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Dental x-ray attached. Wisdom teeth need to be extracted ?

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Dentist, Pedodontics
Practicing since : 1981
Answered : 24 Questions
Dear Sir or Madam
Pls find attached my x-ray. No current pain/issues.

1. Do my wisdom teeth have to be extracted? -Why?/Why not?
2. Which teeth are easy to extract, which difficult/impacted?

Posted Mon, 7 May 2012 in Dental Health
Answered by Dr. Amitabha Chakraborty 17 hours later
Dear Madam,
Thanks for the query.

Impacted tooth is generally caused by more tooth- less bone ratio, where the the third molar does not have space to be erupted in the occlusion.

The most common cause of pain from impacted tooth is the inflammation in the soft tissue covering over the offending tooth(Pericoronitis), mostly caused by food impaction in the soft tissue space over the tooth and/or bite injury over the soft tissue covering the impacted tooth, by upper molar tooth.

In Your case both of your lower third molar is vertically or mild distoangularly impacted and it is a partial bony impaction, i.e. part of the tooth is lying under the bone.

As your third molar has remote possibility to be erupted in the mouth(as cover by bone and no space to be be erupted) the symptom like pain may frequently appear. The Third molar has no function for mastication(chewing) or maintaining occlusion, so it is always better to extract the tooth when it starts causing problem.

In an experienced surgeons hand your impacted tooth can easily be extracted without causing much problem. You may have a mild pain and facial swelling for couple of days after extraction( as some amount of bone is to be removed) and you can also join to your work in couple of days.

Better to do it at weekend.

Hope i have answered your query.I will be available for follow up.

Above answer was peer-reviewed by
Follow-up: Dental x-ray attached. Wisdom teeth need to be extracted ? 14 hours later
Dear Dr. Amitabha

Thank you for your response.

a). At the moment, I don't have any pain or issues. Do I still need to remove them? - Or should I wait until problems occur?

b). If I want to have all 4 removed, is it possible to do 2 first, then 2 after 6 months? (insurance reasons).

c). If b is possible, which ones would you then recommend to take our first
(2 on right side/2 left side six months later OR 2 bottom/2 top six months later)?

Thanks and best
Answered by Dr. Amitabha Chakraborty 13 hours later
Dear madam,
Thanks for the query .

As in your case it is a bony impaction, certainly your problem will recur.

To avoid that recurrence, it is advised to extract those teeth as early as possible. If your surgeon planned to it under General Anesthesia(GA), then it is advisable to remove all four in one sitting.

If you do it under local anesthesia, then it is better to extract the lower pair first, then the upper pair.

In that case you can even extract it one at a time , depending upon your tolerance. The first one should be the tooth which is having more problem.

The extraction of upper pair can be postponed for the time being, to see whether it is really causing any problem after extracting the lower pair.

It is possible that the upper tooth will move down(supra-erupt) to the space of the extracted lower tooth and create periondontal problem and pain. The upper can be extracted if such problem arise, otherwise it can be kept as it is. But in case of GA(general anaesthesia) we remove all four, as 1.

We do not want to keep any chance for further problem . Upper third molar are also a pair of useless teeth like lower third molar and 3. It is unwise to put the patient in GA repeatedly.

Hope I have answered your query.I will be available for further follow up.
Above answer was peer-reviewed by
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