Wisdom tooth advice? (Bony impactions removed with nitrous)

[Jwkennedy]

Hello, I am a 24yo, who went to the dentist for the first time in a while and was told, to my surprise that I have all four wisdom teeth and that I should see an oral surgeon. At my oral surgeon consultation I was told that all four teeth are bony impacted (hence why I didn’t know they were there). I was also told, as you can see on my scan that I have a small dentigerous cyst associated with one of the lower wisdom teeth. I responded that I understood that the tooth with the cyst needed removal but asked if I could leave the other three since they have never caused any issue. The surgeon informed me that the other three would inevitably cause issues in the future and need to come out. I’m of the mindset of avoiding surgery when not needed so my first question is whether I should get only the one tooth removed or just go for all four? Secondly, I am very averse to iv sedation unless absolutely needed. I’ve had bad experiences with sedation in the past and always hate the feeling of going under while knowing there are small risks involved. After asking several times my surgeon offered nitrous and local sedation as an option but begrudgingly and strongly recommended deep iv sedation stating that it will be very unpleasant and that almost nobody in my position opts to stay awake. My second question is, given my anatomy (the lower two teeth will be removed via coronectomy btw), is nitrous and local reasonable or will I be attempting something unprecedented and reckless? Thanks for any advice!

 

[Gordon]

This is a fundamental difference between Europe and the US. Here we would remove only the wisdom tooth with the cyst. There is no reason to remove the others at this stage since they aren't causing any symptoms. The risk/benefit ratio doesn't work out.

However you're in the US so they take a more aggressive course of action.

There is no reason you can't have the treatment without sedation at all, I had my 4 wisdom teeth removed with just local. Be aware that there will be some unpleasant noises etc. if you don't mind that then go ahead with either nitrous or nothing if you want to.

 

[Jwkennedy]

Thank you so much! My main source of anxiety has been the pressure from my surgeon to be sedated but the reasons he was giving (having to stretch my mouth) did not seem like they warrant that level of sedation in my mind. When you say no sedation, you mean still local anesthetic right? Just clarifying I think the nitrous will still be a good added measure for me.

 

[Gordon]

Yeah, I would definitely want local anaesthetic