Dental Education Lecture: Difficult Extraction of Wisdom Teeth from Older Person

Mr. Ling at his forties requests extraction of two upper wisdom teeth in two appointments.  The extraction of the upper left one is associated with breaking off a piece of bone (B in Fig.1-3).  Fig.1 shows cheek view; Fig.2 tongue view: Fig.3 root view.  As we age, the bone may fuse with our teeth.  This phenomenon rarely happens in wisdom teeth at younger age.  The difficulty in extraction mainly arise from the fact that the tooth has three large, long and bifurcated roots (R).  The root grows longer as we get old.

In the second appointment, we are more cautious dealing with extraction of the upper right wisdom tooth.  The bone is not fractured, but one of the roots is (Fig.4-6). Double arrowheads in Fig.4 point to the crack line, whereas the single arrowhead points to an early cavity.

In spite of bone or root fracture, Mr. Ling is doing well after extraction.  However, we should avoid these complications by having wisdom teeth taken out as early as possible.  Return the main text.

Xin Wei, DDS, PhD, MS 1st edition 11/15/2009, last revision 12/20/2009