Wisdom Tooth Extraction vs. Braces

[nikit76]

Maybe this is a stupid question but I'm throwing it out there anyway.  I am 34 and have a ton of crowding in my bottom teeth.  I was unable to have my lower wisdom teeth removed 5 years ago because of the risk of oral nerve damage.  I was told that I had a 99% chance of having permanent nerve damage so they would only remove the uppers which I had done.  I got a second opinion two years ago because I was in a lot of pain from my lower wisdoms pushing and crowding more and that surgeon said it was only about 60% chance and it wouldn't necessarily be permanent nerve damage.  My insurance wouldn't cover it with the second surgeon because he was out of network so I did not move forward.  Orthodontics could possibly solve the crowding pain because they would remove teeth other than the wisdoms that are touching the nerve BUT that is not covered under insurance either.  

Fast forward to today and I have been in pain for the last 2 years from the wisdoms trying to come up and crowding.  I saw my dentist today and he will recommend my wisdom teeth to be removed but said I am still very high risk and the oral surgeon may not do it.  He mentioned orthodontics again but that would be out of pocket and may not completely solve the issue with my wisdoms.  Researching oral nerve damage scares the living daylights out of me but so does out of pocket braces with a chance that the issues my not be solved.  Thoughts???

[StratRebel]

His treatment plan is sound.  It is common to leave the last couple of mm of tooth root behind if removing it has major risks.

[nikit76]

Thanks for both of your responses.  I consulted an oral surgeon today about the situation and he agrees with scottma -that wisdom teeth usually don't cause pain unless there is infection.  I say bull.  Whenever the tissue around my wisdoms flairs up there is throbbing pain in the front where it's crowded.  I can't believe its a coincidence.  Nonetheless, he is recommending a rather new procedure where they extract the top of the wisdom tooth and leave in the roots in hopes that the nerve does not get disrupted.  Anyone familiar with this?  He said it will reduce my chance of nerve damage or infection from around 85-90% to more like 1-2%. That's pretty drastic.    

[StratRebel]

Living in pain is not a way to go either.  Even with the risk involved, a majority of nerve damage cases are temporary, most lasting 6-12 months.  The best thing is to make sure you go to an oral surgeon and not a general dentist if you are high risk.

Braces are an option, but much less likely to help, and most orthodontists prefer the wisdom teeth be removed either prior to treatment or right after starting.

I would have to disagree with Scottma, at least half of the complaints I hear from patients about their wisdom teeth pain is due to crowding or impacted teeth.  And every single one has come back thankful they had them removed.

[scottma]

Crowding and impacted wisdom tooth are not generally the culprit of pain, unless infection is involved.