Does this unicorn dental professional exist and how do I find them?

September 16, 2024 7:03 PM

I've got two problem teeth in the same quadrant that need surgical work. Have previously had work by and endodontist and and oral surgeon but problems persist. I'm hoping to find someone more skilled/confident that can maybe knock both of these issues out in one go.

I'll try and keep context brief.
Problem 1: I had 3/4 wisdom teeth taken out in early 2020. The last, on my bottom right side, was deemed to be too close to the nerve to take out without too high a gamble, and they felt it likely wouldn't shift too much. Bad dice roll. It's now shifted enough that it's pushing significantly into the molar on that side and causing pain/discomfort. The root of that molar is visibly curved due to the intruding wisdom tooth. Currently have a consult with the same surgeon scheduled in November to evaluate options.

Problem 2: I had a root canal done in January 2024 on tooth #30 on that same side, second tooth in from the back on the bottom. That tooth's root is also too close to the nerve and the endodontist wasn't comfortable filling it all the way down, hoping that cleaning it out thoroughly would be enough to alleviate the problem. Bad dice roll. That bottom section is still inflamed and causing pain/discomfort at an increasing rate. They have advised going in surgically and removing a portion of the root structure, but they did not seem overly confident about working around that nerve.

What I am hoping for is to find a more skilled and confident oral surgeon that has more experience with scenarios like this, where these teeth lay so close to this nerve. I am not excited about getting two surgeries in the same area in a small window of time, and both of these doctors have expressed concern about the procedures. I currently feel like I have two issues that only got 75% solved and I want to be done with this.

Are there oral surgeons out there who would address wisdom teeth and Endodontics work?Short of cold calling oral surgeon offices, how would I find these people? My normal dentist is not a big help and typically just refers me to these two other places because that is who they work with.

I am also open to specific suggestions if anyone happens to have any. Location: central Shenandoah Valley in Virginia, but I would be willing to drive to places like Charlottesville, Richmond, Winchester, NoVA, etc. if there was an option there. I appreciate any and all help and advice!

posted by Teadog to Health & Fitness (2 answers total)

A word I know that may help with searches (or when asking for a referral) is "maxillofacial surgeon" which is the type of surgeon who specializes in all things face/neck/jaw (as opposed to an oral surgeon who is more of a dental-only specialist). My neighbor growing up was one of these, and he pulled my wisdom teeth. They might be better equipped to take all of your concerns into account at once.
posted by axiom at 8:29 PM on September 16 [2 favorites]

What you want to look for is a provider who has the ability to take a Cone Beam image, which will show the entire area in 3d, like a CAT scan would. This will allow them to track the nerve in its relationship to the tooth roots. This will aid in both the wisdom tooth extraction and the endo issue.
Oral surgeons will typically not do endo apical surgeries, and endodontists will not do extractions (by and large) but either type of practice might have a cone beam and the image could be shared. Or you might find a group practice that has both specialties, but it's very unlikely you'd have both procedures done at one time.

At this point (failing endo #30) an OS could offer extraction of 30 and 32, and placement of an implant where 30 was. that's the closest to one-stop shopping that you might get.

Wishing you good luck in this.
posted by OHenryPacey at 9:57 AM on September 17 [1 favorite]