DS needs his wisdom teeth removed. He is 23. He met with an oral surgeon who said since his bottom teeth are close to a nerve, removing them could cause permanent nerve damage (!). He suggested a CT scan to see how close the tooth is to the nerve, and if there could be an issue, to remove half the tooth. Does this sound right to you? DD had them removed with no similar comments (but maybe hers weren’t close to the nerve). Thanks all. I know there is another wisdom teeth thread but couldn’t find it.
Google “coronectomy”
As to your “does this sound right” question – yes, this is a thing.
Probably much better to have an oral surgeon who takes the precaution of a CT scan rather than blundering right in and risking the nerve damage. But only a second opinion from another qualified oral surgeon would give you the ultimate answer of what’s best for your son.
Thanks @calmom! Yes I’m going to have him see another oral surgeon. I was not familiar with it.
My H had this when he had his wisdom removed in college, before the days of CT scans. They started the procedure and the doctor realized that the tooth’s roots were wrapped around. The dentist literally cracked the tooth in two with a hammer type tool and took it out in halves.
https://www.nature.com/articles/sj.bdj.2010.673 is an article about coronectomy.
Note: CT scans involve significantly more radiation than ordinary dental X-rays.
The consequences of (permanent) nerve damage outweigh the marginal risks of a CT.
As someone who had sideways impacted wisdom teeth that weren’t removed as a youth, my dentist and I decided to do a procedure to remove a part of a wisdom tooth, which was impacting the next forward tooth after all these years. I didn’t want the risks of an extraction at the older age, and so far its worked out. My dentist is a good technician.
My dentist had to cut my molar in half to take it out one half at a time.
@ucbalumnus – thank you – did not know that.
Ugh - I just had a tooth removed in halves. In my case, though, the oral surgeon didn’t do that on purpose … I grind my teeth, and even though I wear a bite guard, I ground so hard it split in half. Both halves were removed in my case.
I don’t know anything about removing half a wisdom tooth, but I will say that my oral surgeon was incredibly knowledgeable & professional. She is a highly-trained doctor with great recommendations. If I had any reservations about the course of treatment, though, I definitely would have gotten a second opinion to make sure I was comfortable with what she suggested.
Not a wisdom tooth, but my husband had a molar removed in four pieces later year. He was going to get an implant and the oral surgeon wanted to keep the surrounding bone intact and not impact any nerves. The recovery for pulling such a large tooth was probably less too. Seems like a sensible approach.
How did he know the teeth are close to a nerve? Is it something particular about the place ment of these teeth? It would seem most of us have nerves in that area.
The Cone Beam CT is one that will show nerves. Yes, high radiation, but more info, in return.
Get that 2nd opinion. And discuss recovery, as well.
If you live near your state flagship with a dental school, you might see if there is a faculty clinic there where you could get a second opinion. (I’ve had good luck getting second opinions on dental matters at the one near me). This is a clinic that the faculty practice in (not the student clinic!). Not all dental schools have them, though. But it is an option.
A dental cone beam CT has less radiation exposure than a conventional CT scan.
The purpose of the CBCT is to take a 3-D picture and see how close the roots are to the inferior alveolar nerve, something you can’t always determine from a traditional dental X-ray. If the surgeon suggests this scan, your son would be wise to follow that advice.
I have to say in my 30+ years of practice, none of my patients have had a coronectomy.