Anxiety over getting lower erupted wisdom tooth and dentist told me to stop asking questions

[scottBell]

Male, aged 50, general anxiety with health. 2 years ago, I had the upper wisdom tooth out (was erupted and decayed) It was above this other erupted wisdom tooth above.

My general dentist is abrupt, like many of them! (sorry) and said this one above (wisdom) needs to come out also since it is pushing up against other teeth and difficult to clean. It is at a bit of an angle.

I am worried about the nerve down there, and suggested a cone beam and he called be silly tbh and would not agree. I got this OPG instead. He looked at it for about 2 seconds and then told me to book in a date.

Said I should stop looking at the internet. But I read that 1% can get issues, erupted or not erupted, and yes, 1% for me is hard to quantify as I can't focus on the 99% who are fine! I focus on the 1%.

Above is the scan, and from what I can see the roots do make it close to the darker area, so I am not sure really if I should believe the dentist or try at least get a 2nd opinion.

Or maybe I should see a dental surgeon. I would need a referral. This dentist I have is I assume experienced, he isnt young.

He said he would section it into parts and remove.

Partick, up the hill near the cricket ground.

 

[Gordon]

I tend to agree it should come out, it's got a cavity in it and isn't really functional, it's just compromising the 2nd molar in front of it due to being hard to clean.
It's got a nice conical root shape so should be a straightforward extraction. It's well erupted so I wouldn't be over worried about nerve damage.

 

[scottBell]

Gordon.

Thank you. It was hard for me to see the mandibular canal on my scan, it seems wide, really wide compared to others, and I think the roots are in the canal, so hence the "worry" plus I have learnt over time to always get a second opinion.

I'll still worry of course about the nerve, the mind has a very hard time quantifying risk and trust.

But if you think it is ok, roots not near nerve, will proceed.

 

[Gordon]

You can't really trust an OPT x-ray like that for fine detail, like the width of the canal, they're just not that accurate.

But, if you look closely though you can see the outline of the periodontal ligament around the tip of the root of the 3rd molar, so it's not in the canal itself. Remember you're looking at a 3D structure in 2D so it can be deceptive.

 

[scottBell]

Gordon, thank you for your informative response.

This is my other wisdom, impacted, and alarmingly over the nerve area. I am 50 now, and while I have not had any problems, few gum issues around the 2nd molar, I was told once by a dentist that he hoped he was "retired" if that wisdom ever gave me a problem. Not exactly putting me at ease, I already have a dental phobia. Wish he had never said that, I am sure it was well meaning...but. The % of people aged 50 with impactions like this above as very small according the AI tools I asked, maybe they are wrong. My parents (we lived social housing in uphall) who were told by the dentist to remove when I was a teenager, and they ignored. I dont think I was a priority. Would be good to know what my chances are.

 

[scottBell]

 

[scottBell]

Gordon, would welcome your thoughts.

I looked at the xray above and felt inside my mouth, and I realise now, well, I think the impacted wisdom above is in front of the 2nd molar, I can feel the ridge on that side in front of the area and that ridge is missing in the other side, so actually, maybe it will be ok, if it is in front, the gum seems somewhat more sturdy (I am sure it is a dental term!) on that side.

 

[Gordon]

That tooth is in a fairly nasty location, but it's well buried and given your age it's never likely to be an issue for you.
There's absolutely no reason to remove it now (even 30 years ago we would not have touched it).
It's definitely lying in a different plane to the 2nd molar, but you can't tell which way from the x-ray, 2d versus 3d again.

As a small anecdote, my father had all his upper teeth removed during his Navy service in 1946. When I bought a practice in 1990 I installed an OPT machine and my dad was round "helping" me set it up.

We took a film to have a play with the machine and found he had 2 upper wisdom teeth lying horizontally. We had no idea they were there and up till the day he died they caused no issues whatever.

 

[scottBell]

Your father, all his teeth removed. I read the story about your mother also in your bio. This was normal practice in our neck of the woods in Scotland, isnt it amazing to think this was so common! and accepted. Today, it is seen as a tragedy but in those days, people coped and didnt complain. I know people in my family who had all their teeth removed. Never heard a complaint.

The fact you wouldn't have touched that wisdom when I was 20 (30 years ago) is rather a relief, I feel like I missed an opportunity then. I used AI (gemini deep search), supposed to be the best, to look at the image, and it said, I need to get it out and gave me a lot of reasons. I don't think AI is yet to be trusted. I fear it will over medicalise us even more. Your wisdom tells me that it wont probably be an issue for me! thankyou. I will keep that close. The fear of having it removed was growing.

The service you provide here is amazing.

 

[Gordon]

This was normal practice in our neck of the woods in Scotland, isnt it amazing to think this was so common! and accepted. Today, it is seen as a tragedy but in those days, people coped and didnt complain. I know people in my family who had all their teeth removed. Never heard a complaint.

Wait till you hear about my Grannie... went to the dentist in 1940 for a general anaesthetic to have all her upper teeth removed. Woke up and he'd removed ALL her teeth. She was ever so grateful, as a widowed mother of 7 she couldn't have afforded another GA anytime soon to have the lowers done. Of course she had to save up another year or so for the bottom denture, since she'd only budgeted for the upper one.

Tough old bird my Grannie, she delivered a baby for her next door neighbour (at the age of 72), went back to her flat, made a cup of tea and died of a massive coronary

My old tutor in the dental hospital used to tell stories of girls getting clearances and dentures as wedding presents from their parents... changed days thank goodness.

I'm feeling a bit like a Monty Python Yorkshireman now, so best move along

 

[scottBell]

That is a brilliant story, isnt it amazing what our elder folks put up with and did it with normality. To be thankful all the bottom ones were removed, wow, we really have no appreciation for how hard things were there. I know it was much worse before then, but go a little further back and it really is unbelievable. In the working class cities of the UK in the early 1900s, life was really really tough at the bottom. In Victorian times, people ate bread and if you were lucky, cheese. No wonder they had terrible teeth with zero nutrition.