Question:
My wife had an infection about a month ago, which, according to one
dentist, emanated from an infected wisdom tooth. He prescribed a
pencillin dose to defeat the infection and then recommended she have the
tooth out. Considering this history, would one recommend or not recommend
extraction? She has had no further difficulty with it in the last month.
The dentist suggested it was impossible for her to clean that tooth, but
she showed him how she could reach it.
Answer:
The infection will be back; I guarantee it. Tell your wife to get the
wisdom tooth out. If you need a referral to a good oral & maxillofacial
surgeon in NYC.
After the age of 24 or so, the wisdom teeth stop erupting. There is little
chance that they will come into adequate position and contact with the
opposing teeth if they haven't by age 24. If the tooth is covered by a
flap of gum tissue, it will remain so in all probability. This is a
situation which predisposes to an infection around the crown (under the
gum tissue) of the wisdom tooth. If this is the case, the infection will
likely return unless the tooth is removed or the gum tissue surgically
excised (done by some periodontist; oral and maxillofacial surgeons prefer
extraction of the tooth).
If you don't ever want to have another infection associated with this
wisdom tooth, then it should be removed. If you want to go on
antibiotics every time it flares up, (which it will), then leave it.
In 1980, a consensus conference held by the National Institutes of Health,
National Institute of Dental Research defined wisdom teeth removal
criteria. The criteria are, in part, infection, non-restorable carious
lesions, cysts, tumors, and destruction of adjacent teeth and bone.
Complications may be reduced if impacted teeth are removed at an early
age.
