Wisdom Teeth Extraction with Hyperacusis

I have two lower wisdom teeth that are growing in sideways. In about a year I'll need to get them removed from my mouth. The problem is that I have pain hyperacusis, reactive tinnitus, and very weak ears in general, and I'm certain that the drill will considerably set me back. I've considered earplugs and earmuffs, but there's still bone conduction.

The dentist assured me that I'd be anesthetized and therefore wouldn't hear anything, but my logic is that if you're punched while knocked out, you still wake up feeling the pain. They seem to think it's the sound itself I'm afraid of, rather than the subsequent pain.

I'm at a loss for what to do, because I either have to risk losing months of progress, or risk pain/infection and more expensive surgeries from the teeth growing in. I'm boxed in, so I'd appreciate anyone else here sharing their experience.

Should I go against the advice of my orthodontist and dentist and forgo the procedure entirely? Or should I just load up on NAC and deal with the potential setback?

I know I'm thinking very far ahead, but I'm trying to be realistic and proactive, because I know that this will be an issue in the near future.

 

I wouldn’t. I was supposed to get mine out years ago and nothing bad happened. No way in hell I’d do that with noxacusis.

 

I'm no dentist, but it seems like the problem is that they're growing at a 45 degree angle in the direction of my teeth. I agree that I'd much rather keep my teeth as they are to avoid any loud drill or suction, but I'm also afraid that the surgery may be necessary given the direction they're growing.

 

Is it absolutely necessary to have knockout anesthesia for the removal of the two wisdom teeth? Can they be done separately, as in two visits?

 

Why would they "be a problem in a year" if they aren't now? What was the reason they gave?

I would look at it cost/benefit. Are they contributing to jaw pain and nerve sensitivity? Are you getting headaches from them? Or are they more worried about making your teeth crooked and things you might not care as much about?

If you do end up needed it (though I would really try to postpone stressing about it if it's a year from now), some thoughts.

Could they do one side at a time and see how you do? You could even space it out over 6 months apart.

I watched a few YouTube videos on this and average drilling time for one tooth seems less than 4 or 5 minutes. Maybe doable if they took your hyperacusis seriously and took lots of drilling breaks.

Some dentists do this under local anesthesia. Like this guy:

Surgical Wisdom Tooth Extraction (LL8) by...

Which is something to consider if you wanted to be able to monitor jaw strain as well as drill exposure (your dentist might be more inclined to remember your instructions if you are awake to remind them).

 

You said 45 degree angle correct? All four of mine were growing in at 90 degree angle so fully impacted on all sides. For my case, I had to get them removed or face severe occlusion problems later on in life (not just cosmetic) due to my small jaw. I had mild tinnitus and it didn’t affect it at all, thankfully, despite them having to actually straight up break 2 of the wisdom teeth because they were crammed so far in my gum line. I also was under general anesthesia.

Have you gotten a few other opinions regarding the degree of impaction?

From what I understand dental surgeons are very hesitant to remove wisdom teeth later in life unless absolutely necessary due to higher chances of striking the jaw nerve and rendering your lower jaw completely numb. My surgeon recommended removing mine before I was 21. So this might be a consideration, if you’re thinking of putting it off for a long time.

With noxacusis and hyperacusis though, I would be extremely hesitant to go through with this unless they agreed to a local where you could monitor the progress while awake. I know someone personally who had my same degree of impaction and opted for a local, and it went really well.

If this were me, and the degree of impaction made the removal absolutely necessary, I would seriously consider plugs, muffs (even with the small amount of bone conduction) and a local to make sure you can stay attuned to the drilling time.

 

Because I'm 17. They haven't pushed all the way through yet.

The teeth haven't posed any problem as of yet. I don't know the dentist's reasons for wanting to get them removed, but I presume if they continue growing into my teeth it will cause headaches and crowding. I'll have to weigh the risks because I'm pretty sure they can become a problem because they create difficult to reach places where cavities form.

That's definitely a possibility. I saw some people saying to drill for 5 seconds and break for 10 seconds. I wouldn't trust a surgeon to follow through with that unless I was awake. My parents are convinced that if I'm put under anesthetic then it won't affect my ears at all, which I definitely don't think is the case, considering you can still feel residual pain from an operation after the fact.

My biggest fear is that the operation will wipe out all of the progress I'll have made over the past 1 year and 8 months. I need to ensure that this doesn't happen. Would it help to immediately get on a course of Prednisone? Is there anything I can take beforehand to minimize damage?

 

Did this person also have hyperacusis? Surprisingly I haven't found many people online in my scenario.

Right now the situation seems kind of lose-lose, so I appreciate you and FGG's advice. I will discuss further with my dentist about how necessary the operation really is and the risks vs. benefits.

How much does occlusion vs. raw noise exposure matter? I haven't found a consensus on here; some people think you should equally avoid both and others think that it's not as harmful. The drill seems like it'd produce a lot of occlusion, so I don't want to shoot myself in the foot.

 

Did you mention that you have hyperacusis and that the damage may still happen regardless of whether you can "hear" it while asleep?

A lot of suggestions I have seen regarding teeth on here is to break up the procedure into multiple appointments if possible. Also, have the dentist drill for 10 seconds on 10 seconds off. This will take longer, but apparently will help your ears by taking breaks. Also, I am not sure if it can be used in this situation, but see if a local dentist has a laser drill vs the mechanical. Many people on here have said that laser drills are a lot quieter and safer on our ears.

 

It absolutely sucks doesn’t it. Every medical procedure feels like navigating a mine field when you have shitty cochlear problems.

The person who received the local didn’t have any hearing problems, hyperacusis or otherwise. But I meant more that they seemed to tolerate the local pretty well. I’ve never been under a local myself, so they are my only reference point.

For me, I was also concerned about my head tremor causing problems under a local. I also have very random and involuntary muscle spasms when I’m anxious, and I knew being awake for the procedure would make me a nervous wreck. My worst fear was jerking a jaw muscle by accident and having the surgeon hit my nerve or something.

But one thing I can say, is that a month or so after I developed severe reactive tinnitus and moderate loudness hyperacusis I had to go in and get my my front tooth cap replaced and he had to do several minutes of drilling.

We ended up doing about 5 seconds at a time without any muffs or earplugs and it didn’t do any further damage to my ears. And this was at a point in time when my ears were still extremely inflamed and prone to any noise damage.

It took a full hour for what should have been 5 minutes of drilling, but we discussed this beforehand and my dentist came totally prepared.

I too, was concerned about the occlusive effect and opted to go without. I’m still confused about the extent to which the effect makes things worse or not so I feel you on that... the only thing I do know for sure is that I know exactly when occlusion makes everything worse or louder.

I notice it immediately when I’m wearing sandals and go to plug my ears vs when I’m wearing soft sneakers. I wish I could be more help on that front, sorry...

 

@weab00, I had this done when I was your age for the same reason, all 4 wisdom teeth (no noxacusis at the time though). After the anesthetic injections there was no drilling, the guy just pulled them straight out with dental pliers (one side top and bottom first, then the other side 3 weeks later).

 

They can do that when they are non-impacted and have erupted. Doesn't apply here, unfortunately.

 

Ah, yeh mine might have been a bit different. They were coming through slightly angled and were partially out but still had not quite finished but were crushing the other teeth together which is why I had to have them out. There was enough out for the dentist to get a grip of them anyway.

 

@weab00, I just had 4 taken out a couple hours ago with tinnitus and moderate hyperacusis. My conditions feel roughly the same, here's hoping it doesn't deteriorate once the anesthetics completely fade.

I did it only with local anesthesia specifically so I could monitor how make trauma was being inflicted on my ears since I was having 4 taken out at once.

And conclusively, I can say the drill my surgeon used was pretty fucking loud. It was alright until he started actually sectioning the teeth since I'm mid-20s and the teeth were moderately developed. This unfortunately means I don't think ear plugs or headphones would help you too much since most of the noise affecting my cochlear was definitely from bone conduction. The vibrations were pretty killer, I had to ask him to stop a couple times now and then even with him compassionately already acquiescing when I asked for the 5 to 10 drilling rule.

Since you said you had noxacusis, I'd be pretty concerned if you needed as much drilling as I did (probably only about 40 seconds per tooth, but at high intensity). Also, if you have any TMJ issues, make sure your neck isn't too strained during the ordeal. The mouthblock they had me bite wasn't particularly aggressive, but if you feel like your jaw is stretched beyond a range of comfort during the process, it would be wise to rectify that early.

My advice to you would be to find a way to avoid the drilling if at all possible, and then you'd probably be fine as long as you don't over do it on the NSAIDs. If your condition is severe, I don't think the level of drilling I experienced would be tolerable.

 

I was thinking about this earlier today. If you are under anesthesia, is it still possible to get hearing damage even though you are not conscious? I wonder if there has been any studies on this because it seems like an interesting concept.

 

Damn bro this post kind of freaked me out, not gonna lie. How are you feeling two days later? I'm not sure there's a way to do this without drilling, since the teeth are under my gums. I'm probably fucked if the drilling is as loud as you say and there's no way to avoid it.

Was it the same kind of drill they use for wisdom teeth? Glad to hear you were okay, and it gives me some hope that my weak ass ears can survive this ordeal in a year's time.

 

Sorry! It wasn't my intention to scare you. I just wanted to accurately relay my experience since I was also pushed into getting the surgery done even though I wasn't sure if it was a good choice, and I'm still mixed. My teeth were modestly impacted, to the point where getting them out was definitely ideal, but seeing as it hasn't helped my somatic tinnitus, I'm still not sure if it was the right move. Depends on how your situation looks I imagine.

The drill my surgeon used was moderately loud (I guess, it's been difficult to evaluate what's actually loud since I developed hyperacusis), but the bone conduction was the genuinely insane aspect. I don't have noxacusis, but I could still practically feel the noise reverberating in my cochlear. It was particularly bad with the uppers due to their proximity to the ear.

I imagine there are lower speed drills that result in less noise, and I believe some people on this forum have had laser drills used, but I'm quoting that from memory. So there's no guarantee your experience will be as traumatic as mine was -- but fortunately, despite the loudness, I didn't feel too drastically impacted by it. The surgeon was very polite and respectful, taking short breaks and asked me if I wanted to stop for the day after he realized he had to do a lot more drilling on my teeth than he thought he might. However, I felt confident enough to just get all 4 out at once since it didn't seem like the drill was hurting me much even though it felt like it.

I'm not sure if it's because I was taking Magnesium, NAC, and Nicotinamide Riboside for protection beforehand, or if the anesthesia itself numbed my perception to changes in my tinnitus at the time, but I still don't feel like any permanent damage was done overall and I'm usually pretty quick to regret an irrevocable decision. I have been worse off since the surgery, though I attribute this mostly just to post-op inflammation and swelling.

 

I don’t have an article for this specific reference as it’s a case study I read awhile ago and can’t find now. A patient was having a head osteoma removed with a surgical saw and when they woke up they had hearing loss and tinnitus. So yes it can and does happen.

Also, yes decibel level concerns during surgery are a written about in general and not just for surgical staff:

Orthopaedic theatre noise: a potential hazard to patients