wisdom tooth

**Gamma** · 11-20-2009 07:04 AM

Hi all

I have got an upper wisdom tooth that is three quarters of the way through (as said by my dentist) and he recommended it be removed and that he would remove it himself as it is causing me problems. He said that he does not stitch them once they are extracted which I find a bit odd for a wisdom tooth removal. Is this normal practice not to stitch them afterwards? Also, would a normal dentist (not oral-maxillo-facial surgeon) provide as good an outcome as an oral-maxillo-facial surgeon or would I be best get it removed by one of those?

Many thanks for any help or advice.

Kind regards

Gamma

**WildChild** · 11-20-2009 07:10 AM

Getting a second opinion from another dentist might be a good idea.

**KMonte85** · 11-20-2009 07:18 AM

I have been told that once the tooth has projected out of the gum, having it extracted is the same procedure they use on any other tooth extraction - ie only local numbing, perhaps some laughing gas, and then they pop that sucker out, and no stitches.

If the tooth is impacted (not projecting from the gum) they need to do a more serious procedure where they have to cut into the gums and extract the tooth, which would require stitches.

This is what my dentist told me because I have 2 wisdom teeth that are impacted and two that are through my gums. He wanted me to get them all removed too.. but I'm a big chicken and said I would cross that bridge when I had to...

**PJhavinfunagain** · 11-20-2009 11:19 AM

get them out. It's wayyyyyy worse and more painful if you leave them. They can break or break other teeth. Soooooo painful! Wish I had had mine all out at the first sign of trouble.

**ItsASecret** · 11-20-2009 01:26 PM

Before my wisdom teeth even popped out my dentist recommended that I have them taken out because my mouth would not be able to accommodate them. I have had a few teeth pulled with just the regular local anesthetic...and hated the feeling of the pressure when it is taken out. So I asked if he could refer me to the oral surgeon and he did without hesitation. Personally I think it was the best choice, I had an IV and was knocked out and the procedure was done in less than an hour. Warning though, the pain after surgery was the most pain I have ever felt (even my cheeks were bruised for about a week) and I popped those pain killers like crazy.

**kira** · 11-20-2009 03:03 PM

Stitching something up completely is more likely to cause infection. The worst bacteria are the kind that can survive with no oxygen and are killed by oxygen. Closing something up like that just makes them a nice little pocket to multiply in.

Even if they come in fine it's a long painful process and they can still cause problems years later. My mom just had to have her wisdom teeth out because they started shoving her other teeth forward. I have mine and it took nearly a year of my gums painfully swelling up every month or 2 before they were completely in. Years later 2 have cracked for no obvious reason and I'm going to have to have them all removed soon.

**Gamma** · 11-21-2009 03:55 AM

Hi, WildChild, KMonte85, PJhavinfunagain, ItsASecret and kira.

Thanks for all of your replies.

I am wondering whether to get a second opinion but over here in the UK that would be quite difficult as there is such a high demand for dentists over here that they do not have room on their list and it would require a lengthy process. Perhaps I should tell him my concerns? Hopefully he will understand where I am coming from and be able to alleviate the concerns.

It has nearly come out (three quarters of the way there according to the dentist) but that was when I did not have this pain and other symptoms I have got and I am wondering if he knows whether it is partially impacted or not which could be causing me pain and jaw stiffness making my jaw lock up. He never bothered taking an x-ray so does not know whether it could be partially impacted from my guess as he would not know without an x-ray. This does concern me as if he gets started on it and finds it is partially impacted without knowing, he may hurt me and also cause complications which I could do without.

What I do find confusing is I had normal extractions before by an oral surgeon and they stitched them up so perhaps it's personal preference of these dentists and oral surgeons? Or perhaps oral surgeons do it as they know how to stitch them up and my regular dentist does not? There is always that as he is not a surgeon.

Unfortunately he has not offered me anything except a local anaesthetic so I will have to be awake for the whole procedure which I am not looking forward to and have never had anything like this done awake before and he did not ask me if I was ok being awake so was wondering if he will take good care of me and make sure I am ok. I also have a bit of a gag reflex so I may be a bit difficult and it will also be traumatic for me if this happens. Is there any way they can take my gag reflex away while they do it?

Does it take very long to remove or will it be over quite quickly? I just am not keen on sitting there with my mouth wide open as it hurts to keep it open for a long time.

I do not like the sound of 'pressure'. Does it hurt? What sort of tools do they use? Just wondering.

Hmmm...perhaps I should get an oral surgeon to do it and put me to sleep but he does not want to and feels it is not worth it and wants to remove it while I am awake! Why has he not given me the option of either being awake or asleep?

I would rather leave it alone if this is going to be unpleasant.

Wish he would have bothered to tell me why he would not stitch it up. At least I can rely on you all to talk to me and tell me why, etc. Now it makes sense why he will not stitch it up but does that not amount to more bleeding or more chance of dry socket? I really do not want to be sitting all day with a piece of gauze stuck in my mouth as it is quite far back and I just would gag. It sounds horrible.

When I had my two lower ones out via an oral surgeon under general anaesthesia with stitches, they never bled much if at all and I never even had to bother with the gauze.

I am worried that mine is pushing my front teeth forward as I had really bad sticking out teeth before and had to have a brace on to correct them and now this one tooth may undo all of that vital and precious work. I cannot afford to have another brace on. So that is not an option unfortunately.

Many thanks for all of your posts. It's much appreciated.

Kind regards

Gamma

**ItsASecret** · 11-21-2009 10:16 AM

Does it take very long to remove or will it be over quite quickly? I just am not keen on sitting there with my mouth wide open as it hurts to keep it open for a long time.

The tooth is already bigger so it will take more effort to get it out, I think they try to get it out and if it does not they need to crack it into smaller pieces and take them out that way. So the time it takes I would assume would depend on how stubborn the tooth is going to be.

I do not like the sound of 'pressure'. Does it hurt? What sort of tools do they use? Just wondering.

As far as I know they use tools like forceps to just grab and pull. The roots of the wisdom teeth are long so they will need to a lot of pushing back and forth to pull them away from ligaments and muscles that the tooth is imbedded in. The pressure comes from all that pulling, the strength of the ligaments that hold the tooth in are extremely strong so that is why you will feel the pressure.

Why has he not given me the option of either being awake or asleep?

My best guess is that the dentist will assume their patient does not want to opt for surgery as the first choice. For a lot of people the thought of a surgery is a terrible thought so your dentist may just go on thinking that you would do the extraction like has been previously done (with regular local anesthetic).

I would rather leave it alone if this is going to be unpleasant.

If your mouth cannot accommodate the teeth the pain will be far worse when all your teeth get squished together. That slow continuous pain would drive people crazy.

**Gamma** · 11-22-2009 09:31 AM

Hi, ItsASecret

Thanks for getting back to me.

I am not sure how long it will take or how difficult as the dentist never discussed that with me. He only mentioned it needed removing. I was wondering as I have difficulty keeping my mouth open and also a bit of a gag reflex. Hopefully he does not have to go too far back to remove it...

Would pulling this upper wisdom tooth damage any nerves. I know lower ones have that risk, just wondering whether the upper ones do as well. I suffer with my sinuses and have heard that upper wisdom teeth are close to these which may be a problem but I'm not sure.

I had my two lower ones out under general anaesthetic, never had any teeth out via just a local. I am surprised he did not ask me what I felt comfortable doing as at the end of the day, it is the patient who is having the procedure and needs to be at ease and not suffer or be traumatised.

What is the difference between a normal dentist (who is wanting to do mine) and an oral surgeon doing wisdom tooth extraction? Is the oral surgeon the more experienced of the two? Just wondering as normal dentists do not pull wisdom teeth everyday like oral surgeons from what I have seen...

Would I have a better outcome by an oral surgeon?

Just trying to make sure I make the right decision as once it is done I cannot go back.

Many thanks

Kind regards

Gamma

**ItsASecret** · 11-22-2009 11:07 AM

I was wondering as I have difficulty keeping my mouth open and also a bit of a gag reflex. Hopefully he does not have to go too far back to remove it...

Your teeth are not at the back of your throat so the only thing that may trigger your gag reflex is the spray of water from them cleaning the area. If you have had dental work done before, even normal cleaning then you will know what that mist spray will feel like.

What is the difference between a normal dentist (who is wanting to do mine) and an oral surgeon doing wisdom tooth extraction? Is the oral surgeon the more experienced of the two? Just wondering as normal dentists do not pull wisdom teeth everyday like oral surgeons from what I have seen...

Surgeons do surgeries, the wisdom tooth extraction I would assume is their most common procedure so yeah they would have more experience. That is not to say that general dentists do not have experience, they still do many many extractions and have gone to school for it so it is not like they will mangle your mouth.

Would I have a better outcome by an oral surgeon?

Do whatever you are most comfortable with. Ask questions, and then ask more. I chose surgery because I do not like the feeling of them pulling the tooth. Other people are paranoid of needles (you need an IV for the surgery obviously) and medical procedures in general so they would avoid the surgeon. I will mention again though that the surgery is painful after wards, there is also swelling, bruises, and mild narcotics to numb the pain (you can choose not to actually take them though). Some people do not get any bruising or major pain after though. Everyone is different. Also if you are not covered by insurance it will be expensive, with my insurance it only cost me $200 but the bill said it would have cost about $1200 without insurance if I remember correctly.

Just ask questions, I am sure the dentist will not mind because many people will be just as concerned as you.