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Should we extract our wisdom teeth?

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Most dentists I have encountered want to extract my impacted wisdom tooth.

What is impaction?
teeth that fail to erupt into normal position but remain fully or partially embedded and covered by jawbone or gum tissue.

Post-extraction problems:
Bleeding and oozing: unavoidable, can be eased with tea bag as tannic acid contained in tea can help reduce the bleeding.
Dry socket (alveolar osteitis).
Swelling.
Nerve injury.

In the U.K., the National Institute for Health and Clinical Excellence (an authority which appraises the cost-effectiveness of treatments for the National Health Service) has recommended that impacted wisdom teeth that are free from disease should not be operated on. Conversely, in the U.S., the American Association of Oral and Maxillofacial Surgeons (the professional organization representing oral and maxillofacial surgeons in the United States) recommends that all wisdom teeth should be removed at an early age as a prophylactic measure. This would suggest that recommendations regarding the removal of third molars vary widely from country to country, depending on the stakeholders involved. In the United States, oral and maxillofacial surgeons have a significant monetary incentive to extract wisdom teeth.

Jay W. Friedman is a retired general dentist and a consultant and writer living in Los Angeles. Jay advocated the avoidance of prophylactic extraction of third molars. The Prophylactic Extraction of Third Molars: A Public Health Hazard. Am J Public Health. 2007 September; 97(9): 1554–1559.

Concerns:
When a lower third molar is removed, usually the opposing upper third molar is also removed. If we extract our lower wisdom tooth, we may have to extract our upper one.
Risk of paresthesia of the lips and tongue. “Symptoms include frequent drooling, biting of the lip or the inside of the cheek or the side of the tongue, and paralytic disfigurement or drooping of the lip. The sense of taste, the facility of speech, and the sensory pleasure of kissing are diminished.”
Intake of antibiotics, check of patient is consuming other medicine.

The risk of paresthesia is not the same for all extractions. It is highest for the mesioangular impaction, in which the tooth is positioned at a 30–45° angle toward or actually against the distal, or back, surface of the second molar.

Figure of a mesioangular impaction:

The risk of permanent paresthesia following extraction of a mesioangular impaction is as high as 6.8%, much higher than for other types of unerupted or impacted teeth. More than 95% of these teeth will never cause any problem.

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Written by blueroselady

February 15, 2010 at 8:35 am

Posted in health

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