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Terrible tooth pain on lower left side of jaw, Dr advised extraction of both lower and upper wisdom tooth. Is it ok ?

Hello Dr, I am a 35 years old female. Few weeks ago, I experianced terrible tooth pain on the lower left side of my jaw. The pain worsened while chewing or when my upper tooth met with the lower one. I consulted a dentist who said i need to extract both the lower and upper left wisdom teeth which has cavity and are decayed. He said he can t fill it up or have a RCT on them as its not adviced on wisdom tooth . He didn t take Xrays. He said i shouldn t worry much as he will just give me a local anesthetic and pull both the wisdom tooth out at the same time as they are fully erupted. I have sheduled an appointment next week for extraction and I am very worried. Do you think i should ask him to take xrays? And should I extract both teeth at the same time or should i just go for one at the time? And what post operative measures should i take after the extraction. Awaiting your early reply soon. Thanking you in advance!
Asked On : Sat, 3 Nov 2012
Answers:  4 Views:  983
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Dentist 's  Response
Welcome to HCM
I would like to tell you that if your wisdom teeth are decayed then its better to get them extracted rather than getting rct because wisdom teeth don't play any role in mastication.
But i would like to tell you that don't get it done without x-rays because its unethical.
Also don't get it done together because they are of different region.
Do take Tab Zerodol-SP thrice a day after extraction along with Tab amclaid-625 twice a day for three days.

Answered: Mon, 5 Nov 2012
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Dentist Dr. Geoffrey Ward's  Response
Hello and thank you for your question.
Your dentist should ALWAYS take a radiograph on an infected tooth esp wisdom teeth. I find it unethical to extract a tooth without taking a radiograph to see where it is in association to the inferior alveolar nerve (the nerve that gives you feeling in you lower jaw and lip) or to the maxillary sinus. If there is an infection present he/she does not know the extent of it. Based on ADA code of ethics, you must have proper diagnosis of disease before treatment can be rendered. For instance, you can't determine if there is an acute abscess, chronic abscess, acute apical periodontitis or chronic apical periodontitis or how much tooth structure is actually remaining without a radiograph. A panoramic radiograph is standard of care when it comes to extraction of wisdom teeth. Most oral surgeons I know will refuse to extract wisdom teeth without an up-to-date pano in their hands. Fillings and root canals on third molars is typically not advisable but it depends on position and if they were involved in orthodontic therapy. Such has you had one or both premolars extracted and your wisdom teeth are in full functionality.

You should get both extracted at the same time. This is one period of surgery, one period of healing, one period for pain and swelling and feeling lousy.

What to do for post op:
-bite on the gauze firmly for one hour. Do not chew it
-do not suck on anything for a week
-do not forcefully spit, let it ooze out of your mouth and catch it with a napkin or paper towel
-take NSAIDs and narcotics prescribed without missing a dose, stay ahead of the pain.
-first 24 hours you can ice your face. 20 minutes on 10 minutes off for 1 hour 3 times a day
-next 5 days: warm moist heat 20 minutes on 10 minutes off for 1 hour 3 times a day
-clear liquids for the first two days then gradual soft foods. PROTEIN PROTEIN PROTEIN! Eat high calories you need them to heal
-Absolutely no: carbonated, alcoholic, caffeinated, hot or acidic beverages
-after the first 24 hours you can swish and spit warm salt water: 1/2 tsp salt 10 ounces warm water - swish and spit the whole glass 4-6 times a day esp after meals.

Best regards

Dr. Ward
Answered: Sun, 4 Nov 2012
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Dentist Dr. Mukesh Asrani's  Response
I am Dr. Mukesh Asrani and would like to answer your query. Wisdom teeth do cause trouble as they erupt very late. If they are decayed, they can cause too much pain as in your case. Extraction of wisdom teeth is the best option as root canal treatment is very difficult for these teeth.
Don't worry, your dentist will take an X ray before doing any procedure over the wisdom tooth as it is the routine procedure. I would advise you to get both the teeth removed at the same time so that you dont have worry twice. As both teeth are fully erupted, there should be very less difficulty in removing the same.
Post operatively, you should take the medication as prescribed by your dentist, have soft diet, have ice application extra - orally, keep your oral hygeine good, etc. Occasionally there are chances of minor swelling post operatively but it subsides usually in 2 - 3 days. Stiches are taken depending upon the extraction wound.

Thank you and take care
Dr. Mukesh K Asrani
Answered: Sun, 4 Nov 2012
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Dentist Dr. Bibhu Dutt Nanda's  Response
hello and welcome to HCM forum,
i am glad you wrote to us,
i would like to inform you that extracting a tooth without taking an X-ray is not acceptable,
and extracting two teeth at a time is also ideally not recommended,therefore i advise to ask your dentist to view an x-ray before extracting a tooth , it will help diagnose the infected tooth.
only the tooth which is bothering you more out of the two should be extracted first,
if you are unable to convince your dentist, kindly take a second opinion from an oral surgeon.
i hope i answered your query,
i wish you good health,
take care.
Answered: Sun, 4 Nov 2012
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