High Risk for Nerve Damage

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Suzanne C - 25 Jun 2005 18:48 GMT

During my consultation for wisdom teeth removal as part of my ortho treatment,
I was told that I am at high risk for damage to the inferior alveolar nerve.
On my lower right wisdom, I have a good size cyst, which warrants removal of
the tooth, but the roots are criss-crossed with the nerve. The lower left
has no apparent cyst but is also dangerously close to the nerve. The ortho
recommended having all four removed (before consult). The doctor expressed a
good deal of concern for my situation, and said that he would not be
surprised if permanent damage occured. I'm really nervous and am in need of
advise. Are there specialists that deal with high-risk cases like mine?
Should I seek additional consultation? There are two well-respected dental
schools in my region, would I be in better hands there? BTW, I had to sign
my life away in legal papers. I suspect that he has been sued before, but I
don't necessarily think that makes him a bad surgeon. He has 35 yrs
experience.

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Mark & Steven Bornfeld - 25 Jun 2005 19:10 GMT

> During my consultation for wisdom teeth removal as part of my ortho treatment,
> I was told that I am at high risk for damage to the inferior alveolar nerve.
[quoted text clipped - 10 lines]
> don't necessarily think that makes him a bad surgeon. He has 35 yrs
> experience.

    You are not signing away your life, nor your right to competent
treatment. You are signing an informed consent--that you have been
informed of the risks attendant to the surgical removal of the wisdom teeth.
    You should see a respected oral/maxillofacial surgeon, as apparently
you have. This is a common potential complication of some impacted
wisdom tooth extractions.
    I have had surgeons refuse to extract wisdom teeth at my request (defer
would be a more accurate term) because of the risk of nerve damage. IMO
if you have a significant cyst associated with the LR wisdom tooth, it
should be removed regardless of position. If you do not and the cyst
continues to increase in size, you will incur a significant risk of
pathologic fracture eventually. Whether the lower left wisdom tooth
also needs to be removed should depend both upon the potential for
damage from the presence of the tooth and the significance to the
orthodontic treatment weighed against the potential complication of
nerve damage.
    We recently had a lecture at our local AGD chapter by an oral surgeon
demonstrating removal of third molars near, touching or even encircling
the inferior alveolar nerve. While no one can promise you there will be
no damage, in these cases the damage was often partial or transient and
the minority caused significant permanent disability.

Good luck,
Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

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W_B - 27 Jun 2005 15:43 GMT

>Are there specialists that deal with high-risk cases like mine?
>Should I seek additional consultation? There are two well-respected dental
>schools in my region, would I be in better hands there? BTW, I had to sign
>my life away in legal papers. I suspect that he has been sued before, but I
>don't necessarily think that makes him a bad surgeon. He has 35 yrs
>experience.

Get a second opinion from another oral surgeon.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com

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