Wisdom tooth extraction for braces - right questions to ask BEFORE...

[pcspinheiro]

Hi all,
I'm due to remove my last wisdom tooth for my braces. Well, actually, if it was just for my braces I would very well leave it alone, since there´s no space problem in my mandible, but for the last 3-4 days it's been killing me... the reason I'm posting is because I'm VERY apprehensive about this particular extraction... The tooth is really far back in the mandible and even though its fully erupted to the same size as its neighbour, it is still partly covered in soft tissue. The worse part is that it seems to me it is growing into the upper mandible bone, you know the at the back curve of the mandible where it then goes up to the jaw joint (or at least some tough ligament). I think removing its companion on the upper arch may have caused it to try to erupt more and no OTC medication can take away the pain (no prescription medication either, as I have tried an opioid that I still have from my latest disc hernia episode..).
So, what are the right questions and concerns to pose the dentist BEFORE he reaches for the needle, and how to tell him NOT to do it if he feels it's not his ballpark (as in, a surgeon should do it, not an exodontist).

Sorry for posting so close to the event, but I was only told to extract right away after visiting my ortho to complain about some side effects of elastics... and since it's making me so miserable I quickly agreed. Hope I can get some feedback until then! Thanks!

[Ziggy]

My first question would be, "Is this absolutely necessary?" If you don't feel comfortable with the answer don't be afraid to get a second opinion. I had all my wisdom teeth yanked out at once by an oral surgeon when I was a lot younger. I was asleep through the whole thing and the outcome was perfect. Based on friends who have gone to dentists to have wisdom teeth removed, I would go to an oral surgeon, but that doesn't mean your dentist can't do an excellent job. I think, but I'm not sure, an oral surgeon has the tools to knock you out completely before the procedure. Maybe somebody else here knows the answer.

[sandiego88]

If they aren't above the surface you should go to an oral surgeon. Mine showed me where my window teeth were on the X-ray and how he was going to take them out. Unfortunately mine were really close to the nerve, but got infected so it had to come out.

[pcspinheiro]

Thanks for the replies. I had a long talk with the dentist and expressed my fears. We looked at the x-ray together and he sowed me how short and away from the nerve the root was. Of course he could not assure me I wouldn't have paresthesia but he admitted to having some nonpermanent cases. In the end it all went well with the extraction, the problems came very soon after.... I had just driven away, still completely anaesthetized and numb, when stangely pain started setting in. The same pain that had tormented me the previous week but that, a couple of hours later, was 10x worse! I could not function and 600mg ibuprofen did nothing, so I took 100mg tramadol, still nothing. .. Had to call my ortho, who was very nice to give her personal number, and got into a combo of spididen and paracetamol and that took the edge off a little. My whole half-head hurt so much. I think the tooth was growing into the bone going up to the TMJ and messing up with some part of the trigeminal nerve. I just dropped the meds today to see how I was doing and I can now tolerate the pain, it's mostly when moving the jaw, otherwise OK. Hopefully I'll be well into healing by my next ortho appointment on Thursday.
Cheers.

[jude09]

I hope you have healed completely. I'm worried about my situation. I've been scheduled for wisdom teeth removal from a clinic in Toronto ( https://www.dawsondental.ca/dental-serv ... dom-teeth/ ) on 26th of this month. My teeth are away from the nerve but they are partially covered in soft tissue. I think both of our cases are somewhat similar. So I would like to hear your experience with this procedure. Also, can you recommend some wisdom teeth removal recovery tips? Can you send pics of your teeth? Thanks !!

[pcspinheiro]

Hi jude09,
I'm sorry but I don't have photos of my teeth... That one tooth had erupted way back in my mandible because apparently I have a skeletal deficiency. So even though it was adjacent to the second molar it had gown right at the groove were the mandible bone ascends to the coronoid process (see attached picture and arrow) and was, I believe, growing against (or into) that bone. I have thankfully pretty much healed now! It was excruciating the first couple of days, then very hard for a week or more due to this sort of migraine affecting that half of my head. I continued to have some TMJ pain and noise for about 3 weeks post-extraction and the noise is still not gone, Maybe I was just not aware of it before, but it's definitely worse on that side. Also, during this whole time I had a LOT of sensitivity in all my left side teeth, top and bottom, but that has also subsided quite a lot. I suppose my case was a bit particular, but I did have some tissue on top of it on the cheek side, which I think was the soft tissue that covers the mandible bone being pushed along when the tooth grew against the bone...

Hope you have better luck than me, my pain was quite unbearable... Top wisdom tooth was not painful at all, only when it got infected a couple of days later dd it hurt a little. So people don't think I'm a wuss with pain, I once fractured a foot and only several hours later, when it was all blue and the kids were in bed, did I drive myself to the hospital.