Help & Advice Needed about Wisdom Tooth Extraction

[dentalwise]

Hi everyone, I’ve been reading this forum in the past couple of days. I’ve just come across this site recently because I’ve been scouring the Internet for information on wisdom tooth extraction. To be honest, right now this subject has me fraught with fear and anxiety; at night I barely sleep, and during the day I’m barely functional. I’m hoping that I can find something to put my mind at ease here.

So here’s my problem. I’ll be 33 years old in about 2 months’ time and I still have all 4 of my wisdom teeth. On a couple of visits to the dentist last month I learned that the 2 upper wisdom teeth are fully erupted but misaligned, and the 2 lower ones are impacted with partial eruption. The lower left wisdom tooth is impacted horizontally and pushing against the second molar; the lower right wisdom tooth is impacted at an angle and also pushing against the second molar. So far, the 2 upper wisdom teeth have not given me any grief, but the 2 lower wisdom teeth have caused infections on a few occasions as a result of their impaction and partial eruption. The dentist said all four wisdom teeth need to come out, but the impression I get is that dentists and oral surgeons in general are keen to remove wisdom teeth simply because they exist and so I’m a bit sceptical.

My concern right now lies primarily with the 2 lower wisdom teeth that are impacted and I’m having trouble deciding whether I should undergo the surgical procedure to have them removed. Broadly speaking, I’m scared of the possible pain and complications that could result from the surgery as well as the surgery itself. Specifically, my concerns include but are not limited to:

1. Permanent nerve damage
2. Fracture of jawbone
3. Empty sockets that fail to heal and refill with bone/gum tissue
4. Detached/loose gums on the teeth adjacent to the wisdom tooth extraction sites
5. The fact that I’m nearly 33 years old and therefore at higher risk of complications

And just to add to the possible complications, I have mild thrombocytopenia, which is a condition that causes the person to have a smaller amount of platelets (blood cells that facilitate clotting) in the blood than what is considered normal. Basically, I fear that if I go through with the surgical procedure I’ll end up worse off.

So this is my problem, and advice on what I should do would be greatly appreciated.

 

[gapmouthgirl]

welcome to the forum!

while i can't give you any advice on your thrombocytopenia, i can tell you that wisdom tooth extractions are totally not what everyone warns them to be.

i had two wisdom teeth and a molar extracted on August 24th. i have new gum already filling the sockets, getting close to being level with the existing gum line. while none of the three teeth were impacted, the dentist had to take out a bit of jaw bone during the procedure, and called all three extractions 'surgical', but it didn't affect healing or anything. i do have a tiny bone spur working its way out of the gum, but it's not bugging me one bit unless i dwell on it, lol.

dry socket is very rare, and the likelihood of getting it if you follow your after care instructions carefully are extremely low. i did not get dry socket in any of the three extraction sites, and two of those sites were side by side, on my top left jaw.

your dentist can use dissolvable stitches to help keep the blood clots in, and to aid in healing. i had stitches across both my top sites, across the middle of the holes, and my bottom site was stitched so well that it didn't even barely look like a tooth had been removed. the stitches get bloody annoying after a while, i will warn you of that! lol. my stitches came out with the help of me fiddling with them constantly once i had healed up a bit, and the last one came out just this past weekend.

the permanent nerve damage also has a very very low percentage of happening. i would not worry about it.

detached gums and loose adjacent teeth were not a concern for me, as the teeth ahead of both extraction areas were long gone due to decay. didn't have to worry about that at all.

jawbone fracture is not something i would be worried about either. dentists here on the board would be able to chime in better on this than me though, as this issue never crossed my mind much, so i did not look into it. i think if your dentist is careful and gentle, this will not be a problem at all. teeth can be taken out in pieces if need be, and from what i have read, impacted teeth often are removed this way. no yanking, no pulling hard, no jaw fracture.

as for age, i'm almost 32. no complications at all with my healing. i actually am healing a lot faster than my dentist expected me to!

you will be fine

 

[Dr. Daniel]

Hi, welcome to the forum

I get is that dentists and oral surgeons in general are keen to remove wisdom teeth simply because they exist and so I’m a bit sceptical.

I can relate to what you are saying, I also have this feeling sometimes (and I am a dentist) . So you would agree that it is better to concentrate first on the lower wisdom teeth because:
1- They cause you problems
2- The earlier you deal with the surgical procedure the easier it goes. The threshold age for invasive surgical extractions is 28, but also 33 sounds to me as a good age for a partially impacted teeth which usually require a less invasive intervention. In short, I wouldn't worry about the age.

1. Permanent nerve damage
2. Fracture of jawbone
3. Empty sockets that fail to heal and refill with bone/gum tissue
4. Detached/loose gums on the teeth adjacent to the wisdom tooth extraction sites
5. The fact that I’m nearly 33 years old and therefore at higher risk of complications

And just to add to the possible complications, I have mild thrombocytopenia

All these issues you have mentioned are very reasonable and possible to be dealt with. Oral surgeons have very good techniques to avoid these complications. I would suggest for you to make an appointment with an oral surgeon just for a consultation, and ask him specifically about each one of these points, how can it be avoided. A good explanation will help you with your fear because it will answer the uncertainty you are having regarding complications. If making an appointment is too difficult, you can write an email, but an appointment should be the best.
Another sggestion: these complications appear not instantly. You can reach an agreement that the oral surgeon will see you for a check up 2-3 days after the treatment, just to see that the healing process is going well.

all the best

 

[dentalwise]

Hi gapmouthgirl, your positive experience is encouraging.

Hi Dr. Daniel,

2- The earlier you deal with the surgical procedure the easier it goes. The threshold age for invasive surgical extractions is 28, but also 33 sounds to me as a good age for a partially impacted teeth which usually require a less invasive intervention. In short, I wouldn't worry about the age.

Just to provide more information about my situation, the lower wisdom teeth that are impacted are mostly covered by gum and only a little part of them is exposed and visible. Would you still say that surgical extraction on these teeth will be safe for me at my age?

All these issues you have mentioned are very reasonable and possible to be dealt with. Oral surgeons have very good techniques to avoid these complications. I would suggest for you to make an appointment with an oral surgeon just for a consultation, and ask him specifically about each one of these points, how can it be avoided. A good explanation will help you with your fear because it will answer the uncertainty you are having regarding complications. If making an appointment is too difficult, you can write an email, but an appointment should be the best.
Another sggestion: these complications appear not instantly. You can reach an agreement that the oral surgeon will see you for a check up 2-3 days after the treatment, just to see that the healing process is going well.

Can you give me an idea of how common these complications are, especially for people my age or older. For example, from what I’ve gathered on the Internet, detached/loose gums on the adjacent teeth after the surgical extraction of wisdom teeth seem to be rather common. Also, it seems that many people end up with the problem of receding gums on teeth near the extraction sites after a while. Given the risks of possible complications, would I be better off if I just left my impacted wisdom teeth alone and tried to manage the occasional infections if/when they occurred?

Also, are there alternative treatment options to extracting my impacted wisdom teeth? For example, instead of removing the wisdom teeth, what if I removed the second molars in front of them so that the wisdom teeth would be able to grow into proper position and alignment? This way the procedure involved would be a lot less invasive and traumatic.

 

[Dr. Daniel]

Can you give me an idea of how common these complications are, especially for people my age or older.

I can't really answer that because it depends on your situation. The age plays a factor when it comes to the bone elasticity (the younger we are the more flexible is the bone and can endure more mechanical forces applied during extraction) and the healing process (the younger we are the more blood supply the bone gets and the healing is better). So it mainly depends on how much bone (if any) needs to be removed.
I must admit that surgery is not my specialty and it is better to ask an oral surgeon.

would I be better off if I just left my impacted wisdom teeth alone and tried to manage the occasional infections if/when they occurred?

Yes I agree, but it depends if you can clean there well on a regular basis. Usually it is very difficult to clean the wisdom teeth well.

Also, are there alternative treatment options to extracting my impacted wisdom teeth? For example, instead of removing the wisdom teeth, what if I removed the second molars in front of them so that the wisdom teeth would be able to grow into proper position and alignment? This way the procedure involved would be a lot less invasive and traumatic.

Even if the neighbering molar will be removed, and the wisdom tooth will (probably) continue to grow, it will never line up, even with orthodontics.

 

[littlestar88]

Your wisdom teeth sound exactly like mine except my lower right was horizontally impacted! All I can say was I had IV sedation and had no pain or even memories of the appointment. No where near the horror I was expecting. I'm not a dentist so can't say much more other than it was the easiest dental appointment ever!

 

[dentalwise]

Thank you, Dr. Daniel, for your input.

And if there are other dentists/oral surgeons on these forums, I'd appreciate your answers to my concerns as well.


Hi littlestar88,

Your wisdom teeth sound exactly like mine except my lower right was horizontally impacted! All I can say was I had IV sedation and had no pain or even memories of the appointment. No where near the horror I was expecting. I'm not a dentist so can't say much more other than it was the easiest dental appointment ever!

My lower left wisdom tooth is horizontally impacted and my lower right wisdom tooth has a mesioangular impaction (angled forward). I must admit that I'm something of a wuss when it comes to anything involving cutting into my body. I've never had surgery before and the prospect of having to do so to remove my wisdom teeth is terrifying.

So you only had IV sedation and you were left with no pain and memory of the extraction procedure? If I decide to go through with it, I'm thinking that I'll need to be under general anesthesia or else I'll die of a heart attack right there in the chair.

How did you fare after the surgery, though? Did you experience a lot of pain and discomfort during the recovery, and were you able to recover fully (e.g. no loose gums near the extraction sites and no receding gums as a result of the surgery)?

In any case, though, I'm guessing that you're only 23 (from your screen name) so I don't know if an old guy like me could expect to have the same results as you.

 

[littlestar88]

Funny you should say that but I looked on the Internet (don't do this - it doesnt make you prepared it just makes you scared - except this site!) and got myself in a right spin that at 24 i was old and this would be a massive problem since I'm no longer a teen but my dentist said that actually the problem increases very slowly with age and even if I waited 10 years I wouldn't be much at risk as long as I was careful about my weight (too low is a risk too), eating healthily, exercising, and not smoking as these are more important factors. I also know lots of people on here who got wizzies out at much older with no big problems.

The IV was honestly great as soon as it went in I started feeling calmer and remember maybe 5 seconds of that calm feeling before nothing. Afterwards I felt better really quickly though. I walked to the recovery area to wait for my boyfriend to drive me home and was even able to coherently text my mum 15 minutes after. The numbness started to go after an hour or so and it was tingly for a few hours before it went away, odd but not painful. I was careful about taking my pain pills round the clock (i set an alarm) so felt hardly any pain (and I'm normally a massive wimp). I felt tired and a bit groggy for a few days but that was just the pain pills and lack of solid food. I had eggs in a cafe a couple if days later and was fine. You can find my journal with all the day by day details in if you like. I hope it's a reassuring read.

 

[dentalwise]

Actually, from the research I’ve done so far, it seems that the ages of 24 and 25 are the ideal ages for wisdom tooth extraction. Because wisdom teeth generally emerge between the ages of 17 and 25, it is better to extract them after they have reached, more or less, the end of their development and positioning at the age of around 24 or 25. If you extract the wisdom teeth earlier when people are at the age of say 17 or 18, you may be extracting wisdom teeth that will not end up being problematic at all, and the procedure involved may in fact be more invasive and traumatic as a result of the surgeon having to dig deeper into the jawbone in order to access the wisdom teeth in their early stages of development.

So how long ago was your surgery, and how well have the empty socket(s) and the nearby gums healed? I’d be interested to read your journal; can you point me to it?

 

[littlestar88]

Hi, my journal is called 'hello everyone' in the journals section, sorry I'm not sure how to post a link as I'm on my phone. But it has a smiley face next to the title if that helps!

I had all 4 wisdom teeth out on June 13th then got braces on on the 28th June. By then my stitches had dissolved ( only had stitches on the lowers anyway) and I was 100% back to normal. I stuck to soft food for 10 days or so and had no issues with food getting stuck. Didn't even feel like I had 'holes' back there. Now they feel just as strong as ever, I just gave them a poke to check, and probably have done for ages.

 

[gapmouthgirl]

here is my thread on my extractions, in case you wanted to read it as well:

new here, and bloody scared for friday Aug 24th!

hey all, new member here. ready to read a long story? i don't do 'cliff notes' versions too well, lol. to be honest, i don't know exactly where my fear of the dentist is seated. i remember going to the dentist as a kid, but i don't remember any specific pain or hardship brought to me by my...

www.dentalfearcentral.org

i had the iv sedation too, and it helped greatly, although it didn't 'hit' me quite the same as others describe. without it, i would not have been able to stay in the chair.

 

[dentalwise]

littlestar88,

Hi, my journal is called 'hello everyone' in the journals section, sorry I'm not sure how to post a link as I'm on my phone. But it has a smiley face next to the title if that helps!

I had all 4 wisdom teeth out on June 13th then got braces on on the 28th June. By then my stitches had dissolved ( only had stitches on the lowers anyway) and I was 100% back to normal. I stuck to soft food for 10 days or so and had no issues with food getting stuck. Didn't even feel like I had 'holes' back there. Now they feel just as strong as ever, I just gave them a poke to check, and probably have done for ages.

How deeply impacted was your impacted wisdom tooth? Was it a bony impaction, or was it partially erupted like mine?

And thanks for pointing me to your journal.


gapmouthgirl,

Thanks for pointing me to your thread.

 

[littlestar88]

Mine was a bony impaction. A tiny corner had appeared through the bone but it still had a gum flap over it and bone over the top of at least 2/3rds of the tooth, I think from what I remember from the x-rays. Both my lower teeth needed bone to be removed to get them out, the horizontal one needed a lot more though. Still, I have no recollection of any of it, not even the noises or the injections.

 

[dentalwise]

I see. This is what I as a layperson think. Although the surgery on your impacted wisdom tooth was more invasive than the one for mine would be because your tooth was buried deeper in your jaw, the surgeon was able to close up the extraction site after the extraction because of the extensive amount of gum tissue you had covering your tooth. That is probably why you did not feel like you had a hole back there (you in fact didn’t have one). Is this what happened in your case?

In my case, because I don’t have a lot of gum tissue covering the impacted wisdom teeth to begin with, I’m guessing that after the extraction I would just be left with large open sockets, which run the risk of developing dry sockets and may end up not healing and refilling with gum tissue. This is one of my main concerns.

 

[littlestar88]

I'm not sure if the gum flap meant that it was easier to close the site. I still find it too hard to look very closely at my teeth so I certainly wasn't going to take a peek at the extraction sites! But my upper wisdom teeth were both totally erupted and they didn't even need stitches and didn't feel like they had a hole there. Plus they barely bled! You may want to ask this to a dentist but my understanding is that the 'hole' fills up with the clot/scab thing. I'm pretty sure they can do stitches whether the tooth was erupted or not but maybe if the tooth is fully erupted they tend not to need to? Maybe a dentist can explain in more detail?

 

[dentalwise]

My understanding is that fully erupted teeth that require only "simple extraction" tend to heal better than impacted teeth that require "surgical extraction"; extraction sites on the upper jaw tend to heal better than extraction sites on the lower jaw; and when it comes to surgical extraction on impacted teeth, extraction sites that are able to be closed up tend to heal better than open sockets.

And I'm definitely not using the information I gather on the Internet as a substitute for consultation with a dentist/oral surgeon. However, I have nevertheless found your personal experience useful, and I thank you for sharing it.

 

[dentalwise]

Hi guys, I just wanted to come back and give you an update. A few weeks ago I finally underwent surgery to have the impacted wisdom teeth in my lower jaw removed. This sounds trite and it's probably what many of you had expected, but the surgery wasn't as bad as I had feared, and the post-surgery pain wasn't that bad either. I was given pain killers (acetaminophen/paracetamol) for whatever discomfort I might feel after the surgery but I don't think they were really necessary and I stopped taking them before the prescription had been finished. However, I still have two open sockets in my mouth where the teeth used to be, so we'll see how well they heal up eventually.

Now that I too have joined the club of the experienced on wisdom tooth removal, here's my advice for those that may wish to read about it:

1. Relax. If you need to have your wisdom teeth surgically extracted, the chances are it won't be as bad as you imagine in your head.

2. Go to an oral surgeon. These guys are more likely to minimise the trauma of the surgery and thus improve healing outcomes.

Finally, I just want to thank the people who have shared their experiences with wisdom tooth extractions. You have provided me with some helpful advice and encouragement, which has made the prospect of wisdom tooth surgery less daunting for me. Thank you.