Oral Surgeon Insists on Drilling for Wisdom Tooth, No Options — Any Thoughts?

I have an upper right wisdom tooth that broke from decay at end of 2019. I started actually having pain recently, which just so happens to align with the fact my BOTTOM left also broke off, a side/center piece of it. From decay as well. Idiocy on my part for allowing this to happen and not going into a cleaning for last few years due to fear of tinnitus worsening from cleaning, which is just stupid.

The news was broken to me, from a very good oral surgeon where I'm at that unlike the top, the bottom must be drilled to be taken out. No other way. It's fully exposed like all my wisdom tooth, but because of the decay in the middle I guess it makes it hollow and a problem with how rooted wisdom tooth can be at 25+ years old and tightly conjoined to the jaw muscles/nerve.

So now I sit here, with tinnitus/hyperacusis that I've gotten to a bearable place, with recently (last few years) acquired Middle Ear Myoclonus vibrating which has taken over as the hell on earth for me, NOW have to get the tooth drilled and sectioned.

I KNOW this is going to make my tinnitus worse and damage me. It's not possible not to. My ears are in bad shape, genetically I'm prone to noise damage. Got my original tinnitus mind you from ONE musical festival at age 18, worsening at age 24 or so from a wood saw outside my window when I was asleep. So that's how bad off my ear resilience is.

I don't know what to do. The oral surgeon knows nothing about tinnitus really, thinks just plugging the ears with earplugs can perhaps help. Which would make it sound 10000x worse through bone conduction. He also wants to put me out. So, I wake up with the worst tinnitus imaginable? I'm already worried about the nerve getting nicked and having permanent numbness and nerve damage in the jaw and lip. Now this.

Is there no other procedures in 2022 with oral surgery to take out bottom teeth that are broke without drilling to section it? This guy isn't a tinnitus expert, but he's a really good oral surgeon, one of the best in the area. He doesn't believe there is any other way.

I feel absolutely screwed here, all self-inflected.

 

Has anyone had an electric handpiece used to split a wisdom tooth? Is it typically fast? I can't find an oral surgeon that will do it without splitting, as the root curve and closeness to nerve makes it impossible to use a manual tool.

I feel like I have no options here.

 

I haven't, but I have two sets of implants from before I had tinnitus. The thought of drilling into the bone would be daunting, but it sounds like you've got no alternative really, just make sure he agrees to drill for no more than 5 seconds at a time, then a ten second gap.

Also some dentists are starting to use laser drills rather than conventional ones. Laser drills are quieter and probably faster as well, and are effective at removing bone. I found a dentist in my city using them and they are much quieter and more comfortable.

I think @Greg Sacramento has knowledge or experience of dental treatment and its effects on tinnitus, so tagging him here.

 

I like - agree.

Use a small pillow on headset and keep head on it during entire procedure. Doing this will protect jaw and neck.

 

Hi @Mister Muso -- This is great information, thanks for sharing it!

 

The laser is quiet but the compressor driving it makes some noise. Earmuffs would take care of that.

Don’t know if they can use laser for prepping a tooth before crown or in this case splitting it.

Should be checked out.

 

I've not had a problem with noise from the compressor. As long as the dental surgery isn't too small it should be possible to position it at a comfortable distance.

There are some tasks for which my dentist tells me it's better to use a conventional drill. I don't know what they are, but there are dentistry forums where I'm sure you could ask for more information. I've certainly read that laser drills are effective for removing bone, which I'd have thought isn't so different to splitting it though I could be wrong there.

 

Thank you. I've been trying to find someone that does this, but it's been challenging. Most oral surgeons seem to be doing the same thing. No issue with their conventional drills for cutting jaw bone so why change, I guess is the thought process here. I'm seeking alternatives like a root canal but haven't had luck yet. The decay hasn't reached the pulp, or is just very close to it. I'd prefer to just have it cleaned and sealed. Don't care how it looks, it's just a wisdom tooth. But having trouble finding someone to entertain it.

Thanks Greg, so you think a small pillow with a headset would be needed? Am I concerned over nothing over the vibration of the drill hitting tooth/jawbone and noise damage that way to the middle ear, and occlusion effect?

 

Dear friend, use a small pillow on headrest and keep head on it during entire procedure. Doing this will protect jaw and neck. Also consider taking a Magnesium tablet one hour before appointment.

Drilling should be 5 seconds with a break of 10 seconds.

Dentists are very much against wisdom tooth repair as infection will probably happen at some point and that could spread to other teeth and jaw. A root canal or filling may only be possible if there's very little decay and tooth is still positioned normally. There would be some drilling with a root canal or cleaning to fill. More decay and tooth movement with that wisdom tooth will probably happen after treatment within months to three years if tooth isn't gently cleaned with a soft brush right after every meal or after drinking something that contains sugar.

How have you been otherwise? I just looked out my sliding glass door from where I'm sitting, and a bobcat was on my porch. It's about midnight, can't sleep.

 

@Greg Sacramento, why do you suggest Magnesium and how much do you recommend?

 

I've been attempting to find an endodontist who can use laser to clear the decay/remove tooth portions instead of a drill, but not having a lot of luck. Seems far and few in-between that are using the tech.

Supposedly laser can take care of decay, cut the teeth and used in root canals. Just need to find one, which is the problem.

Although I can't seriously entertain it currently, I almost wonder if drilling for a root canal would be better than the drilling a removal would require. To have to drill to section a lower wisdom tooth (if I'm lucky into two pieces) and drill into the jaw bone to create some type of gap area for the section area to easily move into for removal, seems like a lot compared to just removing decay and finishing up with the waterlaser treatment to clean out the root.

 

Hi, can you tell us how it all went for you?

 

I hope it went well. I'm also worried about this because I predict I will have a similar procedure at some point.

 

Noise-cancelling headphones work for me at the dentist. Earplugs would make everything louder internally.

 

I also need to see an oral surgeon to have a root canal near top front where my gum is swollen & infected. I haven't even had any drilling since I ended up with reactive tinnitus & hyperacusis a couple of years ago so this is terrifying for me.

Someone told me to take NAC supplement 2 weeks prior to drilling. I have no idea if that will help with anything.

 

Why not contact a dentist who can do laser dentistry?

 

A regular dentist can not do the root canal that I need & the endo I was referred to, who is considered best in the city, does not do laser either & there doesn't seem to be anyone in my city who is a root canal specialist that does laser root canal.

 

Any updates?

 

I held off as long as I could, but during then and now I got my top wisdom teeth out which was an easy pull, and did some cavities with laser (saved my ears).

Now, the bottom tooth which is the big issue, is in bad shape right now. I have no choice now, as the pain is too much. Looking at two options:

1) Laser that cuts bone/tooth, which I'm seeing someone for that can section the tooth with a high-powered laser. Problem is, they're not an oral surgeon. Also, the complexity of having to leave a part of the bottom tooth, which is touching the nerve, so I suspect some drilling will have to horizontally be used once the laser sections.

2) Advanced endodontist who uses a lot of high-tech stuff normal ones don't, to try to save the teeth and do minimally invasive procedures first. They incorporate the entire health problems you have into treatment. I'm hoping to blend some type of advanced root canal procedure using some type of low pulse laser cleaning they are using, then a way to fill and seal it. I don't need a nice tooth cap, or for it to even look normal. Just hoping for a way to fill and seal. Half the tooth is gone, and there's only a little left on that broke side at the gumline, so I don't know if it will be possible, but that's the goal, and to see if they can figure out a way to seal it off once decay and root canal are done. I'm really hoping this has a way to work, but according to others I've seen, it's not likely/possible.

I'll update once I get the information from them.

 

I ended up on the 13th going in to a periodontist. He used a laser on the bottom wisdom tooth, then was able to elevate it out. It was pretty long and very stressful, but I made it out and thankfully no nerve damage.

What was terrifying though, was what occurred that night. SUDDEN hearing loss, both ears. As a preface, I had been battling an infected tooth, he decided to give me a 500 mg Amoxicillin while at the office (around 11am) as we worked on loosening my jaw to open enough to perform the extraction. I was pretty jaw locked, but with massage and heat pads, we got it done. After getting home, I took a 220 mg NSAID around 2pm. (For the last week, I had been taking 1-2 of those a day for tooth pain, spread out 12 hours.) I then took around 5:30pm my second Amoxicillin and went to bed. I awoke at 11pm and went into the mirror opening my mouth as much as I could, looking at some bleeding around my gums. After about 2 minutes, I had a sudden decrease in hearing in both ears. Everything became muffled. Panic ensued as I broke down. I could barely hear my parents' voices, which sounded muffled and marbled.

I sat on my bed, thinking my life was over. I thought this was SSHL which I had feared for the last 10 years. I sat there, rubbed above my ears in a panic and after about 10 minutes, the hearing started to come back. While this was happening, a sudden burst of tinnitus occurred louder than I ever thought possible. A static on an old tube TV sound. I thought my tinnitus was loud already, this brought it to a level I never thought possible. It could have been my existing low static tinnitus tone just on steroids, I don't know. This disturbing tinnitus lasted a few minutes, then it returned to baseline tinnitus. Was this really SSHL? I don't know if SSHL lasts that short of a time or not. But it was bilateral and quite fast.

1) What I don't know, is what caused it. I'm in fear every day now. Can I ever take an NSAID again, which if you look at HearingLossHelp's website on NSAIDs, has loads of people who got hearing loss from it. But usually from high dosages. How could that have been from 1-2 tablets of 220 mg a day for 5-6 days.

2) Was it the Amoxicillin, the supposedly safest antibiotic you can take with tinnitus? I've never been on it, possible culprit.

3) Was it a delayed result of surgery? I was tense and even lifting up my back and tiling my neck a few times from the pressure, did I bruise one of the vessels around the neck? Did sleeping elevated with my back up a bit and neck up, instead of lying flat, put more pressure on said blood vessel and do something? Seems unlikely as I awoke with no issue and stood at the mirror for a few minutes before the sudden hearing loss.

I'm scared to take NSAIDs again. I get headaches monthly where I usually take 1 pill a month/every other month. I don't know what to do now. Just constant fear of this coming back, and no ability to identify the cause in retrospect.