Impacted wisdom tooth that cannot be extracted causing infection

[Daniela095]

Hi everyone. I have a lower right impacted wisdom tooth coming in that I noticed months ago. Went to my oral surgeon and took x ray and said it is way too close to the nerve in my jaw and he cannot take this one out. He said that taking out the top two wisdom teeth will get rid of a “pressure plug” and somehow help the bottom impacted tooth to surface a little more off the nerve. Needless to say I got my two top teeth out, however, the lower right became infected and even abscessed. I went back and was placed on antibiotics. I felt better and the swelling went down. However, right after antibiotic course was finished, I felt the swelling increase again this time without pain. I thought it was forming another abscess from what it looked like. I went back for a follow up last week, he said it looked like it was getting better and pretty much said it would take time to go away. Meanwhile the swelling just started coming back right before that. I was confused and now I’m worried. I know the infection won’t go away with just antibiotics that I took. The tooth really would just need to be removed. The abscess/ swelling went down on its own over the past week and didn’t last long however I’m concerned that there is still and infection brewing down there and worried about it spreading. He basically told me to come back in a year to see if the tooth can be taken out with less of a risk for nerve damage. Any thoughts?

 

[Sol]

Hello Daniela095,
Not sure how old you are so I don't know if you are at an age where your wisdom teeth are more mobile. That might be why they suggested waiting to see if it moved away from the nerve. However, waiting a year doesn't really seem right since you already had an infection. Is it possible to see another surgeon and get a second opinion?

 

[comfortdentist]

Discuss a partial extraction technique with the OMS. This is an excerpt from a white paper from American association of Oral and maxillofacial surgeons.
"The Possible Role of Coronectomy (also known as partial tooth removal, partial odontectomy or intentional root retention) in Third Molar Removal Five articles were identified in the literature that reported more than a single patient. Four were case series. (Pogrel 2004, 50 cases; O’Riordan 2004, 95 cases with 52 patients followed up; Freedman 1997, 35 cases; and Knutsson 1989, 33 cases) The fifth article was a randomized controlled trial (Renton 2004). In all cases, coronectomy was suggested as a technique of partial root removal when Panorex imaging suggested an intimate relationship between the roots of the lower third molar and the IAN nerve and the tooth still needed to be removed. (Note: Cone beam CT was not available at the time the studies were conducted.) All papers suggested that the technique had merit. "
Basically the top is cut off and you stay away from the lower parts to avoid nerve damage.

 

[Mike]

The infection around wisdom teeth isn't usually an abscess as such, it's just localised infection and/or inflammation under the flap of gum over the tooth. Removing the uppers will usually reduce the incidence and severity as there's nothing to traumatise the flap. Often there'll be a couple of episodes but as it comes through further things can settle.

The best thing you can do is keep the area really clean but certainly if it does keep on coming back then it'd be time to consider getting it removed.