Lessons learned from dental malpractice cases: Risks and precautions when having wisdom teeth pulledPeople over 25 years old have higher risk, require extra precautions
Wisdom tooth extraction problems—they’re the most common type of dental or oral surgery medical malpractice claim that our firm is asked to review.
Wisdom teeth are also known as third molars. In the dental numbering system, the upper wisdom teeth are tooth numbers 1 and 16, and the lower wisdom teeth are numbers 17 and 32.
These teeth are the last adult teeth to come in. They’re also often problematic and pesky. Dentists may recommend removal or extraction of wisdom teeth for reasons including:
• Impaction, which means the wisdom tooth/third molar never breaks through and remains stuck below the gums, where they can decay or cause pain.
• To reduce crowding in the mouth.
• Because of decay or infection.
Although some general dentists perform wisdom tooth extractions, many experts believe that because of the added complexity and risks, the procedure should be performed by oral surgeons. Oral surgeons have additional surgical training, including best practices for pulling wisdom teeth.
Age is a risk of wisdom tooth extraction
I had my wisdom teeth extracted when I was in 10th grade, at the recommendation of my orthodontist. That’s within the typical time window for safe removal of wisdom teeth.
The Parameters of Care published by the American Association of Oral and Maxillofacial Surgery strongly advises that a decision to prophylactically remove impacted wisdom teeth should be made early, because the risks of surgery climb as the patient gets older: “To limit known risks and complications associated with surgery, it is medically appropriate and surgically prudent to remove these impacted third molars before the middle of the third decade and before complete root development.”
The middle of the third decade is 25. This means that there are added risks for patients having wisdom tooth extraction after that age. In older patients (yes, 25+!), the mandible (jaw bone) is denser and has less plasticity.
Complications of wisdom tooth extraction
If too much force is used to pull wisdom teeth, it can leave a patient with a broken jaw and permanent injury to the inferior alveolar nerve or lingual nerve.
• A broken jaw requires surgical repair. That’s what happened to our client in his 30s. Let’s call him Clyde. Clyde had to have a painful open reduction and internal fixation (ORIG) surgery after a general dentist pulled his lower wisdom teeth and broke his jaw.
• Inferior alveolar nerve damage can cause numbness, tingling, or a burning or electrical sensation in the chin, lips, gums, drooling, and speech problems. That’s what happened to another one of our clients in her 30s. Let’s call her Kaye. Her general dentist recommended wisdom tooth extraction, even though they weren’t causing her any problems. One of Kaye’s lower wisdom teeth had deep roots that crossed the inferior alveolar nerve. The dentist used excessive force and severed the nerve, leaving Kaye with a permanent feeling of being under dental anesthesia.
• Lingual nerve damage can cause patients to experience altered or absent taste, numbness or pain in the tongue, drooling, and speech problems.
Reducing the risk of pulling a wisdom tooth
Oral surgeons typically recommend against extracting wisdom teeth in older patients, unless they’re causing problems. When third molar extraction is indicated as necessary, oral surgery experts recommend the consideration of surgical techniques to reduce the risk. These include:
• Coronectomy, which involves surgically removing the crown of the tooth, but leaving roots in place.
• When extracting the entire wisdom tooth, using a drill to trough around the bone and then split the tooth into two or more sections.
I’m glad that my parents took me to an oral surgeon when I was 16 years old for extraction of my wisdom teeth. If our children need their wisdom teeth removed, we will seek a qualified oral surgeon, rather than a general dentist, for this higher risk work.
If you’ve been seriously injured because of poor dental care involving wisdom tooth extraction, then contact a top-rated, experienced Texas dental and medical malpractice attorney for a free strategy session about your potential case.
Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.
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