To pull or not to pull?

[carolinhk]

Dear Dr

After contracting an infection in my lower left wisdom tooth which is slightly peaking through the gum, a dentist gave me antibiotics and painkillers to clear the infection and I started a second course of two antibiotics a couple of days ago. Yesterday I consulted a maxillofacial specialist. My first x-ray showed that my roots are quite long (I'm 32yrs) and pass through the nerve. The second cone-beam scan shows that the root is curved under the nerve, to the extent that there will be nerve damage. As x-rays go, he said that mine was bad and I have to think carefully about what to do. I am reluctant to have surgery to remove the tooth as I don't want my lip (and possibly cheek, tooth area) to have no sensation. I understand that the severity of my case indicates that the nerve damage will most likely be permanent. I am currently living in hong Kong and was wondering if techniques, technology etc. were more advanced back home in the UK. I understand this is an American forum but he mentioned that they are pioneering a new technique somewhere in Europe to leave the roots in, and remove the crown. Do you know of this technique and is it widely available outside of Hong Kong? And do you think the risks of leaving the wisdom tooth in outweigh the permanent numbness? I don't know what to do..

Thanks. Carol

[carolinhk]

Dr Kirsch, thank you for the advice. The specialist told me that they don't perform coronectomy surgery in Hong Kong so.. I will speak to my dentist back in the UK tonight and try and find out if there is a Western surgeon who will be willing to perform a coronectomy here but I doubt it. I just get the feeling we are not as advanced here in Hong Kong as in other parts of the World. I'm not heading home for a holiday until July..

Jeff, thanks for your advice too. I had made my mind up straight away to hold onto the tooth a while longer as there would be damage whether I take it out now or in the future anyway. I'm not so sure now. He said it would be my lip more than anything else which puts me off the procedure.I'll certainly look into getting the coronectomy first and see what they say.

Thanks again.

[Michael H Kirsch, DDS]

Ask your surgeon about performing a coronectomy -  where they just remove the crown and leave the roots.  There still is a chance of nerve injury with this procedure.

I was trained in the USA and only have experience with techniques used in the States.

Ultimately,, the decision is up to you.  There are risk for the surgery and certainly risks of not having the surgery.

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.

[jeffey60]

Hello Carol, I had my wisdom teeth pulled back in 84. I have a damaged nerve in my chin my quality of life hasn't changed very much at all.  Listen to your doctor.