Will I need general anesthesia for wisdom tooth extraction?

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I am 44 years old and have three impacted wisdom teeth. One tooth is under the bone. I am wondering if general anesthesia is necessary or if sedation is enough. I’ve never had general anesthesia, and I prefer not to get it. Thanks. Wade from AR

 

Wade,

Thank you for your inquiry. Although we do not have your case details, most wisdom tooth extractions do not require general anesthesia. Other levels of sedation work well with extractions without making you unconscious, like general anesthesia.

Moderate Sedation for Wisdom Teeth Extraction

Four diagrams of impacted wisdom teeth that require sedation dentistryIntravenous, moderate sedation is known as twilight sedation. Your state will be between awake and asleep. And you will drift in and out of consciousness. Most patients do not remember anything about the procedure except feeling sleepy and relaxed. Moderate sedation offers deeper relaxation than sedation with nitrous oxide, which gives you a sense of well-being while you are fully awake.

Deep Sedation for Wisdom Teeth Extraction

Deep sedation is drug-induced, depresses consciousness, and prevents you from awakening easily.

General Anesthesia for Wisdom Teeth Extraction

General anesthesia makes you completely unconscious. Risks increase with general anesthesia, too.

What Makes Some Wisdom Teeth Extractions More Difficult?

As we age, several factors can make wisdom teeth extractions more difficult. And your dentist will recommend sedation based on your sensitivity and condition of your teeth.

  • Bone – The older the bone is, the less pliable it becomes.
  • Cementum – Calcified bone-like tissue at the tooth roots accumulates. Although cementum and can make extractions more challenging, an oral surgeon or a dentist with experience in wisdom teeth extractions will be successful.
  • Position – Impacted wisdom teeth may grow sideways or lean against other teeth. A skilled dentist or oral surgeon can remove them without harming nearby teeth.

Sedation Second Opinion

If you need a tooth extraction, but your dentist or oral surgeon recommends general anesthesia, ask why. Underlying factors might be influencing the recommendation. If not, you can get a second opinion from another sedation dentist or oral surgeon to discuss your options.

 

Dr. Steven Brooksher of Baton Rouge, LA, sponsors this post.

When will jaw numbness after wisdom tooth extraction go away?

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A week after getting all my wisdom teeth extracted, the lower left side of my jaw still felt numb. Three days ago, the oral surgeon did sensation tests. I will return in two weeks for a follow-up appointment.

The numbness is causing problems when I eat and brush my teeth. Did the IV sedation affect my jaw nerve? Is there anything else I can do to improve the situation? Is this common, or should I be more concerned than the oral surgeon seems to be? – Thank you. Tiffany P. from Athens, GA

Tiffany,

Thank you for your inquiry. Your description sounds like your lower-left jaw nerve is damaged. The extent of the damage determines how much the nerve will recover.

Nerve Damage with Wisdom Tooth Removal

Nerve damage can occur with wisdom teeth removal because the nerve for your lower teeth and lip is close to your wisdom tooth roots. During wisdom tooth removal, the nerve can be damaged. But the damage is not related to receiving sedation to help you relax before the procedure. Before surgery, an oral surgeon should do the following:

  • X-ray your teeth and jawbone to see the location of the nerve
  • Notify you of the risk of damaging the nerve during wisdom teeth removal

Many surgeons overestimate the risk of nerve damage to protect themselves from possible lawsuits.

Categories of Nerve Injury During Wisdom Tooth Removal

The three categories of nerve injury during wisdom tooth removal have different results:

Photo of woman sitting back in a dental chair with her eyes closed; for information on Baton Rouge sedation dentistry during tooth extraction.

Sedation relaxes you during tooth extraction but does not cause lingering jaw numbness

  • Bruised – You will feel numbness for about a month, after which the feeling will return.
  • Crushed – Symptoms last about a year as new nerve fibers grow.
  • Severed – Permanent injury prevents nerve fibers from regrowing, and you will continue to experience symptoms.

What to Expect

  • Depending on the extent of damage to the nerve in your jaw, you may not see improvement when you return to your oral surgeon for a checkup.
  • It may take a month or up to a year for improvement. If the nerve can recover, you will begin to feel tingling in your lip as it heals.
  • Some patients say that their body adjusts to the numbness and symptoms become less intense even with a severed nerve.

Although there isn’t anything you can do to repair the nerve, try to be patient as you wait for signs of improvement. Your oral surgeon can advise you on how much progress you might expect to feel over the next few months.

 

 

Steven Brooksher, DDS, of Baton Rouge, sponsors this post.