Wisdom Tooth broken below gum line!

[Deecee12]

My son is in a wheel chair and was told by an oral surgeon, he could pull that wisdom tooth out while he was in his wheel chair. He said we have to tell everyone this, that there is always a one percent chance of nerve damage to your speech. He was going to do it until he heard that. Has perfect speech and fears getting it pulled from sitting in wheel chair is scaring him too but the tooth is bothering him.

 

[Gordon]

What's the question?

 

[LenaD]

I’m sorry your going through this. If he’s in pain isn’t there only one option?

 

[Deecee12]

Yes i know he has to have it removed but he also has heart problems just had 2 stents unblocked in August so he would have to go off his blood thinners plus I sincerely donot think he should get such a major surgery done from his wheel chair but what do you suggest if they dont have a way to get him in a dental chair. The whole thing is so scary due to this COVID risk you also take if they suggested a hospital.

 

[MumOfBoys1985]

I wouldnt consider it major surgery personally but id imagine it would be pretty uncomfortable and difficult to have a tooth removed whilst sat up in a wheelchair- I'm not a dentist though so happy to be corrected. The more comfortable he is and settled he is during the surgery, the better for him and his dentist.

I had 3 wisdom teeth out (one at the hospital and 2 at the dentist) and I was told that there is a small chance of nerve damage When removing Lower wisdom teeth. When I had the one out at the hospital I had to sign a consent form etc and it did affect the sensation in my face for a few months but it eventually came back. My speech wasn't affected. I think they just have to let you know about worst case scenario.

Can you ask for a referral to a specialist? Or find a surgery that can offer support for a wheelchair user? I'm sure they must have to provide a service that can be safely accessed by everyone?

Is there no way your son can transfer to a dental chair? Without knowing what his disability is its hard to suggest what might be useful in terms of small aids etc (I have some occupational therapy background).

 

[Gordon]

Again, is there something you specifically want to know?

There's no need to stop his blood thinners for the surgery. Much easier to deal with a local bleed than a clot somewhere inaccessible...

Not a big issue doing minor surgery like this on a patient in a wheelchair, I've done it more times than I can count.

There are special platforms available that you can use to make it a bit easier on the operator but they aren't essential.

The stuff about affecting his speech is a risk associated with wisdom tooth removal, for anyone, it's not common but needs to be mentioned in advance. I wouldn't say it's anything like as high as 1 percent though.

 

[Deecee12]

I can't thank you enough, for your replies!
Thank you so much for the information!
It is a relief to me and will be to my son, as well!
My son was diagnosed with mild CP but his speech is perfect, he has 2 college degrees and has a license to drive, works, GF etc. but they diagnosed him with that because it was as close to that physical condition, as they could get. So his physical condition is, he has ALL his feeling and is not paralyzed at all and no speech impediments. The contractures in his lower limbs, has prevented him from balance, if walking and he feels safer and independent, in his power wheel chair. He is very intelligent, to the point of correcting me even on my grammar.
He is so concerned about this Covid too, getting things done inside his mouth, since he also has angina, that never was corrected when he just had 2 heart blockages done in Aug 2020 of this year and his Cardio has him started today going from 500mg to 1000mg 2 x daily. I don't know why but when he has this angina and even though the blockages were stented, he gets throbbing in his front upper & lower teeth, not his jaw, so the Cardio is thinking maybe its the wisdom tooth radiating to the front teeth and not the angina heart issue.
Ever hear of that?

 

[Gordon]

I've never been surprised by the weird way tooth pain can be perceived, it's truly bizarre at times.

Would be sensible to remove the decayed tooth anyway, you don't particularly want a load of bacteria from the tooth trundling around the body when your general health is a bit compromised the way your son's is.

The smartest woman I ever met in my life has CP, I'm sure she won't mind getting a wee name check on here: https://www.dundee.ac.uk/people/annalu-waller her jokes are worse than mine though!

 

[Deecee12]

Thank you so very much again for your reply!
This is a fabulous site and perfect for our case of the wisdom tooth below gum line and my son in a wheel chair.
Thank you for website too! She is super impressive!
But i have to say, in this area of Pa., our dentists and M.D.'s are still behind the times and really need special equipment to get people from their wheel chairs to beds or dental chairs, in these type of situations.
Still on the fence, on who to go to because the Oral Surgeon, one referred to by his dentists, is the one that said he didn't think, he would have a problem getting that wisdom tooth out.
But he scared my son, who has perfect speech by saying about the 1%, that it could give nerve damage to their speech ,with this type of procedure.
I know they have to tell everyone the risks but my son is one to avoid telling those kind of things to because he said on top of all the other issues I have, my speech is one of the best I have going for me. I work and have to host conference calls. What if it messes with my speech? Being in a wheel chair and his Cardiologist says that he stented the the 2 heart blockages, yet my son is still having chest angina and front tooth pain ,upper & lower and Dr. has now recommended Ranexa, 1000mg 2 x a day because 500mg wasn't working. UGH!
Then of course the COVID, is out of control in our area, so my son is worried about having people breathing on him and using their dental utensils, since he is so compromised with all the other problems.
It is the worst time for this tooth problem to come up!
However will we overcome this?

 

[Gordon]

I think your surgeon seems to have caused some confusion with his 1% comment. It's not that the speech is directly affected, in a very worst case scenario, the nerve which supplies sensation to the side of the tongue and lip can be damaged, leading to a sort of permanent numbness, you know the feeling when you've had a local anaesthetic on your lower jaw? Kind of like that, but it can last for ages, sometimes permanently.

It'll make speech feel a bit odd but it doesn't actually cause changes to the sounds that come out, if you see what I mean?

The surgeon should have a very good idea if there is a risk of such nerve damage from pre-op x-rays though, have these not been taken yet?

The CV19 thing is probably less of a risk at the surgeons than elsewhere in the environment, given the fairly strict cross infection measures that all dentists have to maintain.

 

[Deecee12]

Thank you again very much for the information!
It is a very touchy situation, with my son and his heart condition and being in the wheel chair.
I certainly appreciate your feedback to me, on this matter of the wisdom tooth.
I had him rinse with warm salt water for a day or so and then Gly-oxide to cleanse the area or keep it as sterile as possible.
Last night, he said it wasn't throbbing, which it hasn't gotten to that point and he eats on the other side and he drinks cold water a lot, so you would think, if a nerve was exposed, due to the tooth being broken down as far as it is to the gum line, that there may be a small possibility it isn't infected yet? Either way, I contacted his dental office but they had a message machine and explained in short, what the problem was and that he needs an x-ray, to see what we are dealing with here. I would like to keep you updated ,if that's okay with you, after the x-ray, to see what they say. Thank you again for hearing me out and all the great info you have given.
Sincerely,

Deecee12

 

[Gordon]

Yes, feel free to ask me anything else if I can help.