37M: very nervous that my nerves could get damaged during my upcoming wisdom tooth extraction

[RonaldYeo]

I am 37M, non-smoker.

About 3 weeks ago, I extracted my upper left wisdom tooth and a week ago, I extracted my upper right wisdom tooth.

My dentist had strongly encouraged me to extract the bottom 2 wisdom tooth, both left and right. His advice is that the bottom 2 wisdom tooth will eventually erupt upwards as there is no longer a counter-force from the upper wisdom tooth, which is now gone. Is he correct? I am freaking out because he said there is a 1% to 3% chance that it might cause damage to the nerve ending. I am very afraid that I could sustain serious injury to my nerve, and I saw some posts on reddit where people had to suffer with the consequences for the rest of their lives.

Could someone take a look at my X-ray and tell me if the roots of my lower wisdom tooth, both left and right, are close to my nerves?

 

[Gordon]

Any symptoms from the teeth at all?
He's not correct btw.

 

[RonaldYeo]

Any symptoms from the teeth at all?
He's not correct btw.

Thank you very much for your reply. I fully understand that any advice given over the Internet does not constitute medical advice. But I am just trying to understand the risks.

No symptoms, at least so far, for the lower wisdom tooth, either left or right. However, there is occasionally food stuck at the bottom wisdom tooth, which would heighten the chances of decay. I can see the merits of extraction, because as I grow older, I think it will become more difficult to do an extraction

I looked up the internet and I think the technical term is called supra eruption. He seemed sure of it, that it will occur sometime in the future, that, as quoted from a line I found on the Internet, the "tooth may supraerupt beyond the level of the neighboring teeth if there are no supporting tooth opposing it".

i am just a little worried, because my bottom wisdom tooth, though erupted, are still somewhat set within the gums, I have taken some photos:

Althought it dosnt look that way, this is actually the lower wisdom tooth on left from my perspective, which I think is tooth number 17 under the "universal numbering system" (aka American system)



This, on the other, is the lower wisdom tooth of my right fron my perspective, which I think will make it tooth number 32 under the "universal numbering system" (the American system):




Will my bottom wisdom teeth be difficult to take out?

 

[RonaldYeo]

Just to update, I thought I should get a second opinion, so I went down to a private clinic. The dentist took x-rays of me again (I hope I am not doing too many X-rays), a panaromic X-ray if I am not wrong, and explained things a bit more clearly to me. I felt a little bit more relieved. The dentist seemed more confident and said I am low risk of nerve damage (he specifically pointed out my nerve lines on the X-ray diagram he took of my teeth to show how they don't intersect with the root).

Still, he quoted a price that was double of what the previous dentist quoted.

I actually booked a third appointment with another dentist earlier this afternoon but I cancelled it because I suddenly got paranoid of taking too many X-rays.

I was wondering, though:

1) how many x-rays can I do with a 3-week period? I am thinking of consulting at least one more dentist but am worried of x-ray over-exposure. I did 2 x-rays on 29 June and another 2 x-rays on 7 July?

2)is there such a thing as "hand skill" when it comes to surgeon extraction or dental surgery?

3) does a good bedsit manner correspond to good dentistry skills?

 

[Gordon]

1) You don't need further x-rays, 3 OPG films in that short a time frame is a serious amount of radiation. Can you not take the film to the 3rd dentist?
2) Yes
3) Not always no.

In the UK you would not be considered for extraction of these teeth due to lack of symptoms. The risks do not outweigh the benefits. Super eruption is a thing but is very unlikely to happen in your case.
It's a pity really, because if it did happen in your case, it would move the roots of your teeth even further away from the nerve bundles

 

[RonaldYeo]

1) You don't need further x-rays, 3 OPG films in that short a time frame is a serious amount of radiation. Can you not take the film to the 3rd dentist?
2) Yes
3) Not always no.

In the UK you would not be considered for extraction of these teeth due to lack of symptoms. The risks do not outweigh the benefits. Super eruption is a thing but is very unlikely to happen in your case.
It's a pity really, because if it did happen in your case, it would move the roots of your teeth even further away from the nerve bundles

Thank you very much for your reply.

Wow! There is so much running through my head at this time! Especially when I am in the middle of a stressful family dispute.

Just curious, what is an OPG film?

 

[letsconnect]

Google is your friend...

OPG - orthopantogram: A panoramic x-ray of all the teeth and the surrounding bones of the face and jaw. It is obtained by rotating the imaging source around the front of the mouth and is used for orthodontic assessments, evaluations of the wisdom teeth, and periodontal imaging.

Basically, the type of x-ray you posted above (rather than the more common bitewing x-rays that dentists take).

From what Gordon is saying, there is no need to remove the lower wisdom teeth, so that might take some of the pressure off during this stressful time

 

[RonaldYeo]

Google is your friend...

OPG - orthopantogram: A panoramic x-ray of all the teeth and the surrounding bones of the face and jaw. It is obtained by rotating the imaging source around the front of the mouth and is used for orthodontic assessments, evaluations of the wisdom teeth, and periodontal imaging.

Basically, the type of x-ray you posted above (rather than the more common bitewing x-rays that dentists take).

From what Gordon is saying, there is no need to remove the lower wisdom teeth, so that might take some of the pressure off during this stressful time

Oh I see! Thanks very much!

I took a OPG x-ray today (7 july), that's for sure. The 1st OPG that i showed in my first post was taken on 9 June.

But the x-ray I took on 29 June was of the below type, what is it called? Is it a bitewing?

 

[letsconnect]

Yes, that's a bitewing.

 

[RonaldYeo]

Google is your friend...

OPG - orthopantogram: A panoramic x-ray of all the teeth and the surrounding bones of the face and jaw. It is obtained by rotating the imaging source around the front of the mouth and is used for orthodontic assessments, evaluations of the wisdom teeth, and periodontal imaging.

Basically, the type of x-ray you posted above (rather than the more common bitewing x-rays that dentists take).

From what Gordon is saying, there is no need to remove the lower wisdom teeth, so that might take some of the pressure off during this stressful time

I did some Googling and it says OPG x-rays gives off about 5 days of natural background radiation and bitewing x-ray about 6.5 hours. Here is my total x-ray exposure:

9 June: OPG X-ray
29 June: 2 bitewing X-ray
7 July: OPG X-Ray

My next appointment is 13 July. I expect my dentist to start encouraging me to pluck out at least one of the bottom wisdom tooth, I am not sure if my dentist will start asking me to do one more OPG X-ray.

 

[RonaldYeo]

Just to give everyone an update, I just came out from the dentist.

He took a look at my wound and decided not to do an extraction. He said he wanted to give my gums some time to heal first before doing an extraction. The next appointment will be on 12 August.

 

[RonaldYeo]

Just to keep everyone in this thread updated, tomorrow is the date for my lower left wisdom tooth extraction.

The last time I met the dentist, at least this time, he made the effort to explain a bit more.

He explained that as my lower left wisdom tooth roots extended downwards in a vise-like pincer grip, he will need to saw my teeth into half and then extract them one-by-one.

Also, with regards to nerve damage, he said that as my nerves pass below the roots, rather than in-between, he rated it as "low-to-medium" difficulty.