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I understand you have had pins and needles sensations around the lower left or right wisdom teeth area since an operation more than one year ago.
I feel sorry to hear that you have symptom of damaged nerves but it happens sometimes.
There are a few treatment options for numbness after wisdom tooth treatment including nerve regeneration surgery or nerve stimulation by laser or medications, or both combined together.
If you have already got numbness for more than 1 year then it is advised to see an oral surgeon to get an accurate examination.
Generally, wisdom tooth removal involving surgical extraction can be carried out with only local anaesthesia. With local anaesthesia, you will not feel any discomfort or pain during surgery since the tooth and surrounding area will be totally numbed.
General anaesthesic for wisdom tooth removal is hardly used. But it is occasionally used when the surgery is carried out at the hospital, which also requires other surgeries at the same time.
If you are particularly worried about the surgery, sedation would be a good option to relax during the procedure. This will normally be done with an injection into your arm. This procedure can be carried out at private dental clinic with an anaesthesia specialist.
Thanks so much.
Ryan Yun (Dr)
Thanks for your inquiries and I understand you are asking about wisdom teeth removal before braces. This is one of the most common questions when it comes to orthodontic treatment.
There are a few indications for wisdom tooth removal before braces treatment. But treatment is on a case-by-case basis between patients and dentists based on each individual case.
Wisdom tooth removal may be necessary in the following situations:
1. Non-extraction cases for braces but wisdom teeth are impacted
- Teeth alignment can be affected by wisdom teeth, especially if they are impacted, if braces are non-extraction cases.
2. If the teeth on the lower jaw need to be retracted, especially for protruding lower jaw cases.
3. If braces treatment requires a Temporary Anchorage Device (e.g. mini screw) placement around the wisdom tooth area.
4. Generally, if wisdom teeth are heavily decayed or food is trapped in a way which cannot be cleaned by brushing or flossing, this will cause even the loss of teeth beside the wisdom tooth.
5. If wisdom tooth cause gum infection around wisdom tooth and the second last molar area.
6. If there is a deep pocket between wisdom tooth and 2nd last molar, this can possibly cause gum infection.
Wisdom tooth is sometime very unpredictable in causing infection or etc. especially because it requires good care for wisdom tooth during braces treatment.
But wisdom tooth also can be extracted once braces treatment commences, if there are any problems from wisdom teeth.
Therefore it is not necessary to remove wisdom teeth if you can clean well or there are no caries at the moment. But it is advised to get them removed if it affects braces treatment.
Please fee free to leave any questions if there are more.
Thanks so much.
Ryan Yun (Dr)
Thanks for your question and I understand you have a question about wisdom tooth removal even if the wisdom tooth is not causing any pain.
Firstly, it's really important to be seen by dentist for any current wisdom teeth condition, even if there is no pain.
There are many ways that wisdom teeth can be in positions affecting surrounding structures, such as:
- caries (decay) on a wisdom tooth
- impacted wisdom teeth with gum infection
- wisdom teeth causing caries on the second last molar
Interestingly, most cases do not cause any obvious symptoms such as pain even if there are dental diseases caused by the wisdom tooth.
The most worrying thing is if it is too late to save even the second last molar once a patient experiences any symptoms around their wisdom teeth.
In most cases, if a patient has a severe gum infection around the wisdom tooth, including the second last molar, or has severe caries on a wisdom tooth, pain may come from the second last molar.
Therefore, the main purpose of wisdom tooth extraction is more to prevent the loss of the second last molar or serious gum infections, which most likely would happen based on research.
These cases are typical examples where a dentist may recommend wisdom tooth extraction even though there may be no pain:
1. Caries (decay) on a wisdom tooth
In this case, a filling can be done if necessary or the wisdom tooth is fully erupted in the right position.
2. Gum infection around wisdom tooth (including the second last molar engaged)
3. Impacted wisdom tooth (not fully erupted). In this case, part of the wisdom tooth is visible.
- If a wisdom tooth is impacted, the area around the wisdom tooth is most likely not easy to clean.
This includes the wisdom tooth itself and especially in between the second last molar and wisdom tooth.
- This can cause bone resorption of the second last molar, which cause the shaking and loss of the second last molar
- This can cause decay on the root area of the second last molar, which cannot be treated by filling, so it should only be extracted.
- Constant trapping of food in between the wisdom tooth and second last molar could potentially cause gum infection and caries on wisdom tooth and second last molar, which will cause the loss of both teeth.
4. Dental cysts or tumors around wisdom tooth (this does not happen very often)
Number 1 and 3 occur the most often at my dental practice in cases of wisdom tooth removal before the wisdom teeth cause any pain, from my experiences.
The above are very simple examples. The wisdom tooth is sometimes like a "bomb" which potentially causes many problems for those cases.
So it is advised to get a proper examination with an X-ray and get wisdom teeth removed for above cases to prevent from further pain. This is especially since healing time is longer after wisdom tooth extraction if the wisdom teeth caused pain, compared to if the wisdom teeth caused no pain.
Preventing complications is better than wisdom tooth removal after symptoms occur if it is a very obvious case.
Thanks for your valuable question about wisdom teeth and I hope my answer is helpful for you.
Please feel free to contact us or leave further question if there are further questions.
Thanks so much.
Ryan Yun (Dr)