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Medical Forum / General / Dentistry / August 2005A question regarding wisdom teeth.
Hello I'm 21. Over the course of the past 10 months one of my front lower teeth was getting pushed behind the rest by what I guessed at the time to be wisdom teeth coming in. My dentist confirmed this with an X-Ray. I believe the impaction (on both lower sides) to be a full bony mesioangular impaction. Recently I've been feeling a lot of pressure in my lower back jaw. Not painful really, just uncofortable. I suppose the wisdom teeth need to be removed however I was wondering if as an alternative to that I could have my 2nd Molars removed with the view to letting the wisdom teeth move into position. (I'd had my top 2 Top 2nd Molars extracted at 13 y.o just before getting a brace - How I wish I'd had the lower 2 pulled out at the same time!) My question is whether this is even possible or is routinely done? Because from my point of view it seems preferable. (Relativeley easy 2nd Molar extractions compared with digging around in my bone to pull out the wisdom teeth [I presume that's what has to happen] Thanks in advance! > My question is whether this is even possible or is routinely done? Because > from my point of view it seems preferable. (Relatively easy 2nd Molar > extractions compared with digging around in my bone to pull out the wisdom > teeth [I presume that's what has to happen] Forget about it and get the third molars removed soon.  Signature/ Amatus / > Hello > [quoted text clipped - 21 lines] > > Thanks in advance! >My question is whether this is even possible or is routinely done? Because >from my point of view it seems preferable. (Relativeley easy 2nd Molar >extractions compared with digging around in my bone to pull out the wisdom >teeth [I presume that's what has to happen] > >Thanks in advance! It largely depends on the shape (anatomy) and position of the WTs. Mesioangular impactions are *unlikely* to erupt into a functional position. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com First, never assume to extract a tooth that may be still in good condition, later you always wish you hadent. Second, many 2nd molar extractions may be harder then a simple third molar extraction, (even if it's a mesioangular impaction) the 2nd molar will likely have longer roots and you would end up with more bone loss with it being extracted. depending on the amount of root formed on the third molar, and exact position, the bone will most likely replace it self there better. extracting a 2nd, may leave a huge area of bone loss, that is not replaceable. A second molar extraction may cause the first molar to move distally (backward) loosing proper occlusion in the mouth(teeth won't fit properly), Having a retained 3rd molar uprighted and positioned would take an extreme amount of money, first the surgery cost *(yes surgery cost!, becuase you have to expose it and place force on it to upright it. Then the orthodontic cost, to move it, your's talking several thousand. or more. Wisdon teeth Do not cause anterior crowding, even if they appear to be errupting into the arch form. Consult your orthodontist for that, not your general dentsit. Go for general sedation,, the oral surgeron will have the third molars out in no time. And you will heal up just fine. Also I am not sure of your thoughs, but, you sound like you don't like bone "digging around in" The oral surgeon, knows what he is doing and will not have to dig around, they will actually only take about the same time as any other extraction. hope this helps. Dr. P. >> My question is whether this is even possible or is routinely done? >> Because from my point of view it seems preferable. (Relativeley easy [quoted text clipped - 7 lines] > Mesioangular impactions are *unlikely* to erupt into a > functional position. Thanks everyone who replied - all very interesting thoughts! > Wisdon teeth Do not cause anterior crowding, even if they appear to be > errupting into the arch form. Consult your orthodontist for that, not > your general dentsit. Seems a bit of a coincidence how a tooth is getting pushed back around the same time as the wisdom tooth impaction began. I can see that the teeth on my left side are being pushed towards the front (most notably the left lower canine no longer being symmetrical with my right lower canine) - Surely this must be caused by the wisdom teeth? - also, interestingly (or not), both my 2nd molars have become slightly raised and turned inwards towards my tongue - presumably caused by the wisdom teeth pushing up underneath them? > Go for general sedation,, the oral surgeron will have the third molars out > in no time. And you will heal up just fine. Also I am not sure of your > thoughs, but, you sound like you don't like bone "digging around in" The > oral surgeon, knows what he is doing and will not have to dig around, they > will actually only take about the same time as any other extraction. My number one worry is nerve damage - my Dad had his wisdom teeth out and a nerve got damaged somehow and he can't feel a certain are of his gum - admittedly this was a long time ago and in Ireland so possibly the surgeon was drunk! > hope this helps. > > Dr. P. It does It is possible to extract the 2nd molars but and it is a big BUT it is not practical, very expensive and you may not get what you are after in the end. 1) 3rd molars are much smaller teeth and unless the tooth is fully erupted you really do not know how small is too small. 2) the 3rd molar without intervention will tip forward and the upper tooth will extrude into the space . which will create a problem with your bite. 3) I disagree with Dr. P that the 1st molar will tip backwards this does not happen with molar teeth. I have observed a single rooted premolar tip backwards and create spacing in the front but not a multi rooted molar. 4) Untill recently it was almost impossible to move a molar forward with all its roots vs tipping this tooth. Recently they have invented orthodontic implants that are removed after treatment. With these implants you can move the 3rd molar. This will jack up the cost of treatment and unless your 2nd molar is non restorable it is not worth removing it. Also keep in mind that if you use the implants you will need to hold that upper tooth from coming down. 5) your wisdom tooth may already have a cavity in it so it may not be a virgin tooth. And even if it was you would want to place a sealant since the anatomy on these teeth are so deep it is easy for decay to develop. I recommend you save yourself the headache and take out the wisdom teeth. >3) I disagree with Dr. P that the 1st molar will tip backwards this >does not happen with molar teeth. I have observed a single rooted >premolar tip backwards and create spacing in the front but not a multi >rooted molar. I disagree with AV, 1st molars can and do tip distally after loss of the second molar. It just doesn't happen all the time, hence unpredictable. It has to do with occlusal forces. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > It has to do with occlusal forces. Hmmmm,,, great minds work alike. Signature/ Amatus / > >>3) I disagree with Dr. P that the 1st molar will tip backwards this [quoted text clipped - 12 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com Yes, I agree with you. It all depends on a few things. If the patient has a strong muscular pattern, as in a brachyfacial type, they are more likely to hold the 1st molar in position with the functional equilibrium of the oral function, However, if the patient has a week bite and less compisinating forces, the 1st molar will tend to move distally some. It depends on other factors such as bone density and parafunctional issues and tongue position. I am not sure if anybody mentioned the adverse effects that the upper molar will exhibit if the 2nd lower was removed, over time it will be overerrupted, causing a mulitute of problems. I also aggree with Dr. P, the 3rd molars are not the cause of the anterior crowding on the mandible. This is a common belief, however not ture, usually. Consult your local Orthodontist for a eval. Dr. Braces >> 3) I disagree with Dr. P that the 1st molar will tip backwards this >> does not happen with molar teeth. I have observed a single rooted [quoted text clipped - 6 lines] > > It has to do with occlusal forces. We agree with the wisdom tooth not moving anterior teeth and we als agree with the compisinating forces ....... Hey! WAIT A MINUTE ?? -- Joel34 |
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