dental emergency Archives | Williams Family Dentistry

How Great is the Risk of Nerve Damage With Wisdom Tooth Extraction?

Posted on July 8, 2025 by writeradmin.

I am in my mid thirties and have always been nervous about getting my wisdom teeth out. All of them are impacted. Now I’m told I have a small infection on one of them, but the oral surgeon is warning me that it is about one millimeter from a nerve called the inferior something nerve. How much danger is this? Can I just take antibiotics for the infection?

Rose

Dear Rose,

Impacted Wisdom Teeth

We’ll get to the nerve issue in a moment. Let’s start with the antibiotics. That won’t work. Well, it will hold the infection at bay until you can get the wisdom tooth extracted, but as soon as you run out of antibiotics the infection will flare back up again. You’ll have to remove the infected tooth. Given your age, I’m going to recommend that you get all of the wisdom teeth out.

The ideal time to get your wisdom teeth out is your late teens and early twenties. After that the chances of complications go up every five years. If you wait until you hit your forties, there are serious chances of complications. If they are all impacted, it is only a matter of time until the others get infected. You’ll want to extract them before there is a dental emergency and you have less control over the circumstances.

As for the nerve. It’s called the inferior alveolar nerve. Oral surgeons tend to overstate the risks because we live in quite a litigious society. Proclaiming the greatest possible risk reduces the chance of a malpractice lawsuit. A skilled oral surgeon should not have any problem with a nerve that is a full millimeter away. That is a much larger measurement to a dentist than to most people.

In order to hit the nerve, your surgeon would either have to take the tooth out and then drill down another millimeter (a completely mental thing to do) or he’d have to break the tooth and then put downward pressure on the broken tooth fragment. That would be completely contrary to his or her training. Skilled dentists and oral surgeons have taken out wisdom teeth that were literally sitting on the nerve without any issues.

I hope this puts you more at ease. Your safest option is to remove your wisdom teeth now.

This blog is brought to you by Lexington, KY Dentist Dr. James Williams.

Being Scared of the Dentist Cost Me a Tooth

Posted on August 31, 2024 by writeradmin.

I have been scared of the dentist most of my life. Because of that I haven’t gone in years. The only thing that got me there was because I had a tooth hurting so much that I thought there was no way that I could be in more pain than I already was, so I went. He told me the tooth was way too far gone and there was no way to save it. Now I have to get some stupid removable denture. I’m too you for a fake tooth. He also said I have a few teeth that need a lot of work. I don’t want to end up with a mouth full of dentures. Is there any way to get past the morbid fear I have?

Cammie

Dear Cammie,

I’m sorry about your painful tooth! Don’t beat yourself up too much. You are definitely not alone in having dental anxiety. A large number of people do. Most of the time it is caused by trauma at the dentist when they’re young. Too often a child’s first experience at the dentist is with a dental emergency. Those are rarely pleasant experiences, as you’ve seen as an adult.

I have two pieces of good news for you. First, there is a way for you to have anxiety free and pain free dental appointments. If I were in your position, I would see a dentist who offers dental sedation. They can give you a medication that would actually allow you to sleep through your dental appointments. People who have been afraid of the dentist for years have found that dental sedation changed their life forever.

A second thing I’d love to tell you about is dental implants. These are a much better tooth replacement option than removable dentures. Because they are anchored to your jaw bone, they are completely secure and the closest thing to having healthy, natural teeth.

This blog is brought to you by Lexington, KY Dentist Dr. James E. Williams.

Dental Sedation for Wisdom Tooth Extractions

Posted on March 21, 2024 by writeradmin.

My twenty-one year old daughter has an impacted wisdom tooth that is a bit under the bone. I am worried about this procedure and don’t want her in a ton of pain, but am also worried about the idea of her going under anesthesia. Is there a type of dental sedation that will work for her that is strong enough for her to not be in pain while still not being anesthesia? If that is the only option I’ll understand, but want to avoid it if I can.

Daphne

Dear Daphne,

I can tell that you are a good mother and are worried about your daughter. The good news is that she will not need to use general anesthesia. Nothing you have mentioned indicates there is anything overcomplicated about your daughter’s case. She is also at the perfect age for these extractions. Her bones will still be pliable. Plus, there will not be any cementum accumulation on the roots of her teeth. By the time she turns 30, her chances of complications will double. They’ll double again every few years.

To keep her out of any pain during the extractions, I recommend you see a dentist who offers sedation dentistry, specifically oral conscious sedation. This will be administered by a pill. However, it is STRONG. You, or someone else equally trustworthy, will need to drive her to and from her procedure as well as stay with her for several hours until she is lucid and steady on her feet.

I hope this helps to put your mind at ease. Doing the wisdom tooth extractions now will save a potential dental emergency from happening down the road when she will also be at a much greater risk for complications.

This blog is brought to you by Lexington, KY Dentist Dr. James E. Williams.

Worried About Having My Wisdom Tooth Extracted

Posted on March 14, 2022 by writeradmin.

I have a wisdom tooth in my jaw that has a pretty good cavity and is partially impacted. My other wisdom teeth are fully impacted but don’t have any problems. My dentist said I need to see an oral surgeon to have it extracted because of my age (I’m 37), which he says puts me at risk. He also mentioned that there is a risk of nerve damage. I’m not a comfortable patient under the best of circumstances, but now I’m terrified of this procedure. Help me understand how serious this is and is there a possibility I can not have the tooth removed at all?

Sienna

Dear Sienna,

I wish these impacted wisdom teeth of yours had been extracted when you were in your late teens to early twenties. At that age, everything is quite pliable and super easy to remove. As you age, the bone gets thicker as the roots fully form. The older you get the more difficult the extraction. I would not wait for the other ones to bother you before having them extracted. It will only get more complicated the longer you wait. As for the one with decay, it does need to come out. You don’t want to wait for an infection to develop, which can turn into a dental emergency.

As for the potential for nerve damage, that is only a real risk if the tooth is impinging on the nerve. Surgeons always tend to overstate the risk because they want to avoid any possibility of a lawsuit if things happen with a nerve beyond their control. Just make sure whomever you see gets some good 3-dimensional x-rays. This way he can work around any nerves.

I did want to address a different type of nerve issue, however. You mentioned you were not the most comfortable of patients. I want to suggest that you see a sedation dentist for any further dental care you need. Having something like oral conscious sedation when you need any work done will greatly improve your feelings toward the dentist. You will finally be able to have anxiety-free/pain-free appointments.

This blog is brought to you by Lexington Dentist Dr. John Weaver.

Why Extract Baby Teeth

Posted on April 19, 2021 by writeradmin.

My six year old daughter has decay on two of her back molars. The dentist is being a bit rude and wants them extracted immediately, but they are baby teeth. Why is that the right choice? Won’t they just come out? Why pay to pull it?

Sara

Dear Sara,

There are a few things going on here. First, I will say I am sorry your daughter’s dentist was rude. I wasn’t there and don’t know your dentist, but is it possible it was more urgency that came across as rude? It is unusual for a children’s dentist to recommend that a back molar be extracted on a child that age. You mention decay. I wonder if that decay had turned into an infection. I know it is a baby tooth and they do come out, however back teeth are different for reasons we’ll go over in a moment.

Bear in mind, I have not examined your daughter, but here are some possibilities and what to do about them.

1. The teeth are deeply decayed and they going to break and lead to infection. If there is enough of the tooth left to save some of it, you could do a pulpotomy and place a dental crown on it. A pulpotomy is simply a child’s version of a root canal treatment.

You mentioned that their teeth come out. So you are likely now wondering why do a pulpotomy when you can just get rid of the tooth? While it is fine for most baby teeth to be removed prematurely, the back molars need to stay in place until she is twelve years old, when her next set of molars typically come in. In a six year span, her other teeth will drift toward the empty space, then when her adult molars finally do come in, there will not be space for them and it will turn into a crowding problem that needs orthodontics to fix. Getting the crown, will preserve that position so the adult teeth can come into the right place.

2. The tooth is already infected beyond what a pulpotomy can help. Tooth infections are considered dental emergencies. This is because the antibiotics cannot “treat” the infection only hold it back temporarily. If a dentist doesn’t get in there and remove the infected pulp, the infection will spread. Think about how close your daughter’s jaw is to her heart, lungs, and brain. Sadly, people still die of tooth infections, even though it is completely treatable.

If her decay and infection have progressed, then even though it is a molar the tooth will have to be extracted. If that happens, make sure to get a space maintainer. This is a device they can place which will keep the space protected so there won’t be crowding.

Because your daughter is likely already in some pain and you don’t want it to be a traumatic situation for her that makes her afraid of dentists for the remainder of her life, I recommend you go to someone who uses dental sedation. This way it will be an anxiety-free/pain-free experience for her.

This blog is brought to you by Lexington, KY Dentist Dr. Weaver.

Novocain Didn’t Work for My Daughter

Posted on January 23, 2021 by writeradmin.

I have an eleven-year-old daughter who developed a tooth infection. The dentist gave her Novocain but it didn’t work. She was in agony. I eventually had to stop the procedure because I couldn’t stand the pain she was in. I was also a little distressed that the dentist didn’t even seem to care about what she was enduring. I am going to switch pediatric dentists, for obvious reasons, however I still have to deal with my daughter’s infection. Do you know why the Novocain didn’t work? If so, is there a way to get her numb?

Miranda

Dear Miranda,

I am so sorry both you and your daughter had to experience that. I do believe I know what happened with the Novocain and know what will help. I can tell you are a kind and caring mother, so you will know that the infection will have to be dealt with before it has a chance to spread. These type of issues are considered a dental emergency. The first thing I would do is ask for an antibiotic to help hold off the infection briefly while you find the dentist you need to handle this. It is a short, temporary solution. Tooth infections are not treated by antibiotics, they are just held at bay for a period. The only way to get rid of the infection is for a dentist to physically remove the infected tissue.

Many dentists are not yet aware that there is a connection between dental anxiety and numbing medication. While we don’t understand why, we do know that higher a person’s anxiety the less effective the numbing medication is. The solution is to help bring down her anxiety before the procedure. The best way to do that is to see a pediatric dentist who offers dental sedation options.

There are different levels of sedation. Nitrous oxide is the lowest. However, given her recent experience, I think you need to find a dentist who offers oral conscious sedation. This is much stronger and is often called sleep dentistry. She will be quite loopy so you’ll want to keep an eye on her for a few hours after the procedure. It is perfectly safe and she will wake up with her procedure done.

Then, for the next few procedures she can use the nitrous oxide. This helps relax her and she will very likely fall asleep, but she will not be loopy when the procedure is over. With this sedation they will switch the gas back to oxygen and she’ll be back to normal in a few moments.

Hopefully, a few good procedures will enable her fear and anxiety to become controlled by her instead of medication.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Daughter Resists Dental Care

Posted on July 29, 2020 by writeradmin.

My five-year-old daughter hates the dentist. She’s hard to treat under the best of circumstances, but the last few appointments it has become clear she has a lot of decay, more than I would expect for a child her age. I assure you we do brush her teeth. They can’t get to it because she won’t stay still in the chair. Every time they try she takes off running. What do we do to get her the treatment she needs?

Pamela

Dear Pamela,

Kids are tricky sometimes, but it is fairly normal for them to be rambunctious. One thing I would suggest is you find a pediatric dentist who also offers dental sedation. This way your daughter can receive all the treatment she needs while sleeping through the whole procedure.

What you don’t want is to let the needed treatment go and then have a dental emergency on your hands. This can not only end up with your daughter in a lot of unnecessary pain, but dental emergencies have a way of turning into life-threatening emergencies quickly.

I did want to address her extensive decay. I do believe that you care about your daughter and that you are brushing her teeth as any good parents would. For her to develop significant decay at her age would mean that she is having tons of snacks and possibly juice or soda throughout the day.

It may mean some tougher love on your part but if she is snacking a lot or drinking sugary drinks, her body doesn’t have time to keep her teeth properly defended from all the intake. My suggestion would be to limit her snacking to no more than one a day. You’ll likely find she is eating her meals better as well, as a result of having to wait on her food.

This blog is brought to you by Lexington, KY dentist Dr. John Weaver.

Can a Holistic Dentist Heal Cavities?

Posted on May 15, 2020 by writeradmin.

Just before COVID-19 started, by regular dentist, who is not a holistic dentist, diagnosed a small cavity. I asked if it was possible to try to heal it since I’ve heard that’s possible when they’re small. He totally dismissed me and got an attitude, telling me that I was eventually going to lose the tooth if I didn’t get it taken care of. Well, now I can’t even go into the office and get it done because this is apparently not an emergency but I’m thinking about revisiting my idea that maybe I could be using my time to try to heal the cavity since I really can’t do anything else with it right now anyway. Is there a chance a holistic dentist could help with this? Or is there maybe something I could be trying at home in the meantime?

Thanks,

Greg

Dear Greg,

Decay in an opportunity preditor. If a tooth is healthy it won’t set in. Instead, it looks for weak spots. If a tooth is in that demineralized stage, it is still possible to mineralize the tooth. At this point in dental care, we aren’t able to regrow enamel on teeth with decay. Though, ongoing research is promising.

A Holistic Dentist Can’t Heal a Cavity, but…

As long as you don’t have a dental emergency, there is no harm in trying to remineralize the tooth. This is not a guarantee, but it is better than doing nothing.

The first thing I’d suggest is to make sure you are brushing after every meal. I know that most people only brush twice a day, but that extra cleaning and fluoride will help your body use the decay fighting minerals in your saliva more efficiently. Use a fluoridated toothpaste. It would be okay to call your dentist and ask if some additional supplements will help as well. If your dentist doesn’t want to bother and just wants to wait until the decay advances, you can call a holistic dentist in your area and see if they are willing to be more proactive.

Secondly, be careful of your diet. Make sure you are only drinking water throughout your day. Other drinks contain acids and sugars that can eat away at your enamel. The healthier you eat, the better chance you have of fighting the decay as well.

Don’t Wait if Infection Develops

Monitor the tooth. If it starts hurting or showing signs of infection, such as a pimple on your gums, treatment shouldn’t be delayed. Tooth infections are considered dental emergencies. You will be able to be seen even during the COVID-19 quarantine.

Don’t put that off. Dental infections can spread. Your jaw is close to your heart, lungs, and brain. Delaying treatment can turn a dental infection into a life-threatening one.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Can a Tooth Infection Cause a Fever?

Posted on March 31, 2020 by writeradmin.

I’m worried about my daughter but my pediatric dentist won’t see her during the quarantine. She’s had a loose tooth bothering her and now she has a fever. I called in but they said a tooth infection doesn’t have a fever. Is that true? Do I really have nothing to worry about?

Mandy

Dear Mandy,

I’m hoping there is some sort of miscommunication here. Maybe what your pediatric dentist said is that a tooth infection doesn’t usually have a fever. However, any infection can cause a fever. Before you panic, that doesn’t mean your daughter does have an tooth infection.

My guess is you are very diligent with her dental care. Unless there was a cavity they were watching at her last checkup, there likely isn’t one now that has progressed far enough to become an infection. It’s likely she’s fighting something else off right now. You mentioned the tooth is loose and bothering her. Sometimes loose teeth can be painful themselves.

Because of COVID-19, they’re asking us to stay quarantined and only treat essential cases. I’m sure this is making you nervous because it feels like you don’t have access to the care you need for your daughter. You’re a caring mother and want the best for her. Here’s my recommendation.

Keep an eye on her. If the pain in her tooth gets worse, pull it. It’s loose and should come out without too much problem. If there is an infection there, pulling the tooth will take care of it.

If you do that and she’s still in pain a couple of days after you pulled the baby tooth, you can call the dentist back and tell him you want to come in for an emergency dental appointment. It shouldn’t still be hurting a couple of days after it is removed.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Dentist Wants to Extract Tooth Prematurely

Posted on March 23, 2020 by writeradmin.

I have pain in a molar and went to see a holistic dentist. He did some x-rays and said there doesn’t seem to be much of the canal left only calcification. He’s giving me antibiotics and if that doesn’t work he wants to extract the tooth. I’m not too crazy about that. Have you heard of this before? Is there another alternative?

Casey

Dear Casey,

When a tooth is infected, it needs a root canal treatment.

I want to hit the pause button here because I’m concerned regarding what I’m hearing. I’m worried your dentist doesn’t understand some things. There are good and bad medical practitioners in every field, including dentistry. It sounds like your holistic dentist is at best confused.

Let’s start with the antibiotics. If you have a tooth infection, these will not cure it. When antibiotics are used for dental infections it is to hold the infection at bay until a root canal treatment can be done. What will happen is the pain will go away as you’re taking the antibiotics. However, once they’re done, the infection will blow up again. Until the infected pulp is physically removed it will spread.

Let’s say, however, the antibiotics don’t help at all, not even when you’re taking them. That means an infection isn’t the cause of your pain. This means your dentist will be extracting a tooth without a true diagnosis.

Just because your dentist can’t see the canal well on the x-ray doesn’t mean it is not there. I’m going to recommend you get a second opinion, if possible from an endodontist.

As for the calcification, as we age, our canals tend to shrink. Plus, if a tooth is irritated, it will build up dentin on the insides of the pulp chamber. In the more extreme cases, it will block the canals. However, an endodontist will have special tools to get through the calcified parts.

This blog is brought to you by Lexington, KY Holistic Dentist Dr. John Weaver.