Most Difficult Wisdom Tooth I Have Ever Extracted - Dental Minute with Steven T. Cutbirth, DDS

[@PrachiNadk]

I’m not a dentists (though both my parents are) - but I absolute love watching these surgeries. Dentists and doctors are artists, truly! I have so much respect

[@centerforard]

Thank you. I love going to work every day. The dental treatment I get to perform in my practice as well as the fabulous conversations with the patients is marvelous.

[@louishackett5342]

The absolute carnage. Oh my god thank you so much to these surgeons. Just had my wisdom teeth taken out and my bottom two were very similar to the one in this video. I feel like I need to buy my surgeon a gift.

[@centerforard]

I agree, you probably should! Really impacted wisdom teeth can be a challenge.

[@ang695]

did you have any nerve damage?

[@lazyfloyd5476]

I am a general dentist with a degree of dental surgery specialization practicing surgery for the last 5 years and I can attest that this is a very complicated case. Great work! One question comes to my mind, sir how do you keep your composure in cases like these?

[@centerforard]

Good question. I guess it comes from performing complex cases for 40+ years and having a lot of initial training. When things get complicated, I slow down. 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

[@TahitianBlissMeeBee]

i work in a high security prison and am constantly seeking to improve my surgical technique. thank you

[@centerforard]

Glad the videos are 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

[@adrienbeatty]

I appreciate this video. I had an impacted one done a week or so ago. I think they actually had to cut my gums as I had the sutures in my mouth. I will say my gum and jaw pain is not desirable but it hasn't worsened. After seeing this surgery I can understand why I feel sore still. My oral surgeon has about the same amount of years of experience and also does facial reconstruction for children with cleft palletes. Patients like me greatly appreciate Dentists like you who provide the upmost care and beside manners.

[@centerforard]

Thank you. Glad your procedure went well.

[@mitchmartin1871]

Very skilled surgery Dr. Cutbirth. That kind of patients with getting teeth out has served me well for many years of taking teeth out. Well done!

[@centerforard]

Thank you. Glad the videos are helpful and interesting. 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

[@Aboshihab1]

Was there an indication for extraction of this impacted wisdom tooth doctor? I mean as it looks roots are already formed and no pathological signs ,we cannot just leave it and watching? Thank you

[@centerforard]

Good question. Please read my answers to several question in comments above, or you can look up that question on Google.

[@Aboshihab1]

Thank you for your reply! I would like to ask another question…I noticed that in extraction wisdom teeth we don’t apply PRF or bone grafting in order to accelerate the healing ! Am I right? It’s something achievable? Thank you

[@Lonezewolf]

I appreciate the information presented, and the cool tone displayed.

[@centerforard]

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

[@itoothitooth4943]

As an Oral Surgeon, I would never do extractions of impacted teeth with a high-speed general dental handpiece. Using it can cause an air embolus or soft tissue emphysema. Use of high pressure air/water irrigation is risky. Should use only normal saline irrigation without air pressure.

[@centerforard]

This is an electric handpiece. Also, it is important to not elevate all the attached gingiva from the alveolar bone. I do not recommend any dentist perform difficult surgical procedures such as surgical extractions or implants without excellent hands on training. I was in an oral surgery fellowship in the oral surgery department of Baylor College of Dentistry for 2 years following dental school. Thanks for your comment. 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

[@Mrponders9]

If I close my eyes I'd think you were Dr.Phil.

[@lanehaws8349]

That’s not called a fellowship. A fellowship is further training beyond residency. You completed part of a residency. Billing it as a fellowship is disingenuous.

[@950prashantsaini]

Its was real difficult case and you handled it well,

[@sunitabali3786]

You are a genius Dr Steven❤❤

[@centerforard]

Thank you. You are kind. 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

[@Sodainspace]

I had my impacted wisdom tooth surgery few days ago, it ended up being very similar to your video, he spent a long time and got really frustrated towards the end, however my dentist couldn't get out one root and ended up leaving one root behind as he said he didn't want to risk damaging my nerve. now I'm left with severe pain, I wish I had an expert dentist like you to go to, I felt really betrayed by the dentist as he initially told me its an easy job but he failed. I wonder, is it possible for another surgeon to fix / remove the remaining wisdom tooth root at some point in future ? thanks

[@centerforard]

Normally, it is not a problem to leave a portion of a root. It is referred to as "sleeping a root." Over the years I have "slept" many roots for various reasons and have never had a problem from "sleeping a root" that I am aware of. Do not feel "betrayed," You would much rather have a "slept" root that will most probably never cause a problem than a numb lip from trying to remove a fractured lower posterior tooth root that was close to the inferior alveolar nerve and damaging the nerve. That is called good judgement.

[@Jatav79602]

hw r u feeling now any improvemt

[@Tye-zl9ne]

@@centerforardWhat about the top Wisom teeth; are there less risks? I feel like my wisdom tooth is 80% but i believe it has chipped; i’m researching what I should do next

[@brownladKR]

I love the concept remove some of impacted tooth not the bone as tooth is supposed to be removed anyways & it allows the required movement to luxate the tooth.

[@centerforard]

If you can remove tooth structure and not bone, that is good. You need some space to luxe the sectioned tooth section into. Sometimes you must remove some bone, but try to create the space by removing tooth structure if possible, since the tooth is going to be extracted anyway. 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

[@DemoBallisticsCar]

Im suprised something is difficult for you. You make stuff look easy

[@centerforard]

Thank you. Good dentistry, like most other things done well, takes a lot of training and is not easy. Not to mention the psychological aspect of dealing with patients and staff. Most interesting, but not easy. 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

[@RômuloBSC]

Hi Dr. Im a Brazilian dentist and i wanna know why have u did this retromolar incision like a V. Thank u doctor.

[@ScientificallyStupid]

Doctor, thank you so much for this fascinating case! I feel like I have a better understanding of the complexities of surgical cases when I'm communicating that to my patients (hygienist of 20 years).

[@centerforard]

Glad the videos are helpful. As motivated as you are, you would enjoy subscribing and watching these videos. The dentist in your practice should be subscribed also. 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

[@treeduck3705]

I had three of my wisdom teeth removed in 1997, I've still got #17 because the surgeon at the time didn't want to remove it to avoid nerve damage and it hadn't erupted and wasn't giving me any issues. Now though it kind of is, and it still hasn't erupted, probably because it isn't physically possible. I wonder this one can be removed without damage?

[@centerforard]

Have an oral surgeon examine you.

[@asvarien]

I just had a badly decayed wisdom tooth removed, thankfully it went very easily. Came out in one go, all in one piece with no gum cutting, which I'm thankful for. The last time I had a wisdom tooth out, I did develop dry socket which was a very unpleasant experience. So far though, no pain at all.

[@centerforard]

Glad the procedure went well.

[@gratitudetouniverse3754]

@asvarien How did you fix the dry socket ?

[@asvarien]

@@gratitudetouniverse3754 The dentist prescribed some antibiotics and it went away after a day or two.

[@miufke_]

​@@gratitudetouniverse3754he didnt and passed away

[@forreststrong797]

I don't know how I stumbled upon this video but it's very interesting. One of my wisdom teeth the exact same one actually was identical to this at least in the x-rays I was also roughly his same age. I remember just horrible pain, I went to a emergency place and they did imaging and then sent me somewhere else because they said they couldn't prescribe pain medicine for whatever reason and couldn't do such a job. But my x-ray looked identical to this man's my first thought was holy crap its completely sideways and underneath the other tooth my x-ray was seriously nearly identical. I ended up going to a dental surgeon place the same day the one I was recommended to and they gave me medications and sent me home then got me back in one or two days later and put me completely under and removed the tooth. I don't know too many details but they said it was very difficult and they got it out in pieces, 3 or 4 pieces. I had stitches and I think it took over a week for me to really start feeling better. I remember the dentists and everyone nerding out a little bit over the technical stuff or how difficult something like that was they seemed very excited for the challenge. There was quite a few people there all talking about it. I was just happy to get that damn thing out of my mouth.

[@centerforard]

Glad the procedure went well.

[@wasupman2284]

How old where you when you got them extracted?

[@ROGSYT]

How long did this surgery take and was there a lot of inflammation?

[@josetapia8903]

A have partial impaction on my lower right wisdom tooth can this be done with regular anesthesia or will I be put to sleep? Also how difficult is this king of surgery. I’m nervous watching these videos

[@centerforard]

I would suggest IV sedation along with local anesthesia. The surgery can be difficult.

[@Rensldn.]

After seeing this hats off to my dentist doing my extraction today. Mine were very complexed like this case. He was very gentle and compassionate aswell as my anxiety was hitting the roof. Not only am I going to be pain free, I left with breathing exercise tips 😂There’s so much involved than just ‘drilling’

[@centerforard]

Correct. Thank you for recognizing that fact.

[@MaverickTomcat69]

That looks so jammed up and super surprised how clean you got to it! Well done!

[@centerforard]

Thank you. Glad the video was helpful. Definitely difficult case. 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

[@mudkipmilk]

What was the indication for removal? It seems completely boney impacted, thus unlikely to cause any perio issue/ caries to the adjacent tooth.

[@centerforard]

Impacted teeth can develop dentigerous cysts from the follicular sac surrounding the impacted tooth. Detigerous cysts can turn into ameloblastomas, causing the bone of the jaw to degenerate. The impacted tooth pressing on the adjacent second molar can cause a bone defect or damage to the adjacent second molar. Bottom line, if the impacted teeth are to be removed, it is better to perform the surgery on a younger patient in their late teens or early 20s because the surgery is less difficult and the recovery is better than on an older patient. It is best to perform the surgery before the roots of the impacted teeth are completely formed. Easier surgery and easier recovery. 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

[@holleywood25]

I'd be interested to see a poll from dentists on whether they would go after this or not. I seriously doubt most would mess with this, I know I wouldn't unless resorption or evidence of pathology was present. That tooth will never erupt or cause issues in 99% of patients.

[@johnburstedt8427]

No pathology, no surgical removal. What did the patient benefit from having it removed? What were the risks? Did the benefit outweigh the risks? What would you say if there were permanent nerve damage? "Tough luck, buddy. It could have developed to an ameloblastoma. Incidence is 1 per 1 000 000 by the way"

[@ajax1472]

​@@johnburstedt8427so the risks outweigh the benefit

[@mals5694]

I can’t imagine the live without a dentist

[@centerforard]

Thank you, although I think you may have misplaced a word in your comment. I am not sure what you intended to say. 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

[@Ytwhna]

Is it ever an option to remove the second molar and then remove the wisdom tooth from the same hole? I have a deep horizontally impacted wisdom tooth. PS I’d then get an implant to replace the second molar.

[@centerforard]

I've never heard of that being done. I would not suggest that procedure.

[@ettamae05]

I had the same wisdom tooth, in the same place removed and 3 more. I had no problems healing.

[@centerforard]

Terrific. Glad to hear you had a good result.

[@galaxytab7689]

Great case , what if the tooth was infected and a root tip was left near the mandibular nerve ? What should we Do then ?

[@centerforard]

Do the least amount of harm. In my oral surgery fellowship at Baylor Dental School I was taught not try to remove most root tips less than 1/3 of the root if the tip is in proximity to the nerve. You do not want the patient to develop lip paresthesia. I have "slept" many root tips in 42 years of dental practice and, to my knowledge, a problem has never occurred. 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

[@anjalisawant8765]

Hello Dr. Steven , you are amazing. Actually I am scheduled for coronectomy on both of my lower impacted wisdom tooth #17 and 32. 32 is horizontal and 17 is too deep near the nerve , i got infection on 17 and was twice back to back on antibiotics. Oral surgeon said its complicated so i was refer to Maxillofacial surgeon , he said due to my age factor and the location he is going to do coronectomy. With one tooth i agree its too deep but the other tooth is horizontal, he can do extraction right ? My question is does really age matters for extractions? I am 46F , no diabetes .

[@centerforard]

Sorry, I do not diagnose without examining the patient. Good luck with the procedure.

[@juanicaza3568]

I had no idea how much of a bloodbath was to extract one of those things. that looked difficult as hell.

[@centerforard]

Removing impacted third molars is definitely complicated.

[@wrinkle1784]

Hello sir , i have an impacted wisdom teeth as well but my dentist and oral surgeon upon examining my teeth x-ray recommend not to remove my wisdom teeth as it was placed too deep and close to the nerve endings,citing high risk of nerve damage and partial face paralysis. Now I have to use an interdental brush every night to clean out the gap created by the impacted wisdom teeth and it takes me a long time everytime. would it still be wise to ask my dentist to reconsider his decision since its been a year and teeth positions might have changed.

[@centerforard]

Sorry, I do not diagnose without examining the patient in person.

[@butterpecan111]

I have always been told that my jaw would need to be broken if they ever attempted to extract my wisdom teeth. I'd love to share a pic of my xray with you to get your thoughts. If want to travel to you to do mine.

[@centerforard]

Feel free to contact my office in Waco, Texas or find a good surgeon in your area. I can't imagine your jaw would have to be broken to extract your wisdom teeth.

[@Looking4hopelife]

What handpiece are u using? Electric handpiece to prevent subcutaneous emphysema right

[@centerforard]

Yes, an electric handpiece, and I do not reflect the attached gingiva on the lingual surface, only the unattached (non-keratinized) gingiva. 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

[@haylock9430]

Very interesting video, was this aftercare different to normal due to the special circumstances?

[@centerforard]

No, the same as most impacted wisdom teeth post op care. 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

[@khaledmzher9015]

Amazing work best regards

[@centerforard]

Thank you. Glad the videos are 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

[@euplot]

Great job Steve💪

[@centerforard]

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 $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@euplot]

@centerforard I'm not a dentist. I only enjoy watching it. Thanks for posting!

[@centerforard]

Terrific.

[@Peeveish]

Just checking video before undergoing this, but it was mistake to search it as it makes me even more nervous when is has a heading of "most difficult". I have it pretty much similar from my patient point of view, just on the upper jaw, which sounds even worse. No idea how I will go through this if I already half fainted during normal tooth drilling (my dentist does not like using anesthesia, and always tell it wont hurt, .. but id did). Most likely I will be more happy with extraction of both teeth, I don't want to be youtube case scenario. But good job.

[@centerforard]

If you are apprehensive, I suggest IV sedation if there is a good dentist in your area who is certified.

[@mariamkekelidze7359]

Hello Dr. Steven, Did the patient get to keep their second molar in this case? Cause it looks like it took a massive hit. Im asking because I’m in a somewhat of a same situation myself.

[@centerforard]

Yes, the second molar was preserved. 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

[@galaxytab7689]

how do you make sure your angulation is there when you are cutting the tooth in two halfs ?

[@centerforard]

By the pa radiographs. 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

[@foxinbox500]

Doctor, regarding techniques for special needs patients, specifically cognitive/behavioral/autism combined: My son has all four teeth at 90° against the roots of the adjacent molars. Will the surgeon I choose appreciate a reference to a study? I can’t find a study available to the public that gives much information. Your suture choice here would definitely help with my son’s sensory issues.

[@centerforard]

Sorry, I cannot help you in this area.

[@beratsahinoglu7990]

I just wondered didn't you experience emphysema in patient because of using normal high speed handpiece ? In academy why they tell us to use a surgical handpiece while doing surgery?

[@centerforard]

So long as you do not reflect the attached gingiva completely, there should not be an issue with gingival emphysema. The potential problem occurs when all the attached gingiva on one side of the tooth, especially the lingual, is reflected to the unattached gingiva. Do not reflect a big flap, especially on the lingual. Aim the air/water of the handpiece into the tooth, not the gingival flap. 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

[@beratsahinoglu7990]

@@centerforard thanks for information :)

[@meetrasurrik6982]

I'm from England and I've recently had braces put in for an upcoming jaw alignment surgery in 2 years from now but I recently recovered from an awful wisdom tooth infection like one side of my face just balloned out and I had awful pain. It was my lower right hand side wisdom tooth which was causing me agony. My dentist just put me on antibiotics and said swill with warm salt water. He seems very reluctant to take any of my wisdom teeth out for some reason

[@centerforard]

I would think the oral surgeon who is performing your upcoming jaw surgery would want the wisdom teeth removed as soon as possible so you had plenty of time to heal prior to your upcoming jaw surgery. I would suggest you go see the oral surgeon who is performing your jaw surgery and possibly have him remove your wisdom teeth ASAP.

[@meetrasurrik6982]

@@centerforard Thank you for the advice, one of the oral suregeons at the hospital will be removing all my wisdom teeth over a series of appointments in January next year

[@borobrown7077]

I dont understand something Shouldnt you have left some of the apex part of the root in the socket to avoid parasthesia (permenant lost of lip sensation)? If not then how to avoid damage to the nerve?

[@centerforard]

The key is not to have damage to the nerve from the burr. It is fine to dissect the tooth into 2 or more segments, separate the segments, then elevate the segments out of the socket with elevators. 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

[@deryakuru6548]

Can it be an option excracting the second molar and then wisdom tooth.He would loose one of his tooth but maybe the operation could be easy?

[@centerforard]

I wouldn't think you would want to extract a good second molar. 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

[@deryakuru6548]

@@centerforard ,you right but, to avoid from serious complications,It can be an option.a broken jaw, nerve damage etc.

[@azwth]

Is this contra 1:5 handpiece?

[@daiyas_3596]

Hey I have some questions about wisdom teeth removal, because I have some I need to remove.

[@centerforard]

Watch the videos and ask the guy who knows everything, "Google."

[@TooToxicAries]

Any way I can send you a picture of my xray I had done today and you tell me what you think I need a second opinion 😭

[@centerforard]

So sorry, I do not diagnose without examining the patient.

[@taniahashemi6166]

I love your notebook! ❤

[@centerforard]

Glad the videos are 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

[@venkateshpraveen]

Sir why are you using airotor handpiece for sectioning the tooth? Air may get trapped into soft tissue spaces & it will end up in air emphysema complication.

[@centerforard]

Good comment. I ensure the attached /keratinized gingiva remains attached. I do not reflect the attached gingiva all the way to the non-attached/non-keratinized gingiva. So long as the attached/keratinized gingiva remains attached to the alveolar process, there should not be an issue with air emphysema. I have used air driven handpieces, carefully, for 40 + years without an air emphysema issue. If you use air driven handpicks for sectioning teeth, you must be sure not to reflect all the attached gingiva. 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

[@lyfeisfun]

this is a very tough one with the deep impaction, but Dr. Cutbirth just does it as if it was a regular exo

[@centerforard]

Thank you. I have had a lot of training and experience. 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

[@akimhassan430]

I've just had my impacted wisdom tooth extracted a month ago.. and right now the area seem to swell for the past 2 days, should I be worried if it is an infection and get it checked?

[@centerforard]

Not a bad idea to have it checked.

[@luisramrod9121]

3rd day and i still have some bledding and som pain 😢

[@centerforard]

Sorry. It may take a week or so for the issues to subside. You can watch my video on "How to Never Get a Dry Socket."

[@Stragomue]

Is the high speed bur indicated in cutting the bone?+ water instead of saline?. Do pacients swell more or the same as if using straight handpiece with saline ?

[@centerforard]

I use a high speed electric handpiece with regular clean tap water and have used that water and handpiece method for over 40 years. The touch is very light with high water volume. I have had no healing issues other than normal light to moderate swelling and light to moderate discomfort. Those issues resolve in 5-7 days. I always pack the mandibular impacted wisdom teeth sockets (refer to videos in DMC.com library). Do not reflect the attached gingiva completely. 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

[@xevora9310]

Did you have a CBCT before the procedure?

[@centerforard]

No, I did not have a cone beam radiograph taken. I had pa's and a panograph. I very rarely have cone beams taken for extractions. 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

[@Flumazenil]

Age of patient? Symptomatic?

[@ascending1988]

My wisdom tooth is impossible to extract because it is very close to the nerve. But it causes a lot of pain, can I just remove the 2nd molar?

[@centerforard]

Have a good, experienced surgeon evaluate your impacted wisdom tooth. It is very rare that a wisdom tooth cannot be safely extracted if the procedure is carefully performed by an experienced, skilled surgeon.

[@bar9886]

my 4 widsom teeth are horizontal, and im scared that they might touch the nerve, what would happen if they did ? is ot true that half my face would get paralized ?

[@centerforard]

Find a good surgeon and have the surgeon evaluate your condition.

[@wasupman2284]

That must be scary! Have you got an evaluation?

[@ModyMody-vn9yg]

Well done Very good professional work. Was the patient receiving nitrous oxide gas????

[@centerforard]

Thank you. IV sedation with Versed and Demerol. I find Nitrous Oxide makes dental work more complicated because of the hoses and nosepiece. They are in the way and make moving the patient's head more involved. I use nitrous occasionally on smaller cases, but prefer IV sedation for many reasons. I completed a 2 year oral surgery fellowship at Baylor Dental College following dental school and was certified in IV sedation. 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

[@centerforard]

Thank you. IV sedation. 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

[@CS_Star-w4i]

Been a month and my tongue is still numb. Should I worry?

[@centerforard]

Possibly. It may be a "transient paresthesia," which means the inferior alveolar nerve was not damaged, just shocked from the pressure of the lower wisdom tooth being extracted. If it is a "transient paresthesia," the feeling in your lip should return within 6 months. I would have the surgeon examine you and advise.

[@theATF]

this was exactly what I had done And man even tho I'm a male I definitely shed tears

[@centerforard]

Sorry. I hope things went well.

[@theATF]

@@centerforard both my lower wisdom teeth were super far down and basically on top of the nerve horizontally. I had them add extra anesthetic multiple times through the procedure and it didn't do anything once they were at the bottom of the tooth.

[@theATF]

@@centerforard they prescribed me Tylenol 3+30mg codeine and I have some amoxicillin clavulanate leftover from some past ear complications I am taking to help prevent infection

[@dr.mohammedabdulaziz7992]

Great job prof ♥️👌🏻

[@centerforard]

Thank you. 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

[@koohborp]

Hi Dr. Steven I realy do enjoy your dentistry masterclass.I have already subscribed to DentistryMasterClasses.So much tips and tricks that I have learned which are completely new to me. I watched all extraction videos .Even though I have done so many surgical extractions still I do not feel confident in extracting lower 3Rd molar and most of the time I refer them out. You advised against trying these extractions without having proper training but what do you advised for a general dentist who wants to get proper trainig and not being able to go through routes like residency. There are some courses out there but most of them are very impractical because most of them are on dental model or pig jaw and you don't gain enough skills required to work on your patients.I would appriciate if you could give an advise. Thanks

[@centerforard]

That is a tough situation. My feeling has always been that most surgical training requires hands on training on live patients with close supervision. That includes implant placement and difficult extractions. I do not have a good answer for you question. You can get "over your head" with a difficult surgical case very quickly. My surgical videos are intended to possibly enhance the surgical skill of a dentist who already has surgical training. 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

[@lavemrai6880]

Is that an electric handpiece or an air rotor

[@centerforard]

Electric. 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

[@keldonselman7981]

What is this paste? Is it Alvogel

[@centerforard]

I list the paste on the video. 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

[@azeryky]

Does the 2x2 guaze need to be removed after a while?

[@centerforard]

Yes, the gauze should be changed about every 45 minutes, until it is not bright red anymore when removed. When is starts just being brown, the gauze can be left out and have the patient keep mouthfuls of iced teas in the extraction area. Tea has tannic acid in it which is a good coagulant, along with the cold. It is not the drinking of the tea, but the iced tea soaking the extraction site.

[@yahiachorfi698]

you are a legend

[@centerforard]

You are kind. Glad the videos are 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

[@minhhop3208]

Thanks so much for sharing , Dr!

[@centerforard]

You are welcome. Glad the videos are 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

[@marochatzistogianni2841]

I would 100% trust this doctor !!

[@centerforard]

Thank you. Glad you like the videos. 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

[@georg3706]

How can you use Topex when its not in production anymore?

[@centerforard]

I didn't know it was not in production. One of my staff orders supplies, A small amount goes a long way. 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

[@georg3706]

@@centerforard Wrote them an email the other day and they replied Topex is no longer in production :( Thank you for your videos!

[@centerforard]

You are welcome. The resorbable gauze is the most important part of the packing. There are probably many medicaments that could be combined with the packing. The packing serves as a matrix to hold the blood clot it the socket to prevent the dry socket.

[@jimjam656]

Hi Steven great job with this extraction as always. I’m a 4th year student and I’ve recently started doing extractions. I always have trouble with lower right 7s and when attempting to use lower molar forceps or cowhorns I always get a little bit of movement and then when I continue to apply movement then I get a crown fracture and the tutor has to do an MOS to get it out. The tutor I normally have doesn’t provide much advice to preventing this, are there any tips you would suggest for a student to do when attempting lower right 7s in particular? Thank you!

[@centerforard]

If the molar roots are long ,you are not going to extract the tooth in one piece with forcepts unless it has periodontal disease and bone loss. Just approach the extraction as a surgical extraction and section the tooth, dividing it into two or 3 sections depending on how many roots (upper molar 3 roots, lower molar 2 sections). You will probably also need to make a trench around the facial and lingual/palatal of the tooth, then elevate the roots and that section of the clinical crown separately. Watch my videos on extractions. 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

[@TK-gd9td]

Doc is right, not too commonly do you simple extract 3rd molars as whole pieces from just elevation. You either trough the bone holding around it or you section it into pieces.

[@tarekabdel-naby9709]

If there is no 3rd molar you can apply the luxator mesially and try and move the lower 2nd molar distally even if only to luxate it slightly before applying the forceps. You can also apply the luxator buccally and try and push the tooth lingually while elevating like you would for a 3rd molar. Remember that a lot of 2nd molars want to move lingually as the lingual plate is thin and buccally there is the thick external oblique ridge. Once you apply the forceps and start moving the tooth bucco-linugally bear in mind that most of the effective movements for the lower second molar are towards the lingual to start with. Once it is loose enough then buccolingual and then buccal at the end to deliver the tooth. It's moving the tooth against the thick buccal external oblique ridge that can fracture the crown. Otherwise sometimes you just have to pick up the drill.

[@basamesmaeil510]

Great job. Can I keep absorbable gelatin sponge with alveogel in the socket after surgical extraction?

[@centerforard]

If you have watched my videos, you know I place medicated resorbable gauze in almost all mandibular wisdom teeth extraction sites and any other surgical extraction sites. I am not familiar with the product you mention. Watch my video on "How to Never Get a Dry Socket." 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

[@drsyedfarooqshahdentist8543]

Chief complaint ?? Is the tooth symptomatic ???

[@centerforard]

The third molars were completely impacted. 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

[@acash93]

Dr cutbirth, were you wearing loupes? The access was so difficult that it would have been a nightmare to carry out the extraction without loupes

[@centerforard]

Yes, I wear 2 power magnifying loupes with a mounted head light for 99% of my procedures. Interestingly, I have used loupes for 40+ years and my eyesight is terrific. I have never worn glasses and when I have my eyes and vision checked annually, my ophthalmologist tells me, "You have the eyesight of someone who can see the spin on a baseball." I would have assumed wearing loupes would have caused my eyesight to diminish. Luckily, hasn't happened. 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

[@trylyhourkh]

I really like this job

[@centerforard]

Thank you. Glad you enjoy the profession of dentistry. I like it also. 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

[@abdollahmojavezi3414]

Thanks

[@centerforard]

Welcome. Glad the videos are 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

[@fernandocastillo8125]

este caso requiere una tomografía para hacer un correcto diagnóstico.

[@centerforard]

Sorry, I never quote costs because they can vary depending on many factors.

[@wisdomtoothfairy]

Good job!! 😊 I also do wisdomtooth surgery everyday.

[@centerforard]

Thank you. 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

[@Adil-uq7ph]

Using air turbine for surgical extraction??? Surgical emphysema??

[@centerforard]

It is an electric handpiece. Also, do not reflect the attached gingiva completely on the facial or lingual. 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

[@alexcucos7323]

Very dangerous incision for lingual nerve

[@centerforard]

Not true so long as you keep the incision facial to the distal lingual line angle of the lower second molar. This is the classic incision I was taught in my oral surgery fellowship for extraction of impacted mandibular third molars. 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

[@JongYoon-q2n]

I agree. On a rare occasion, there is lingual nerve at the crest. Never incise past midline of the 2nd molar.

[@ikeyshuster9801]

Incredible

[@centerforard]

Thank you. I hope 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

[@ikeyshuster9801]

@@centerforard will do! I was wondering.. do you suture maxillary 3rd molar extraction sites?

[@centerforard]

Normally yes.

[@12382576]

What happen if an oral surgeon left a piece behind?

[@centerforard]

Normally no problem. Tips of roots or even entire roots are often left in the bone vs. trying to extract the root and damaging the inferior alveolar nerve. Also, roots are sometimes "slept" to preserve the bone height.

[@12382576]

Thank you

[@123birdsfly]

I just wish the volume was higher. I turned up everything and still to silent.. Otherwise its lovely.

[@centerforard]

Interesting, I am not sure why you had an issue with the volume. Sorry. 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

[@MrDevanphillips]

Was the patient put to sleep?

[@centerforard]

I am certified and use IV sedation almost daily. I would not recommend extracting difficult teeth or other difficult procedures without sedation. It is too emotionally traumatic for many patients as well as the dentist without sedation. I would not recommend performing difficult extractions or other surgeries without good training. 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

[@TebaAlaa-r1s]

Truely greattt case😍😍😍💚

[@centerforard]

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

[@ivanescobar2057]

What was the purpose pf the extraction?

[@centerforard]

Good question. Please see my answer to that question in above comments, or you can look up that question on Google.

[@JerettFranklin]

That looks so complicated.

[@nathansumanion3543]

the same case for me

[@centerforard]

I hope the procedure went well.

[@makhosimayisa5800]

The problem with leaving that impacted tooth is risk of decay on the 2nd molar.

[@georg3706]

Decay? You mean resorption.

[@yuli7458]

That's exactly what happened to me. The 2nd molar ended up with a giant cavity because there was no space for me to clean the impacted side and I ended up losing it. The wisdom tooth ended up taking that place 😅👌🏻

[@centerforard]

That is one very good reason for impacted wisdom tooth removal. There are other reasons I stated in answer to a previous comment above.

[@KingMCIV]

My dentist took 2hrs to get my teeth out. I'm think this is what happened to me ..

[@centerforard]

Wow! I hope the procedure went well.

[@perskjelbred7099]

I cannot see the indication for removal??

[@centerforard]

Look up on Google the reasons for impacted wisdom teeth removal.

[@sophiat2058]

Wow 👌

[@centerforard]

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

[@jacqal9922]

wow I though my teeth were difficult!

[@centerforard]

I hope you. are not loosing teeth.

[@jacqal9922]

@@centerforard I did get my upper wisdom tooth 3rd left molar extracted in two sessions due to my tough roots but the dentist couldn’t do my lower wisdom tooth as it was close to the nerve (didn’t take a ct scan)

[@annisabaksh4533]

he sounds like dr.phil lol

[@centerforard]

Interesting comment!

[@sayetazonen6607]

I already know his recovery was painfulllllll lol

[@centerforard]

The recovery was not that painful.

[@MassimoClVideo-zd9bq]

👏🏽👏🏽👏🏽👏🏽👏🏽👏🏽💪🏽🦷🦷

[@centerforard]

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

[@emiliaaraujo4956]

⭐️⭐️⭐️⭐️⭐️😷😷😷😷👌👌👌👌

[@centerforard]

Glad the videos are 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

[@MDhabiburRohman-vn3ip]

😅

[@perskjelbred7099]

The OPG shows no obvious pathology and the tooth is impacted with bone all around. Removal could cause injury to the inferior alveolar nerve. I still see no reason to take it out!!!

[@centerforard]

Do not let the sectioning burr come close to the nerve. Elevating the sectioned parts of the impacted tooth will not damage the nerve. Most/all impacted third molars approximate the inferior alveolar nerve. For that matter, all mandibular posterior teeth approximate the inferior alveolar nerve. You just have to be careful /precise not to cut the nerve with the burr. 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

[@jtra3440]

Gosh I wish he could speak faster! 😂

[@centerforard]

Sorry, I grew up in west Texas. I don't think any of us talk very fast.

[@right_around_the_corner]

Speak non-dentist so us hicks can understand what the thunder yall's saying.

[@centerforard]

Ha, ha, I'm trying to make it as simple as I can.