I will have this discussion with my OS tomorrow, I'd just like to see other opinions. Ideally, I don't want anything pulled, but I don't see that as a choice. I've heard the tooth could suffer from damage or infection without a protective crown. Since the root canal tooth is the one causing all the trouble, would it be feasible to pull that instead? It seems it would be easier for the OS - it's straight, not touching my jaw nerve, and a good deal of it is gone anyway. Is there any medical reason why extracting the wisdom is better? Would pulling the root canal tooth cause problems for surrounding teeth? Any alternatives I'm not thinking of?
I apologize for the length of this post, and I know I won't get many responses before my appointment, but I think it helped calm me just to write about it. Thank you for your patience and replies.