Email: Wisdom Teeth Question
I recently go this question from a friend about a wisdom tooth extraction…Question:
I had a question for you about wisdom teeth extraction. My girlfriend now needs to have her bottom wisdom teeth removed (had the top ones out a few years ago).
While they were numbing her on her right side, they hit the nerve (I believe the one that connects to the lower lip) and gave a brief shock. Thankfully the numbness went away later that day, but they ended up only removing one left wisdom tooth and leaving the right one since the needle touched the nerve.
Apparently there’s some imaging that can be done to help prevent this in the future when she goes back. Any other advice or types of dentists we should see who would be good at this type of case? What questions should we ask?
I read that the risk of this nerve damage with wisdom tooth extraction goes up with age because the roots are more fully formed, but figured there must be ways to alleviate this risk.
Answer:
The shock sensation she felt is a result of the needle grazing the nerve. It does happen occasionally and there isn’t a good way to prevent it because the injection is “blind” (we estimate where the nerve should be based on other landmarks and try to get as close as possible… sometimes we just hit it dead on). In rare situations it can cause some lasting nerve damage but most heal completely on their own. If all her sensation came back a couple of hours later then you don’t have to worry about nerve damage from that.
Nerve damage directly from the wisdom tooth extraction is a different matter. Lower wisdom have a tendency for the roots to be in close proximity to the mandibular nerve especially when fully formed. During the extraction you can get nerve damage from severing or damaging this nerve. One of the best ways to avoid this is to have a 3D conebeam CT scan done. Many oral surgeons have these now. It’ll give them a 3D reconstruction of the lower jaw so that they can see exactly where the nerve lies in relation to the tooth. If the nerve is wrapped up with the tooth sometimes they’ll cut the top of the wisdom tooth off and leave the roots in place. Success rates with this are really good and avoid the risk of nerve damage.
If there is a concern with the proximity of the nerve, I’d definitely have her see an oral surgeon and get the 3D scan done. Most oral surgeons do these all day, every day and are really good at it.
Hope that helps!
November 27, 2017 @ 1:10 pm
Thanks for sharing this question and answer for wisdom teeth.