wb

Post some x-rays and I will gladly give you my opinion.

Anything less and I would be guessing.
--

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steven bornfeld

I'm not sure I understand this. Certainly, if the risk(s) of
extraction are expected to be greater than the risk(s) of retaining the
wisdom tooth, you would expect to defer extraction unless and until that
equation changes. You also can't rule out the possibility (depending on
the relative positions of the second and third molars) that damage COULD
be done to the second molar during extraction. But why would the
dentist expect the crown to be fractured?

This sounds very black and white; in practice it is not. Partially
impacted wisdom teeth can contribute to periodontal damage to the second
molar without clinical infection. While I am on the conservative side
with respect to advising extractions of assymptomatic teeth, in practice
the criteria are not rigid and this is a judgement call.

I can only say that there are no hard and fast rules. I would advise
you get a second opinion. Based on your lack of symptoms, this does not
sound urgent.

Steve

jpstahl

The first (MD) dentist didn't "expect the crown to be fractured".
However, in laying it he had to go very deep - almost to the root-
and couldn't be sure how long it might hold. In his words: "It may be
two months, two years, five years or ten years, I just can't say for
certain."

However, if and when the crown did come off, he advised that the nerve
from the adjoining wisdom tooth would be best to use- to preserve a
root-bearing artifact- instead of having to fit for a denture or some other appliance.


That certainly sounds reasonable, but there's no evidence from where I
sit (or chomp) that either of my wisdom teeth are the least bit impacted.


I tend to agree with that, so that - all things being equal don't
intend to be drumbeaten into getting (possibly unnecessary) work done-
in this case wisdom teeth removal.

Btw, the authors ('The Whole Tooth') previously cited, noted the
millions of man-hours of productivity lost - because of unnecessary
wisdom tooth extraction- including the analgesic-anethesthetic effects
in the aftermath.

What I think: "If it ain't broke, don't mess with it".

Thanks again.

wb

This is not a "black & white" issue.
Each case must be evaluated on its own merits.
If the risk of future pathology is significant, then
removal of the WT is often indicated.

We had a lady here a few months back who's son
lost a significant part of his Maxilla and associated
boney sinus structures due to an ameloblastoma
associated with an impacted WT.

Prevention must always be considered.
I have no problem with 'letting sleeping dogs lie'
as long as there is minimal risk.

WB
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Take out the G'RBAGE to reply
wubbabubbazG@RBAGEyahoo.com

mark & steven bornfeld dds

Good advice. Remember the "as long as". Steve


--
Mark & Steven Bornfeld DDS
Brooklyn, NY
718-258-5001
http://www.dentaltwins.com

lefort3

-->
-->
-->WB wrote:
-->
-->> On 8 Sep 2003 09:31:10 -0700, jpstahl@msn.com (P.A. Stahl) wrote:
-->>
-->> >Btw, the authors ('The Whole Tooth') previously cited, noted the
-->> >millions of man-hours of productivity lost - because of unnecessary
-->> >wisdom tooth extraction- including the analgesic-anethesthetic effects
-->> >in the aftermath.
-->> >
-->> >What I think: "If it ain't broke, don't mess with it".
-->> >
-->> >Thanks again.
-->>
-->> This is not a "black & white" issue.
-->> Each case must be evaluated on its own merits.
-->> If the risk of future pathology is significant, then
-->> removal of the WT is often indicated.
-->>
-->> We had a lady here a few months back who's son
-->> lost a significant part of his Maxilla and associated
-->> boney sinus structures due to an ameloblastoma
-->> associated with an impacted WT.
-->>
-->> Prevention must always be considered.
-->> I have no problem with 'letting sleeping dogs lie'
-->> as long as there is minimal risk.
-->>
-->> WB
-->
--> Good advice. Remember the "as long as".
-->

Oh the good old 'as long as'. Not bad advice at all. I tell it like it
is; infections happen, cavities happen, tumors happen etc. because its
informed consent. If they (patient) don't want them out, their not
coming out. The bad thing about the 'as long as' is, they tend to
arrive rude, obnoxious and unannounced. Dave
-->Steve
-->
-->>
-->> --
-->>
-->> Take out the G'RBAGE to reply
-->> wubbabubbazG@RBAGEyahoo.com

~~~~~~~~~~~~~~~~~~~~~~~~
David A. King, DMD
Diplomate, American Board of Oral & Maxillofacial Surgery
Fellow, American Association of Oral & Maxillofacial Surgeons
AAOMS Special Committee Member
HTTP://WWW.DEOMFS.COM

carabelli

Third molars suck. I used to refer for extraction. Now I refer for
evaluation of the third molars. CMA.

Consider this, all of my own kids will be referred to have them out. Two
are almost ready, one isn't yet. The oldest had a missing lower second
bicuspid (closed that puppy up after the deciduous second molar was removed
with ortho) and I am waiting until that last potential mandibular (males
only) growth spurt has had its' chance. Maybe one can be functional.

More often than not, with the skewed population that I see as an ortho, most
would IMHO benefit from having them removed. Recovery is easier when you are
young. There is no black and white answer with regards to thirds. However,
at least in my area, most oral surgeons are well are of the possible morbid
sequela and practice appropriately.

carabelli

linda

I agree carabelli - same for my two boys. One son has had them extracted,
the other will in a couple years. People usually can't clean around them
properly. Heck, I can't clean them properly half the time. Most seem to
eventually get infected in some way.
Hate the eights.
Linda.
(hygienist .... from Canada)

carabelli

That's quite a bit more poetic than "third molars suck".

Could apply to my golf recently also.


carabelli

linda

LOL - you guys are great.
Linda.