So after about two years deliberation I’ve finally decided what I would do with my lower wisdom teeth. The reason it took so long to make a decision was because the roots of my lower wisdom teeth have decided to grow in a way that would wrap themselves and fuse around the nerve as suspected by the x-rays and later confirmed by the 3D CT scans. The worst thing that could happen is permanent paresthesia which would be a very high chance if my wisdom teeth were removed in the traditional way. Some surgeons said I could just leave it while others said to do a coronectomy…making that decision on my own knowing the risks was a hard one to make. Given new circumstances (complications with pocketing) I’ve finally made that decision.
I’ve talked to a number of different surgeons who had different opinions on what I should do. It wasn’t until recently that my wisdom teeth started causing me problems, not necessarily pain but pocketing between my second molar and the wisdom tooth since the wisdom tooth is impacted. The pocket space next to each tooth should usually be between 1-3mm…but because of the wisdom tooth pushing against my second molar, the pocket is 6mm. The problem with this is that it can lead to food impaction, it’s hard to clean, and can lead to cavities in that space in between the wisdom tooth and the second molar that’s right next to it. So if I don’t do something about these wisdom teeth then eventually I may have to extract the second molars.
At this point, with the pocketing and all, most of the surgeons I’ve talked to (shadowed, worked for, and consult at the school) have said they recommend a coronectomy, a removal of just the crown portion of the wisdom tooth to not cause damage to the nerve as removing the whole tooth would cause an extremely high change of disruption to the nerve. Permanent paresthesia is probably one of my worst fears…the feeling of having a fat, tingly, or completely numb lip, the way you feel after an injection, or possible random shooting pains. These are terrifying possibilities. Anyways, with a coronectomy, based on papers and meta-reviews and such, it sounds like this is the way to go.
Here is an image from one of the studies I was reading. In most of the studies, all the participants had roots that were too close to the nerve and after the procedure almost all did NOT have any nerve damage (one did and it was only temporary) and in some occasional incidents, the remaining roots rise up and can be easily removed once they are at a safer distance away from the nerve. Other times the root remain where they are without complication. Because the roots are being left in there is also a much higher change of infection so the surgeon I have scheduled to do the surgery said he would put me on a full course of antibiotics. I’m considering asking him if I should take premed as well, medications before the surgery, as many of the participants in the research studies did this and it is also something we learned about in class for certain patients.
Moral of the story – get your wisdom teeth out when you’re a teenager! And not when you’re 24 after the roots have grown out long and possibly closer to the nerve. As you get older, bone gets denser, and roots get longer leading to a surgery that has a much higher chance for more complications. In my own defense, my stupid dentist when I was a kid had told me that I didn’t “need” to get my wisdom teeth removed (hello? They were impacted and were never going to erupt) and I was content with that…until years down the line I understand why I should have gotten them out earlier.