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Wisdom For The Pain

Tribune file photo

Complications such as paresthesia - nerve damage upon extraction - can occur even with the most proficient of dentists.

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By PHILIP MORGAN | The Tampa Tribune

Published: November 6, 2008

It was when the dentist was banging away with a professional version of hammer and chisel that I questioned the wisdom of having my wisdom tooth extracted. And maybe it wasn't smart to go to a discount dental clinic.

The dentist was having a terrible time. He seemed to panic in the middle of the procedure, muttering that he'd never encountered such a difficult problem. He brought in a colleague to help.

By the time they got the tooth out, I had lost too much blood. They summoned my wife back to the room, where paramedics were giving Lazarus a transfusion.

But, hey, don't let that discourage you from getting your wisdom teeth out.

I survived, though my jaw half-died. Even today, some 30 years later, I have a partial numbness on the right side of my chin and lower lip. Sometimes a tingling sensation makes me think everything is about to wake up. No luck.

Paresthesia, the condition is called. In my case, it's the result of damage to the inferior dental nerve running along the lower jaw. In some cases, it's another nerve that's damaged, and that causes a numbness of the tongue.

At first, I thought this was the fruit of my practitioner's discount dental degree. On an earlier visit, his colleague told me they called him "Thumbs." I laughed, thinking he was joking.

Although Thumbs didn't inspire confidence, I can't be sure he bungled the job. I learned that paresthesia can occur in patients who visit the most competent clinics.

"I would argue that most of the time it's not because of a poor job," says Thomas B. Dodson, an oral surgeon at Massachusetts General Hospital in Boston and expert speaker for the American Association of Oral and Maxillofacial Surgeons. "It's a basic anatomic problem."

If the root of the wisdom tooth has grown down to the nerve - a risk of waiting too long to remove it - there's a greater chance of nerve damage during extraction. It could heal in a few days, weeks, months or, well, I'm still waiting.

Still, paresthesia is rare, happening in about 1 percent of cases, Dodson says. And the kind of luck I have is rarer still. Dodson says the chance of permanent nerve damage is 1 in 1,500 or 2,000.

Not much could be done about the problem 30 years ago. Now, Dodson says, surgeons can reconnect the severed nerve strands and improve the sensation, though rarely do patients recover completely.

Dentists debate whether wisdom teeth should be taken out as a matter of course. Dodson says if patients don't appear to be having a problem, he brings them back every year to re-evaluate. Statistics show that 85 percent or more of the population will have a problem with their wisdom teeth - they decay, or get infected, or come in sideways and push other teeth out of alignment.

Patients 20 years old and younger fare best in these operations. As people age, the wisdom teeth roots grow deeper and the jawbone grows denser. I was about 30 at the time of my ordeal.

For my left wisdom tooth, I decided against bargain dentistry. I went to an oral surgeon, who knocked me out instead of letting me watch the horror on Novocain. It was a breeze - no numbness, no transfusion.

I'm sure there are excellent discount dentists out there. Just make sure yours isn't called Thumbs.

Reporter Philip Morgan can be reached at (813) 259-7609.

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