Have been following Dr Steven for some time now. I am also DDS and you clearly can see what experience in dentistry looks like. Very carefull professional he is. Keep giving us tips! Thank you’
@@centerforard I am getting my wisdom tooth removed in 6 months, thanks to the NHS dental care waiting list. My wisdom tooth looks the same as the one in your presentation. I will definitely mention about the dry socket and your technique to my consultant.
Awesome video, I'm a recent grad from dental school, and about 99% of us new general dentists wouldn't even think about touching impacted wisdom teeth (my school didn't give us much experience in extractions sadly). Hoping I can incorporate stuff like this in my practice ASAP, thanks a bunch!
I am not suggesting dentists extract impacted wisdom teeth, or perform any type of complicated surgery, without significant hands on training with supervision on actual patients . These surgery videos are intended to enhance the techniques of those trained in surgery. I do not believe most dentists can learn complex surgery thoroughly enough from a video or lecture to be competent to perform the procedures alone. I was in an oral surgery fellowship at Baylor Dental College for 2 years following dental school.
@@centerforard i wish i would have You on my university when i was studing (that was 8 years ago?). they always told me "dont do that! it's to complicated!". during my studies i extracted only 1 tooth! but I found some great mentors who helped me learn surgery and you are helping me improve my skills. i wish every teacher would be like You. Thank You very much doctor.
Hi doc, I saw this video before I removed my horizontally impacted wisdom tooth few months back. Somehow this video gave me the strength to go do it.. It turned out fine.. Thanks doc. Then I went in to remove the other side a few days back and it was the absolute worst took an hour to come out.
I am certified in IV sedation from a 2 year oral surgery fellowship following dental school. I am not an oral surgeon, but obviously have extensive training in "office oral surgery," like implants, wisdom teeth extraction, pathology diagnosis and treatment, etc., but I am not certified or trained in orgthognathic surgery or fixing broken jaws. I use IV conscious sedation primarily with versed and a small amount of demerol almost every morning treating a patient from 8-1. The patients are monitored just like they were in a hospital with a Critical monitor. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Nice elaborative video Dr. One question is that why you prefer cat gut sutures? Generally In India we Maxillofacial surgeons prefer black silk sutures. In many cases buccal fat pad teases out from the extraction site while extracting the tooth. Suturing is more critical due to access and due to the slipery nature of the buccal fat pad. So what should be done in such cases?
As an Oral & Maxillofacial surgeon, I have to say that buccal fat pad exposure should NOT be a common effect of extracting 3rd molars. In 100% of cases of removing 3rd molars in my practice, I have NEVER exposed buccal fat pad when removing third molars. Making a full thickness subperiosteal incision to the bone of all third molars should eliminate this from occurring. If exposing buccal fat is a common practice removing upper thirds molars, more diligence in making sure you are taking the scalpel to bone and reflecting subperiosteal with the periosteal elevator needs to be accomplished. Use the periosteal elevator as it is intended to be used and not for luxating teeth. IF I was to get exposed an buccal fat pad during extraction of upper third molars I would do 1 of 2 things: 1. Place fat pad back into its compartment and suture the periosteum back over it. 2. Use the fat pad as a secondary protective barrier at extraction site just like if I got an large exposed maxillary sinus and primary close the gingiva over the entire site. As far as silk sutures being used for intra-oral incisions, this is not a good practice as they take 8 months to absorb or require a post-op visit for removal. Patients don't always come back for visits and because they are a braided suture, they have a greater tendency to accumulate bacteria which can further cause inflammation or infection of the surrounding tissues leading to delayed healing, especially if the patient doesn't have good oral hygiene. Although silk suture is cheaper, it is not a better option in the healing process.
I am not saying exposing the buccal fat pad is a common thing, but it occurs. In 40 years of practice I have probably only had it occur 2-3 times. I saw it occur periodically during my 2 year oral surgery fellowship at Baylor College of Dentistry. I want the dentists to know what to do if it should ever occur while they are extracting a maxillary third molar.
I most frequently use gut suture vs. silk primarily because you do not have to remove them. Also, the silk suture holds more plaque. Exposing the buccal fat pad should not be a common occurrence, but if it should occur, simply place more suture to ensure the flap is closed securely.
Excellent video! With raising a flap on the buccal aspect, I am very concerned about damaging the long buccal nerve. How far is too far when making a buccal incision? Thank you Dr. Cutbirth!
You would really have to screw up to damage the long buccal nerve. Keep the incision distally on the line angle from the distal facial of the lower second molar.
Thank you for this video Mr. Cutbirth! I’m just curious, like I want to eat, I’m on day 5. I’m just anxious about biting and having force where the wisdom teeth were removed. Should I worry about that, or is the only thing to worry about the pain? I take really good care of everything doing salt water rinses and keeping up good hygiene. I also have stitches so will that help the healing process? Might try salmon today!
Thank you for this brilliant video Dr. Cutbirth. What would be the best mouthwash to irrigate the socket with after a week of extraction? (as suggested in the video)
Thank you. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Had 4 impacted wisdom teeth back in jr high. My regular dentist sent me to the surgeon to handle it. The surgery went fine. Liked the gas and didn’t mind the process, the shots were the worst part. But recovery was horrible. They sent me home still bleeding Within an hour of being home I had to hold my head over a bucket to drip blood into all night until I went to sleep. Called Dr the first day, he said it was normal and I didn’t have to come back in. Next few days had the dry socket thing and had to go for daily packing for like two weeks I’ve only been back to the dentist a few times since in the last 25 years since because it was such a horrible experience
Bummer! Sorry that happened. Give dentistry another try for your sake. In the meantime, watch my videos on "How to Keep Your Teeth for a Lifetime," "How to Brush and Floss Your Teeth" and "Tooth Decay Explained."
In the case that the gum is not around the tooth enough to sew? what will he do? I have pain as if the roots of the tooth pressing vertically on the veins.
I have made my appointment to get my wisdom teeth removed next weekend. I am 25 and I have 2 of my bottom wisdom teeth with curved roots. Will they need to break my jaw while extracting them? I’m incredibly nervous. I’ve gone to get them extracted once and had a panic attack. Cried while on the chair and came back home. Now going back because I’m in pain and determined to get them removed. Wondering if I should be awake or pay the $500 extra for general anesthesia?
I had full roots at 20, and all I had was Novocaine. My surgeon was excellent. I took the teeth home in a pouch and still have them. My face did bruise badly and swell more than normal, but we did not know at the time I had Ehlers Danlos type 3. You will do fine.
If you subscribe to DMC.com all the Dental Minute videos are in an organized library as well as many comprehensive cases and important technical articles. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
No, the dry socket is caused from loosing all or part of the blood clot in the socket. The blood clot insulates the nerve endings in the bony walls of the socket. That is why I feel it is so important to pack the mandibular sockets at the time of extraction so the blood clot has a matrix to hold it in the socket for the 7 days it takes for the connective tissue lining to cover the bony walls of the socket and insulate the nerve endings.
I'm getting mine removed next month if I wear clear retainers that are completely flat for my snake bites (lip piercing) can I keep it in during the surgery so they don't close up? Only asking cause I just got these done and don't want them to close up after I paid so much to get them done
hello doctor ! was curious, is using your curent dry socket protocol effective in cases where intraligamentary anaesthesia is required , or do you generally avoid IL anaesthesia. thank you
So my wisdom tooth has pushed out of my gum and a gum flap is there. I don’t think it’s fully emerged yet so I was wondering if I need the surgery to remove the gum or could the tooth naturally disconnect the flap from the gum.
Is there any difference in the effectiveness of the absorbable gauze/socket paste vs PRF to prevent dry socket? My dentist is pushing for the PRF and I wanted a second opinion. Thank you Doc
I think they both work well. The key is to have something in the socket to stabilize the blood clot and keep it from being lost before the connective tissue lining forms over the exposed nerve endings in the bone lining the socket. The connective tissue lining normally forms in 7 days.
Hey doc, i have a wisdom teeth but not on horizontal(where the tooth moves toward another molar tooth) but instead sideways toward the sides of the tongue. First time it hurted when it appeared but now it doesn't. Does it need to be removed?
One was very deep down and I had to carefully clean the indent for 6 months because otherwise it smelled bad. After six months the indent filled. The other 3 were fine.
Both air driven and electric. Just be sure with both types, if there is compressed air coming out of the handpiece head, that you do not reflect the lingual attached gingiva or you could get an air embolism. Be sure to use lots of water and light pressure if you are cutting bone. Cutting of bone should be minimized. Primilary I am sectioning teeth.
That Lowe incision looks very lingual! The nerve often loops onto the alveolar crest when the tooth is unerupted, does that concern you? One other thing - what is the science behind packing the socket post surgery? Isn’t a blood clot the ideal substrate for healing? The evidence seems to suggest that bony trauma and patient factors such as smoking and the contraceptive pill are more significant influencers of dry socket incidence.
The incision is not an issue. Stay on top of the ridge. The packing material stabilizes the blood clot. It gives the clot a matrix to keep it in the socket. You must not extract many teeth, especially not impacted wisdom teeth. If you did, you would know that the blood clot is often lost for no obvious reason if the socket is not packed, producing a dry socket. I have not had a dry socket in almost 40 years packing the sockets post surgery in this manner. You can argue technical points, but I am telling you what works. Pack the mandibular sockets at the time of surgery if you do not want dry sockets.
Dental Minute with Steven T. Cutbirth, DDS thanks for the response, you should definitely publish your findings, so we can examine and peer review the methodology, as well as benefit the profession, it seems like we could completely eradicate dry socket as a complication! Not a single dry socket in 40 years is honestly astounding, it's impressive but hard to believe. Particularly with smokers and those who are on bisphosphonates etc? What exactly do you put on the gauze?
Glad you like the video. Subscribe to DentistryMasterClasses.com if you want the really good stuff. An organized library of all the Dental Minute videos plus many complete comprehensive cases on everything from composite fillings to SDI supported removable full and partial dentures to increasing vertical dimension with full mouth reconstruction.
Glad you liked it. I hope you are subscribed to DentistryMasterClasses.com. Only $20/month. An organized library of all the DM videos plus many other complete comprehensive cases.
Sir i have 2 wisdom teeth on my upper jaw...but my teeth are not fully arise it lie down inside my gums...but i feel pain lil bit sometime ..what shouldi do..sir m so worried
There should be no pain during the surgical procedure because you will have local anesthesia (numbing). I would suggest you also be sedated. As with any surgery, post operatively there is some recovery, but the discomfort is minimized if the lower sockets are packed at the time of surgery. You should also have pain medication and, possibly, antibiotics.
Are there guidelines in USA for dentists stating clearly what are indications for extracting of wisdom teeth? What was the reason for extracting upper unerupted wisdom teeth in presented case? Seems like this was elective extraction. I would probably wait for upper teeth to fully or partially erupt. Extraction would then be much easier to do.
The White Positional Paper from American Association of Oral & Maxillofacial Surgery has good indications for removal of 3rd molars. Maybe you should look at that.
The key is normally extracting wisdom teeth when the roots are about 1/4 to 1/3 formed. There are many reasons for extracting impacted wisdom teeth, including the possibility of dentigerous cyst formation leading to ameloblastoma, periodontal problems/bone loss between the impacted wisdom tooth and the adjacent second molar and decay if the tooth is partially erupted. These reasons are just off the top of my head. I am sure there are more.
Appreciate the video, gave you a like, but would be more helpful if you had proper radiographs of the entire impacted tooth, rather than just portions...just saying.
Thanks for the comment. Glad the video was helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Is this normal to cut a wedge like that, or is this guy a bit of a cowboy? Great video. Im a newly graduated dentist, so I need to learn alot more things about surgical exo's, as we had pretty minimal experiences in this area. How well is the healing with the triangle vs a normal raised flap?
When you are doing surgery distal to the most distal tooth in the arch a "distal wedge" is normally taken so the lingual and facial flaps will approximate and not overlap. Look up "distal wedge" on the internet. I learned this in my oral surgery fellowship at Baylor Dental College following dental school.
No. I was in an oral surgery fellowship at Baylor Dental college for 2 years following dental school. I was also an oral surgery clinical instructor during those 2 years. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
New subcriber here,sir i have something to ask, about wisdom tooth,i have a problem sir about my wisdom tooth, because last June 20,I came to dental clinic to remove my wisdom tooth,but what happen is my wisdom tooth got cut,and its to pain and the dentist stop because i can't do it ,because its really Pain, and the 2feet of my tooth got stock and I afraid of them i always cry because that happen and I think have already a trauma because that happen, what should I do sir please help me,I'm a Filipino 😭😭😭
Here in Africa Uganda..most of them come after 30 years... With carious neighbours and various impactions... And most of them genuinely can't afford a radiograph... So its basically .....Jesus
@@mcastream im good, for me it was just the whole unconsciousness thing that made me uneasy, since i have a phobia of that, otherwise it doesnt really hurt that bad if you take care of your mouth afterwards
I agree with Joe Doe. Sleeping a root is always preferable to damaging the inferior alveolar nerve. I have left partial roots fairly often when extracting mandibular third molars and never had a post op problem. Just be sure to inform the patient you have left a part of the root and why you did not try to remove it.
I am not an oral surgeon, but was in an oral surgery fellowship for 2 years following dental school in the oral and maxillofacial surgery department at Baylor Dental College. I have employed the methods I learned in that fellowship program with chairman Dr. D. Lamar Byrd for 40 years. Are you an oral surgeon? If you are, what is it you do not agree with in this video.
@@centerforard The making of a lingual incision, the use of an air driven hand-piece that is not reverse airflow, the minimal visualization of upper third molar, the missing throat guard with start of elevation. Most of the individuals watching this video are inexperienced with 3rd molar extractions and need to be instructed on doing everything they can do to minimize post-op complications, like your AO packing does.
@@centerforard it was awesome doctor...they gave me local anesthesia...i dont feel any thing....i have 4rootes wisdom tooth with infection and small cyst...doctor done surgery in a rocket speed😍woah...now i am not scared of dentist...i trust my doctor...i went 400kms to remove my wisdom tooth by trusting him and it was worthful😎😘
hello sir, can you please tell me - can you transplant an impacted wisdom tooth? i need first right upper molar removed, and id like my wisdom tooth put in its place if its possible. my x-ray: imgur.com/a/RuQr7bH
You can and we used to do it occasionally, years ago before titanium implants. I would have an implant placed, not transplant a wisdom tooth. Much more predictable.
@@centerforard My dentist said that he would need to remove the wt in x-ray sooner or later anyway, because where it touches with 2nd molar, a cavity has started to develop, and the only way he can fix the cavity on 2nd molar, is to remove the wt. So i thought, id have nothing to lose if i transplant it, right? Also from what ive read online i understood that transplants also have a high long term success rate of over 90%, or no? Also where i live, transplant would cost me 2.5 times cheaper. All this makes me lean towards a transplant. Maybe you disagree?
Bad idea. If you had a third molar transplanted the third molar would require endodontics and it probably would not be an exact fit for the interproximal space, so you would probably have an open contact between the transplanted tooth and the adjacent tooth and pack food when you eat. Also, the occlusion with the opposing dentition would not be accurate. From having done quite a few wisdom teeth transplants in the early 80s, I assure you wisdom teeth transplants are not nearly as predictable as a regular titanium implant.
@@centerforard ok i understand. and what if the transplanted wt gets a crown, wouldnt those problems be fixed? or are there any other serious issues the transplanted wt would have?
Glad the video was helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Have been following Dr Steven for some time now. I am also DDS and you clearly can see what experience in dentistry looks like. Very carefull professional he is. Keep giving us tips! Thank you’
You are welcome! Glad you like the videos. I hope you subscribe to DentistryMasterClasses.com. That s the really good stuff.
Thank you Dr. Cutbirth! I'm so happy to have subscribed to your masterclasses.
Great! I think you are really going to like them. We are adding new cases and technique videos weekly.
@@centerforard I am getting my wisdom tooth removed in 6 months, thanks to the NHS dental care waiting list. My wisdom tooth looks the same as the one in your presentation. I will definitely mention about the dry socket and your technique to my consultant.
I am a 40 something patient with a small jaw as confirmed by my new NHS dentist at the Royal London Hospital, London, UK :-(
Awesome video, I'm a recent grad from dental school, and about 99% of us new general dentists wouldn't even think about touching impacted wisdom teeth (my school didn't give us much experience in extractions sadly). Hoping I can incorporate stuff like this in my practice ASAP, thanks a bunch!
I am not suggesting dentists extract impacted wisdom teeth, or perform any type of complicated surgery, without significant hands on training with supervision on actual patients . These surgery videos are intended to enhance the techniques of those trained in surgery. I do not believe most dentists can learn complex surgery thoroughly enough from a video or lecture to be competent to perform the procedures alone. I was in an oral surgery fellowship at Baylor Dental College for 2 years following dental school.
@@centerforard i wish i would have You on my university when i was studing (that was 8 years ago?). they always told me "dont do that! it's to complicated!". during my studies i extracted only 1 tooth! but I found some great mentors who helped me learn surgery and you are helping me improve my skills. i wish every teacher would be like You. Thank You very much doctor.
Ur a master of surgery sir...
Ur my idol...
Huge love and respect from India 🇮🇳
Thank you.
I am Maxillofacial surgeon from India...
I liked your video , really it is very informative 👍
The way you teach is Superb...
Thank you. I completed a 2 year oral surgery fellowship at Baylor Dental College in Dallas following dental school. I am glad you like the videos.
Masterful removal of impacted teeth sir... Thank you for the wonderful presentation
Thank you.
Had 4 removed this morning. One of them was in there horizontal. Glad to finally have them gone.
Great. Hope all went well.
Hi doc, I saw this video before I removed my horizontally impacted wisdom tooth few months back. Somehow this video gave me the strength to go do it.. It turned out fine.. Thanks doc. Then I went in to remove the other side a few days back and it was the absolute worst took an hour to come out.
Sorry about the second procedure. I wonder what the problem was?
How was the recovery?
Do you use gas or an IV sedative? Do you monitor vitals during the procedure?
I am certified in IV sedation from a 2 year oral surgery fellowship following dental school. I am not an oral surgeon, but obviously have extensive training in "office oral surgery," like implants, wisdom teeth extraction, pathology diagnosis and treatment, etc., but I am not certified or trained in orgthognathic surgery or fixing broken jaws. I use IV conscious sedation primarily with versed and a small amount of demerol almost every morning treating a patient from 8-1. The patients are monitored just like they were in a hospital with a Critical monitor.
Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Click here to subscribe:
membership.dentistrymasterclasses.com/purchase/?plan=513
This has made an Impact on me! Hahhaa
I hope a positive impact!
Nice elaborative video Dr. One question is that why you prefer cat gut sutures? Generally In India we Maxillofacial surgeons prefer black silk sutures. In many cases buccal fat pad teases out from the extraction site while extracting the tooth. Suturing is more critical due to access and due to the slipery nature of the buccal fat pad. So what should be done in such cases?
As an Oral & Maxillofacial surgeon, I have to say that buccal fat pad exposure should NOT be a common effect of extracting 3rd molars. In 100% of cases of removing 3rd molars in my practice, I have NEVER exposed buccal fat pad when removing third molars. Making a full thickness subperiosteal incision to the bone of all third molars should eliminate this from occurring. If exposing buccal fat is a common practice removing upper thirds molars, more diligence in making sure you are taking the scalpel to bone and reflecting subperiosteal with the periosteal elevator needs to be accomplished. Use the periosteal elevator as it is intended to be used and not for luxating teeth.
IF I was to get exposed an buccal fat pad during extraction of upper third molars I would do 1 of 2 things:
1. Place fat pad back into its compartment and suture the periosteum back over it.
2. Use the fat pad as a secondary protective barrier at extraction site just like if I got an large exposed maxillary sinus and primary close the gingiva over the entire site.
As far as silk sutures being used for intra-oral incisions, this is not a good practice as they take 8 months to absorb or require a post-op visit for removal. Patients don't always come back for visits and because they are a braided suture, they have a greater tendency to accumulate bacteria which can further cause inflammation or infection of the surrounding tissues leading to delayed healing, especially if the patient doesn't have good oral hygiene. Although silk suture is cheaper, it is not a better option in the healing process.
I am not saying exposing the buccal fat pad is a common thing, but it occurs. In 40 years of practice I have probably only had it occur 2-3 times. I saw it occur periodically during my 2 year oral surgery fellowship at Baylor College of Dentistry. I want the dentists to know what to do if it should ever occur while they are extracting a maxillary third molar.
I most frequently use gut suture vs. silk primarily because you do not have to remove them. Also, the silk suture holds more plaque. Exposing the buccal fat pad should not be a common occurrence, but if it should occur, simply place more suture to ensure the flap is closed securely.
ive subscribed, cheers from mexico my friend. these videos help so much. thank you
Terrific!
Excellent video! With raising a flap on the buccal aspect, I am very concerned about damaging the long buccal nerve. How far is too far when making a buccal incision? Thank you Dr. Cutbirth!
You would really have to screw up to damage the long buccal nerve. Keep the incision distally on the line angle from the distal facial of the lower second molar.
Thank you for this video Mr. Cutbirth! I’m just curious, like I want to eat, I’m on day 5. I’m just anxious about biting and having force where the wisdom teeth were removed. Should I worry about that, or is the only thing to worry about the pain? I take really good care of everything doing salt water rinses and keeping up good hygiene. I also have stitches so will that help the healing process? Might try salmon today!
Soft foods that are not really hot are normally not a problem. Speak with your surgeon about eating.
Thank you for this brilliant video Dr. Cutbirth. What would be the best mouthwash to irrigate the socket with after a week of extraction? (as suggested in the video)
Crest whitening is a good one. Mix it with water.
beautiful video Dr. Cutbirth !! thank you so much
You are welcome. Subscribe to DentistryMasterClasses.com. There is the really good stuff.
Will this procedure hurt if the tooth is already erupted and is vertical in orientation along the gums?
Sorry, I cannot diagnose your condition without examining you. There are many variables in surgery.
I’m having two mandibular removed soon, right ninety degrees impacted and resorbing molar left is partial eruption and will remove the crown.
You are amazing,doctor !
Crongrats from Brazil👏🏻👏🏻
Thank you.
Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Click here to subscribe:
membership.dentistrymasterclasses.com/purchase/?plan=513
Had 4 impacted wisdom teeth back in jr high. My regular dentist sent me to the surgeon to handle it. The surgery went fine. Liked the gas and didn’t mind the process, the shots were the worst part.
But recovery was horrible. They sent me home still bleeding
Within an hour of being home I had to hold my head over a bucket to drip blood into all night until I went to sleep. Called Dr the first day, he said it was normal and I didn’t have to come back in.
Next few days had the dry socket thing and had to go for daily packing for like two weeks
I’ve only been back to the dentist a few times since in the last 25 years since because it was such a horrible experience
Bummer! Sorry that happened. Give dentistry another try for your sake. In the meantime, watch my videos on "How to Keep Your Teeth for a Lifetime," "How to Brush and Floss Your Teeth" and "Tooth Decay Explained."
In the case that the gum is not around the tooth enough to sew? what will he do?
I have pain as if the roots of the tooth pressing vertically on the veins.
Sorry, I cannot diagnose your problem without examining you.
I have made my appointment to get my wisdom teeth removed next weekend. I am 25 and I have 2 of my bottom wisdom teeth with curved roots. Will they need to break my jaw while extracting them? I’m incredibly nervous. I’ve gone to get them extracted once and had a panic attack. Cried while on the chair and came back home. Now going back because I’m in pain and determined to get them removed. Wondering if I should be awake or pay the $500 extra for general anesthesia?
No, they will not break your jaw. Be sedated intravenously and you will do fine.
I had full roots at 20, and all I had was Novocaine. My surgeon was excellent. I took the teeth home in a pouch and still have them. My face did bruise badly and swell more than normal, but we did not know at the time I had Ehlers Danlos type 3. You will do fine.
hey doc! great video! are you using an alveolotome to retrieve the dental pieces? best regards!
No, I am not.
Dear doctor
How can I access your content in links..
It’s locked 8:06
If you subscribe to DMC.com all the Dental Minute videos are in an organized library as well as many comprehensive cases and important technical articles.
Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month.
Click here to subscribe:
membership.dentistrymasterclasses.com/purchase/?plan=513
Can I get a dry socket by swallowing? I just got one wisdom tooth removed and I’ve been swallowing quite a bit because of all the saliva forming.
No, the dry socket is caused from loosing all or part of the blood clot in the socket. The blood clot insulates the nerve endings in the bony walls of the socket. That is why I feel it is so important to pack the mandibular sockets at the time of extraction so the blood clot has a matrix to hold it in the socket for the 7 days it takes for the connective tissue lining to cover the bony walls of the socket and insulate the nerve endings.
I'm getting mine removed next month if I wear clear retainers that are completely flat for my snake bites (lip piercing) can I keep it in during the surgery so they don't close up? Only asking cause I just got these done and don't want them to close up after I paid so much to get them done
That is a new one for me. Maybe you can leave the piercings in during and after the surgery.
Thank you so Much Dr.Steven
You are welcome! Glad you liked the video. Subscribe to DentistryMasterClasses.com if you want access to the really good stuff!
hello doctor ! was curious, is using your curent dry socket protocol effective in cases where intraligamentary anaesthesia is required , or do you generally avoid IL anaesthesia. thank you
If you watch my videos, you will know I always use intraligamental local anesthesia.
So my wisdom tooth has pushed out of my gum and a gum flap is there. I don’t think it’s fully emerged yet so I was wondering if I need the surgery to remove the gum or could the tooth naturally disconnect the flap from the gum.
Get a dental exam.
Dental Minute with Steven T. Cutbirth, DDS ok
Is there any difference in the effectiveness of the absorbable gauze/socket paste vs PRF to prevent dry socket? My dentist is pushing for the PRF and I wanted a second opinion. Thank you Doc
I think they both work well. The key is to have something in the socket to stabilize the blood clot and keep it from being lost before the connective tissue lining forms over the exposed nerve endings in the bone lining the socket. The connective tissue lining normally forms in 7 days.
Yep! Probably shouldn't have come and looked at this before i get my problem complete bony impaction taken out at 45! Terrified!
Don't worry, if you have a good dentist skilled in surgery you will do just fine.
@@centerforard Supposedly he is, so fingers crossed. Thank you!
I’m getting all 4 wisdom teeth taken out tomorrow and I’m pretty scared. This kinda calmed my nerves
Great!
Hey doc, i have a wisdom teeth but not on horizontal(where the tooth moves toward another molar tooth) but instead sideways toward the sides of the tongue. First time it hurted when it appeared but now it doesn't. Does it need to be removed?
Unfortunately, I cannot diagnose your condition without examining you.
How long is the recovery process from impacted wisdom teeth ?
Normally several days to a week.
One was very deep down and I had to carefully clean the indent for 6 months because otherwise it smelled bad. After six months the indent filled. The other 3 were fine.
Which rotor do you use, air driven or electric?????
I have both air driven and electric handpieces. The electric are more powerful. Both have air/water spray.
Do you use air driven for impaction????
Both air driven and electric. Just be sure with both types, if there is compressed air coming out of the handpiece head, that you do not reflect the lingual attached gingiva or you could get an air embolism. Be sure to use lots of water and light pressure if you are cutting bone. Cutting of bone should be minimized. Primilary I am sectioning teeth.
@@centerforard thank you sir
That Lowe incision looks very lingual! The nerve often loops onto the alveolar crest when the tooth is unerupted, does that concern you?
One other thing - what is the science behind packing the socket post surgery? Isn’t a blood clot the ideal substrate for healing? The evidence seems to suggest that bony trauma and patient factors such as smoking and the contraceptive pill are more significant influencers of dry socket incidence.
The incision is not an issue. Stay on top of the ridge. The packing material stabilizes the blood clot. It gives the clot a matrix to keep it in the socket. You must not extract many teeth, especially not impacted wisdom teeth. If you did, you would know that the blood clot is often lost for no obvious reason if the socket is not packed, producing a dry socket. I have not had a dry socket in almost 40 years packing the sockets post surgery in this manner. You can argue technical points, but I am telling you what works. Pack the mandibular sockets at the time of surgery if you do not want dry sockets.
Dental Minute with Steven T. Cutbirth, DDS thanks for the response, you should definitely publish your findings, so we can examine and peer review the methodology, as well as benefit the profession, it seems like we could completely eradicate dry socket as a complication! Not a single dry socket in 40 years is honestly astounding, it's impressive but hard to believe. Particularly with smokers and those who are on bisphosphonates etc? What exactly do you put on the gauze?
I have 4 impacted wisdom teeth extraction in a couple of weeks and I'm concerned if it's going to change the shape of my face .
The extractions should not change the shape of your face.
Good educational video. Greetings from Malaysia✌️
Glad you like the video. Subscribe to DentistryMasterClasses.com if you want the really good stuff. An organized library of all the Dental Minute videos plus many complete comprehensive cases on everything from composite fillings to SDI supported removable full and partial dentures to increasing vertical dimension with full mouth reconstruction.
Thank you so much sir
You are welcome.
When I got mine polled it looks like somebody punched me in the face for about the first 36 hours
Me right now 😥
Thnx Doc that was so important tricks to know
Glad the video helped.
excellent work thanks doc..about the awesome video.
Glad you liked it. I hope you are subscribed to DentistryMasterClasses.com. Only $20/month. An organized library of all the DM videos plus many other complete comprehensive cases.
Sir i have 2 wisdom teeth on my upper jaw...but my teeth are not fully arise it lie down inside my gums...but i feel pain lil bit sometime ..what shouldi do..sir m so worried
Have an examination by a good dentist or oral surgeon.
Thanks for this doctor...
You are welcome.
How painful is this removal? I'm so terrified but are in so much pain :(
There should be no pain during the surgical procedure because you will have local anesthesia (numbing). I would suggest you also be sedated. As with any surgery, post operatively there is some recovery, but the discomfort is minimized if the lower sockets are packed at the time of surgery. You should also have pain medication and, possibly, antibiotics.
Always with new things to gain benefits . iam greatfull to you my master
Aren't you kind. I hope you subscribe to DentistryMasterClasses.com.
Are there guidelines in USA for dentists stating clearly what are indications for extracting of wisdom teeth? What was the reason for extracting upper unerupted wisdom teeth in presented case? Seems like this was elective extraction. I would probably wait for upper teeth to fully or partially erupt. Extraction would then be much easier to do.
The White Positional Paper from American Association of Oral & Maxillofacial Surgery has good indications for removal of 3rd molars. Maybe you should look at that.
The key is normally extracting wisdom teeth when the roots are about 1/4 to 1/3 formed. There are many reasons for extracting impacted wisdom teeth, including the possibility of dentigerous cyst formation leading to ameloblastoma, periodontal problems/bone loss between the impacted wisdom tooth and the adjacent second molar and decay if the tooth is partially erupted. These reasons are just off the top of my head. I am sure there are more.
Appreciate the video, gave you a like, but would be more helpful if you had proper radiographs of the entire impacted tooth, rather than just portions...just saying.
Thanks for the comment. Glad the video was helpful.
Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month.
Click here to subscribe:
membership.dentistrymasterclasses.com/purchase/?plan=513
Is this normal to cut a wedge like that, or is this guy a bit of a cowboy? Great video. Im a newly graduated dentist, so I need to learn alot more things about surgical exo's, as we had pretty minimal experiences in this area. How well is the healing with the triangle vs a normal raised flap?
When you are doing surgery distal to the most distal tooth in the arch a "distal wedge" is normally taken so the lingual and facial flaps will approximate and not overlap. Look up "distal wedge" on the internet. I learned this in my oral surgery fellowship at Baylor Dental College following dental school.
@@centerforard ok thank you for the reply and your time. I will research this technique. Appreciated
Are you an oral surgeon?
I had my impacted wisdom teeth removed in 2000 at age 20
No. I was in an oral surgery fellowship at Baylor Dental college for 2 years following dental school. I was also an oral surgery clinical instructor during those 2 years.
Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Click here to subscribe:
membership.dentistrymasterclasses.com/purchase/?plan=513
Thanx doc!
You are welcome.
New subcriber here,sir i have something to ask, about wisdom tooth,i have a problem sir about my wisdom tooth, because last June 20,I came to dental clinic to remove my wisdom tooth,but what happen is my wisdom tooth got cut,and its to pain and the dentist stop because i can't do it ,because its really Pain, and the 2feet of my tooth got stock and I afraid of them i always cry because that happen and I think have already a trauma because that happen, what should I do sir please help me,I'm a Filipino 😭😭😭
You should be sedated.
rất hay cám ơn thầy
You are welcome. What country are you in?
Here in Africa Uganda..most of them come after 30 years...
With carious neighbours and various impactions...
And most of them genuinely can't afford a radiograph...
So its basically .....Jesus
God help you and all your companions!
Do the best you can. That's all you can do if you are the only option the patient has.
Watching this because they removing my wisdom teeth tomorrow and they all impacted 😪
just got mine removed
Great.
How are you now ? Getting mine soon and I'm super anxious
@@mcastream im good, for me it was just the whole unconsciousness thing that made me uneasy, since i have a phobia of that, otherwise it doesnt really hurt that bad if you take care of your mouth afterwards
I was put out for mine
That's the best way to have the wisdom teeth extracted.
Why do u sound like dr Phil
Interesting! I wish I had his income!
Doctor.. Advise on incidences where the patient has an already formed roots and so near the inferior dental nerve....
Is coronectomy a viable option
Yes
I agree with Joe Doe. Sleeping a root is always preferable to damaging the inferior alveolar nerve. I have left partial roots fairly often when extracting mandibular third molars and never had a post op problem. Just be sure to inform the patient you have left a part of the root and why you did not try to remove it.
Humbled my seniors....
It is so relieving to know
This is a training for people who already have wisdom teeth training.
Me: well hyped up on drugs from getting them out counts right?
He sounds like peyton manning
Ha, ha! I wish I had his $!
Doc is probably from Texas.
Correct! Waco, Texas.
@@centerforard doc, you have that waco accent .
Your bur numbers are wrong (or just old).
1st is Komet (former Brasseler) H1.316.018 , 2nd is Komet H33.104.021
Thank you. We are checking it out.
This video is in no way endorsed by the Oral & Maxillofacial Surgeons of the USA, especially those that are Board Certified.
His methods work though & are according to what Oral surgeons would do anyway.
I am not an oral surgeon, but was in an oral surgery fellowship for 2 years following dental school in the oral and maxillofacial surgery department at Baylor Dental College. I have employed the methods I learned in that fellowship program with chairman Dr. D. Lamar Byrd for 40 years. Are you an oral surgeon? If you are, what is it you do not agree with in this video.
@@centerforard The making of a lingual incision, the use of an air driven hand-piece that is not reverse airflow, the minimal visualization of upper third molar, the missing throat guard with start of elevation. Most of the individuals watching this video are inexperienced with 3rd molar extractions and need to be instructed on doing everything they can do to minimize post-op complications, like your AO packing does.
incision past the mid distal of the tooth?? that's a big NO!
Sorry, I do not understand your comment.
That bolo tie tho
I just got my wisdom teeth taken out and I’m only 14 yrs old 😀
I hope the procedure went well.
My appoitnment was at 4pm noe itz 1pm...i am scared of death 😂
If you are sedated, you should do very well.
@@centerforard it was awesome doctor...they gave me local anesthesia...i dont feel any thing....i have 4rootes wisdom tooth with infection and small cyst...doctor done surgery in a rocket speed😍woah...now i am not scared of dentist...i trust my doctor...i went 400kms to remove my wisdom tooth by trusting him and it was worthful😎😘
Ugh do mine pls
Sure, but I'm sure you can find a good surgeon in your area.
@@centerforard buuuut I want you, you seem experienced 🤪
👏👏👏👏👏👏
Great! Glad you like the videos. Subscribe to DentistryMasterClasses.com if you want the really good stuff.
4 impacted at the same time? I bet they were miserable.
Thank join me to learn from you syria dentist
Great!
hello sir, can you please tell me - can you transplant an impacted wisdom tooth? i need first right upper molar removed, and id like my wisdom tooth put in its place if its possible. my x-ray: imgur.com/a/RuQr7bH
You can and we used to do it occasionally, years ago before titanium implants. I would have an implant placed, not transplant a wisdom tooth. Much more predictable.
@@centerforard My dentist said that he would need to remove the wt in x-ray sooner or later anyway, because where it touches with 2nd molar, a cavity has started to develop, and the only way he can fix the cavity on 2nd molar, is to remove the wt. So i thought, id have nothing to lose if i transplant it, right? Also from what ive read online i understood that transplants also have a high long term success rate of over 90%, or no? Also where i live, transplant would cost me 2.5 times cheaper. All this makes me lean towards a transplant. Maybe you disagree?
Bad idea. If you had a third molar transplanted the third molar would require endodontics and it probably would not be an exact fit for the interproximal space, so you would probably have an open contact between the transplanted tooth and the adjacent tooth and pack food when you eat. Also, the occlusion with the opposing dentition would not be accurate. From having done quite a few wisdom teeth transplants in the early 80s, I assure you wisdom teeth transplants are not nearly as predictable as a regular titanium implant.
@@centerforard ok i understand. and what if the transplanted wt gets a crown, wouldnt those problems be fixed? or are there any other serious issues the transplanted wt would have?
Sorry, I cannot explain it any more.
Nice
Glad the video was helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month.
Click here to subscribe:
membership.dentistrymasterclasses.com/purchase/?plan=513