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Old 06-06-2004, 01:33 AM   #1
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jay123 HB User
Post If you think you need your wisdom teeth extracted, Read This First!!!!

Hey all.
I'm really angry about all of the misinformation I've been fed about third molar impactions, so I want to offer you a different view than what you've most likely been hearing. I posted about a month ago that I have an impacted wisdom tooth and my dentist thought I should have all four removed. For the doctor types, I have a partial soft tissue mesial impaction of the left mandibular third molar. I decided to research this subject on my own to investigate other options. One of the first things that I learned was that many impactions are iatrogenic, meaning caused by the practitioner. When the orthodontist put braces on you, he didn't allow room in your mouth for the third molars to come in. It seems that it's easier to shift the teeth when the orthodontist affords himself more space to work with, instead of leaving an empty spot at the rear of your dental arch. This is FYI; I don't have any orthodontia. I also learned that, believe it or not, an impaction is not always a medical indication for extraction. It seems that all of the people I know have this mantra stuck in their heads; "Impaction...extraction", "Impaction...extraction". The rarest types of impaction angles, horizontal and vertical, do need to be extracted because they will cause the root of the second molar to be reabsorbed. People who have bony impactions many times can leave them entirely alone. Most angles of impaction are mesial which means that the crown is slanted at an angle to face towards the front of your mouth. This what I have, and my tooth is partially erupted. It is a soft tissue impaction as opposed to a bony one, meaning that the tooth was rising to a higher position in the dental arch and trying to erupt. So, the one problematic tooth is halfway into my mouth, and my dentist is telling me that I need all four pulled. Now think about this for a minute. What the hell kind of sense does that make? All four? Now, I get to thinking, "Whatever happened to orthodontics?" Orthodontics is all about straightening teeth. I had a tooth that was coming in crooked, and it's just like any other tooth that ever came in crooked. It stands to reason that it can be fixed. I later find out that it is more common for upper canine teeth to be impacted than it is for upper wisdom teeth to be impacted. You don't see people without canine teeth, now do you? It seems that these impactions are somehow fixed. I start reading in online journals how impacted canine teeth are made to erupt normally using surgical exposure and wiring. I get to thinking, "What if I had a spacer installed between my second and third molars?" The slanted tooth would shift backwards and erupt normally. I posted a question about my idea on this board. I have a small confession to make. I said in that original thread that I was religiously opposed to surgeries of any kind. In truth, I am simply apprehensive of interventionist solutions to minor problems. I told that fib so that I wouldn't be deluged with posts saying I should just have the teeth pulled or offering reassurances that it wouldn't be so bad. I appreciate your well wishes, but I was already on to something, and I wasn't going to quit until I found an intellectually satisfying solution. [ removed ] I solicited the advice of one dentist/dental researcher, one orthodontist/pediatric dentist, and one oral surgeon. The orthodontist/pediatric dentist tells me that I could probably have a spacer installed that would make the tooth erupt correctly. I found out that I would have to go to a dentist once or twice a month for three to six months. Each time the doctor would increase the width of the spacer until the tooth erupted normally. Next the oral surgeon replies. He tells me that I should have at least the problematic tooth and the opposing tooth extracted because they have a high chance of developing periodontal disease. He told me that the root formation of 3rd molars makes them susceptible to periodontal disease. Then he said that I should have the remaining two teeth removed at the first sign of periodontal disease. Well, seeing as how periodontal disease is caused by food particles collecting at the neck of the tooth, I had a difficult time understanding what the roots had to do with developing the disease. They may play some role once it is established, but definitely not in it's original cause in the tissues. This is also poor reasoning because gingivitis is the precursor of gum disease. You have to ignore gingivitis for at least, a bare minimum of, a few months before it develops into gum disease. It doesn't just spring up over night. I floss my teeth, so if my gums start bleeding, I know they're inflamed. Finally, the last person gets back to me. This is Dr. Stephen Moss, and he had the most impressive credentials of any of them by far.
[ removed ]
He elaborates on what the first person said. Any dentist can do the work I need, it will cost less than 50 bucks to do(a few dollars for materials and sterilization and the rest for the dentist's time), it should work after about four months, it's completely non-invasive, Iíll spend all of two minutes in the chair at each visit, and there is little to no chance of infection!
Here is the recap. I have a problem that can be fixed quickly, easily, and EXTREMELY cheaply (for dental work), AND I get to keep all of my teeth!
Now tell me, why the hell would I want to pay 1200 bucks for pain, the possibility of complications, AND lose my teeth? There is absolutely no reason at all! The risks of complications are too numerous to list here, but I was not impressed with the measures that oral surgeons take to avoid nerve damage. "Winging it" and guessing where the alveolar nerve bundle is is not my idea of quality medical care, especially when the nerve could be wrapped around the root of the wisdom tooth. The diagnostic uses of panoramic radiographs are also highly overrated. Dr. Moss said so himself, and I infered the following. Ever heard of distortion? You know, if you look at a Mercator projection map of the world, Greenland looks to be the size of South America when it is really only a fraction of that size. Any time you try to depict a curved object like your mouth or a round object like the earth on a flat surface, there is going to be distortion. The difference is that maps have latitude lines that act as a standard to measure distance against, where as panoramic radiographs do not. How can you tell me that there isn't enough room in my mouth for wisdom teeth based on that tool when the picture is distorted, and there is no standard to account for it? You don't know how much distortion is present in each part of the picture, and you don't know the absolute size of the objects in the picture.

In summary, the solution to my problem is superior to extraction in every way possible. If your doctor is telling you that you absolutely need to get those wisdom teeth extracted, it could be the truth or it could be BS. Some people really do have incorrectable, crooked teeth, some people do have impacted teeth that cause tons of cavities, some people do have orthodontic work that won't let their full dentition erupt, and it's a lost cause by that late date, BUT most people do not. The moral of the story is if it sounds like BS, it probably is. None of the explanations offered to me were intellectually satisfying. Using comm0on sense, I knew something was wrong. I took charge of my own health by researching options, so now I will save: $1100 -1200, all that pain, any possibility of infection or other complications, and last but certainly not least, I get to keep my teeth! Do your own research, find options that your doctors isnít telling you, and ensure your own health! Be informed!

Any questions, rejections, or rebuttals? I'm interested in what the response will be to my thread. Please post your sentiments.

-Jay123

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Old 06-06-2004, 07:27 AM   #2
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fyrelight74 HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

Um, I had impacted canines. They are NOT more common than impacted wisdom teeth (which I also had). They are the SECOND most common impacted teeth, wisdom teeth are the most common.

I had some dentists telling me to leave my wisdom teeth alone, and some saying to get them pulled. THey were totally vertically impacted in bone, but VERY close to my 2nd molars. I left them alone a while. I turned 30, started getting jawaches when I sang, and lots of headaches. I begged them to take them out. Jawaches and headaches are gone. Apparently they were pushing on my other teeth, even though they were not fully formed even. Just remember, for some people, if they leave them alone now, they might STILL have to get them out later, when they are older, and risk more complications. I had a blood clot develop in one cheek and a sinus connection created. They both healed, but if I were younger, I probably wouldn't have had those problems.

 
Old 06-06-2004, 02:35 PM   #3
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jay123 HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

Quote:
Originally Posted by fyrelight74
Um, I had impacted canines. They are NOT more common than impacted wisdom teeth (which I also had). They are the SECOND most common impacted teeth, wisdom teeth are the most common.
You can't group all wisdom teeth together when you're talking about statistical probability of impaction. The mandibular (lower) third molars are more likely to impact than the maxillary (upper) ones are. Mandibular 3rd molars are most likely to impact, maxillary canines are second most likely to impact, and maxillary 3rd molars are third most likely to impact. Which dental arch the teeth are on really affects the likelihood of impaction. I can dig up my sources if you like. I also agree that vertical impactions which try to erupt must be extracted because they will cause damage to the other teeth. If those impacted teeth had stayed encased in bone and not pushed upwards, then it would have been better to leave them alone. Unfortunately for you, this was not the case. What I'm angry about is the misinformation on mesial impactions which are far more common than vertical ones. These can be corrected in cases like mine, but the doctors decide to make a quick buck instead. [ removed ]

Last edited by moderator2; 06-06-2004 at 02:53 PM. Reason: This is not a professional advice forum, it is for non-professional peer-support only. Do not ask for dentists to post replies.

 
Old 06-06-2004, 02:44 PM   #4
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Doppler4000 HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

There is no wisdom tooth extraction conspiracy. Those teeth are just so prone to problems (even if erupted) later in life that for the average person it makes a lot of sense to do this routine procedure and never have to give them another thought.

Last edited by Doppler4000; 06-06-2004 at 03:05 PM.

 
Old 06-06-2004, 04:27 PM   #5
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jay123 HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

Doppler, it's all about the Benjamins. There is no conspiracy. It's just a lot of people doing what is best for themselves, making money. Routinely removing a natural part of the human body is assinine. We don't have parts that we don't need, and we don't have parts that habitually develop abnormally. Some people do believe this, however, because they are not aware of the current theory of evolution. The current theory of evolution disallows the existence of vestigial organs. These ideas come from a now defunct theory that was in vogue around the 1880s and continues in come circles to this day. I don't know how old you are Doppler, but do you remember a time when tonsils were supposed to be prophylactically removed or removed at the first instance of tonsilitis? Do you remember a time when the appendix was believed to serve no purpose and should be prophylactically removed simply to avoid the possibility of appendicitis? Well, we now know that both the tonsils and appendix are part of the lymphatic system. Do you remember a time when bottled milk was supposed to be better than breast milk and when mothers should only give birth when they are knocked unconscious with drugs? Do you remember a time when tooth fillings were believed to be better than natural tooth enamel? Prophylactic wisdom tooth extraction is simply another vestige of a bygone era of quack science. Just like tonsils and appendixes and breast milk and natural birthing and enamel, the function of wisdom teeth will eventually be vindicated.

Albeit, some people do need teeth extracted for one reason or another,but the prejudice against third molars will eventually end. Many impactions can be corrected, but the teeth are pulled unnecessarily. What's worse, healthy teeth are extracted too for no good reason. BTW, there are many theories about why wisdom teeth are the most common to impact. Very, very few wisdom teeth impact in people who live in third world countries or non-technologic societies. There have been a few studies on this. One theory is that soft, processed foods produce far less interdental wear, resulting in an overall longer dentition. People who don't eat processed food therefore have extra space in their mouths. It could also be racial. For some reason Europeans have far more impacted teeth than people from any other continent. There are a lot of theories and not much evidence, but it is clear that not nearly as many wisdom teeeth need to be extracted as are extracted.

Last edited by jay123; 06-06-2004 at 04:33 PM.

 
Old 06-06-2004, 06:31 PM   #6
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brwneyez9 HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

Ok. So it really sounds like maybe in the past you have just been burned by a dentist. Which i am very sorry if that is the cases.I don't know how it will only cost you $50.00 to have to teeth moved into place. Since they are not fully erupeted they will need to be to straighten them out. I don't know how old you are, but after a certain age you can expect not to get any more eruption out of them. So if you ask me $50.00 to erupt and straighten is BS. Lot of people don't get braces and still don't have room for them. You really need to think about this in the long run. Long run more expensive then just getting them taken out. I hate to tell you but it's not a money making thing for dentist. Dentist don't like to pull out healthy teeth. Impacted wisdom teeth can be not healthy. Like you said mesial impaction can cause so serious problems with the other teeth. Guess what not every one has all four wisdom teeth. Guess what that causes a problem. If you don't have the opposing tooth why have the other tooth. No need for it. So you go through the hasle and PAIN of having the wisdom tooth straighted and poss. erupted. Not to metion the cost of having ortho done on those teeth. Then guess what. For most people they are to far back to keep clean. So cavities that need to be replaced every couple of years making it more costly. So when you could of paid like 400 or so to have them pulled (All four with IV sedation). It really depends on the area you are in, how impacted, and if you want sedation or not. So you spend roughly I don't really know exact numbers 400-1000 dollars on getting them out. Or you spend that much having ortho done on teeth the in the long run you will be taking out later, because you can not keep them clean and there of no use to you. Let think about this how much on the popultion brushes and flosses their teeth. You will be suprised maybe, but not very many. Now out of the ones who do do this how many really brush and floss the correct way. Again when i ask people to show me how they brush or floss i in the 3 years not one person i have asked has shown me the proper method. Dentist are not out there to make money off of people to have wisdom teeth or anything else for that matter done.Also gum disease does come from not keeping that area clean. What happens is if affects the bone and gums surronding that tooth. Since the disease has to do with bone loss the infection really does come from around the root of the tooth. The bases for the infection. So as you are right it doesn't just spring up over night. If you can not properly clean aroun the 3rd molars that is something else to consider. There are alot of people who don't have perio disease have a very healthy mouth. When the get there perio eval. they usually show signs of it around the wisdom teeth. I have seen alot of cases like this, they have a really healthy mouth, but show concerns around the wisdom teeth. That is not good. Means they can not properly clean this area. Over time that is a huge concern. If you let that happen and continue perio disease can spread. It's infection. It can spread from one area of the mouth to others. You can every spread it to you partner.It's bactiera it just needs a place to grow. Well what ever you do i hope works for you. I don't see how it can be cheaper then gettig them taken out. You are talking about ortho and that isn't any cheaper then oral surgery.Ortho can be more costly. Then the cost if you need fillings b/c you can not properly take care of them. Good luck hope if works for you.

 
Old 06-06-2004, 06:35 PM   #7
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letsconnect HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

Hi Jay, great post! There are a lot of indicators that in some countries (and by some dentists), wisdom teeth are extracted too readily for no good reason, if the stats are to be trusted. Of course, this doesn't mean that situations which warrant the extraction of wisdom teeth don't arise.
Fair play for the amount of research you've put into this!

 
Old 06-06-2004, 07:21 PM   #8
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martid HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

People from third world countries also have less gum perio. disease problems because they do not eat soft and fast food. By the way oral surgeons and periodontists know about the images from x-rays being distorted. That's why they use tomography (spel ?) now. It's like an MRI and is very accurate. My daughter has all her wisdom teeth out now. So far she has no problem, so when her dentist offered to extract them in case they give her problems later, she said no. I hope she has no problems with them later in life, she is 32 now. Marti

 
Old 06-06-2004, 08:59 PM   #9
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jay123 HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

letsconnect,
Thanks for the encouragement. I just wanted to get the word out. I don't mean to condemn dentistry. Most dentists simply want people to have nice, healthy smiles, but I also hold myself personally responsible for my own health.
I refuse to blame the doctor if a correctly performed procedure does not give me satisfying results. That's why i research.

martid,
I'd be interested to learn more about tomography. This route was never mentioned to me, although I have heard it in reference to other branches of medicine. It wasn't until I contacted that expert that I ever learned the diagnostic limitations of x-rays. After he wrote that, I just thought back and said to myself, "Duh, there must be distortion just like in cartography." It should have occurred to me earlier. It's good that your daughter kept her teeth. By 32, everything in her mouth is pretty much set in position. Edit: FYI, My dentist wanted the wisdom teeth extracted based only on a bitewing x-ray in which she could only see the very edge of those teeth in the picture. It was really a radiograph of my premolars and 1st and 2nd molars, but you could just barely see the 3rd molars also. This was one of the first things that made me suspicious of just how accurate these diagnoses are.

brwneyez9,
I can only comment that you have some glaring factual errors. Periodontal disease starts with gingivitis which is due to plaque and tartar accumulating at the neck of the tooth. Keeping that pocket clean has everything to do with preventing periodontal disease. There are plenty of other errors also, some of which stemmed from you misreading what I wrote. For one thing, the correction does not require an orthodontist, and my price range was confirmed by two independent practitioners. I can also assure you that I am more than capable of maintaining my own dental hygiene. The condescension of one person on an internet board will not persuade me to believe that "you can not keep them clean and there of no use to you." I'm an adult, and I can take care of myself.

Last edited by jay123; 06-07-2004 at 01:18 PM.

 
Old 06-07-2004, 02:17 PM   #10
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martid HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

Jay, the reason I mentioned tomography is because that is what my periodontist used to place my lower implants, and also he uses this to see how much bone is in the area where he needs to place implants. I think it has been in use since 2002. My perio loves it, he said that it's the most accurate type of x-ray available to him to do the implant placement especially as in my case, he practically has to KISS the nerves in the the bottom molars area. I have a friend who had implants placed last year same area as I have, her surgeon only used to other x-ray, I forgot what it's called (the one that goes around your head, I had that one also with the tomograph), and he did not use the tomography, and she has been numb in the molar area for almost a year now because her surgeon did some damage to the nerve. Marti

 
Old 06-07-2004, 03:35 PM   #11
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jay123 HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

Martid,
Thanks a lot for the info. I'll try to repay you in kind. What your friend has is called paresthesia. The x ray that your friend had done was the panoramic x ray that we've been talking about. The machine for that moves an arm contraption around your head. Paresthesia from work around the molars is extremely common when doctors do not find out the exact placement of that alveolar nerve bundle. I've read that 10-12% of people who get lower wisdoms pulled get temporary paresthesia and 1% get permanent paresthesia. I don't have stats for implants, though. Most of the time, the dentist just bruises the nerve. That causes the temporary kind. It sounds as though your friend's dentist actually tore the nerve, and that is why the condition hasn't resolved itself. I strongly recommend that your friend consult a neuromuscular dentist. The nerve damage could probably be repaired. I don't know if full functionality would come back, but it's best to investigate.

 
Old 06-07-2004, 04:25 PM   #12
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martid HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

She said it's getting better, slowly. It still is not 100%, but much better than one year ago. At least she does not drool anymore. Thanks a lot Marti

 
Old 06-07-2004, 09:45 PM   #13
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jay123 HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

Marti
BTW, how much more does tomography cost than regular x-rays? Does insurance usually cover it?
It would be a good idea for your friend to stay away from that dentist. If her lower lip was so numb that she was drooling, that doc did something really, really bad. If he just sewed her up without mentioning it, I think there could even be malpractice charges pressed. Damaged nerves tend to get worse over time. Even if it seems like it's getting better now, the condition of that nerve could deteriorate as she ages and impede her speech in later years. Nerve repair is one of those things that has had huge advances in recent memory. Even after the better part of a year, the damage may be able to be completely repaired. I strongly, strongly encourage her to consult with a neuromuscular dentist. If money is a problem, she may be able to get her old dentist to pay for it. If the neuromuscular dentist looks at the damage and concludes that it was reckless and avoidable, she may have a case. I really hope every thing works out.

Last edited by jay123; 06-07-2004 at 09:46 PM.

 
Old 06-07-2004, 10:43 PM   #14
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martid HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

Hi Jay, I had the panoramic and tomography at the same time last year, and the total cost for both was 600.00, but I do not know what each procedure cost. Keep in mine I live in California where everything is more expenseve. And no, insurance does not cover that, not for me any way. But I think some of it might be covered if it is for orthodontics, not sure. BTW, when you get implants, you have to sign a form that specifically mentions the fact that there is a great possibility of temporary or permanent nerve damage (. So, as far as most dentists are concerned, the patient has been warned. I just happen to have a great guy for a periodontist, who really cares and goes out of his way to get it right. I already mentioned to my friend the fact that maybe she should take that further, but she does not want to, she keeps saying 'it's getting better, I'll be fine'. There are not really any good neuromuscular dentists here in my area, but there are some great ones in Los Angeles Marti

 
Old 10-03-2005, 09:53 PM   #15
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Mb1980 HB User
Re: If you think you need your wisdom teeth extracted, Read This First!!!!

Dear Jay123,
I had to register for this just to respond to one of your comments. I am just a regular lib arts college student, but I know a little about the history of wisdom teeth removal in relation to our ancestors. It may be true that tonsil and appendix removal has gone on unnecessarily and for profit motives/ignorance, but here is why our ancestors didn't have a hard time with wisdom teeth and we suddenly do: our ancestors simply didn't have good oral hygiene, and as a result, by age 20 or so, they had lost half of their front teeth, leaving ample room for the wisdoms. Medical advancements ran way ahead of man's evolution, and now we must find a solution, which has been inevitable removal of these back teeth. The irony is here--we take better care of our teeth and are left with an entirely new problem. Dentists may well often use the phenomenon toward a corrupt advantage, but a reason exists.

Last edited by Mb1980; 10-03-2005 at 09:55 PM.

 
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