What is the risk of nerve damage associated with wisdom tooth extraction? (photo)

Nerve damage is a known potential risk when extracting wisdom teeth, particularly when the roots of the lower wisdom teeth are in close proximity to the inferior alveolar nerve. Here’s an overview of the risk, preventive measures, and alternatives:
Risk of Nerve Damage1.- General Risk:- Temporary nerve damage (lasting weeks to months) occurs in up to 8% of cases.- Permanent nerve damage (loss of sensation or altered sensation) is much less common, occurring in less than 1% of cases.
2.- Factors Affecting Risk:- Proximity of the tooth to the nerve: When the tooth roots are closely related to the inferior alveolar nerve (as seen on X-rays or a Cone Beam CT scan), the risk increases.- Surgical difficulty: If the wisdom teeth are deeply impacted or angulated, it may increase the complexity of the procedure.
Coronectomy: A Viable AlternativeA coronectomy involves removing the crown of the wisdom tooth while leaving the roots intact to avoid disturbing the nerve. This is a suitable option if:- The tooth is in very close proximity to the nerve.- The roots are not causing symptoms and can be left in place safely.
It’s important to note:- Coronectomy carries its own risks, such as infection or the possibility of the roots moving over time.- A skilled oral surgeon will assess whether this is a viable alternative for you.
Importance of a Cone Beam CT ScanA Cone Beam CT scan (CBCT) provides a 3D image of the jaw, allowing the surgeon to:- Precisely evaluate the relationship between the tooth roots and the nerve.- Better plan the surgery to minimize risk.- Determine if a coronectomy is necessary.
What You Should Discuss with Your Oral Surgeon1. Ask About the Exact Risk in Your Case:- Based on the X-ray or CBCT scan, your surgeon can estimate your risk level.2. Consider a Cone Beam CT Scan:- If not already done, this scan provides the most accurate assessment of the nerve’s position.3. Discuss Coronectomy as an Option:- Ask if a coronectomy might be a safer alternative in your situation.4. Plan for Nerve Monitoring:- Some surgeons use advanced techniques or tools to minimize the risk during surgery.
Steps to Mitigate Risks- Choose a Skilled Oral Surgeon: Experience significantly reduces complications.- Discuss All Options: Including delaying extraction if there are no active issues with the teeth.
Dr. Miller Vieira