I had two wisdom teeth removed and looked at them after my dentist completed the procedure. My dentist declined and said she was behind schedule because my case was more complicated than she thought. She didn’t want to keep the next patient waiting any longer. It took almost four weeks for the area to heal.  Now I have pain on the left side of my face and behind my eye. I think a root tip may be left in the socket. It’s probably why my dentist wouldn’t show me the tooth. Should I ask my dentist about it or go elsewhere? I don’t want this problem to linger too much longer. I’m supposed to start Invisalign in March. Thanks, Heidi

Heidi,

You can ask your dentist about any complications during wisdom teeth removal and give her a chance to explain. You can get a second opinion if you’re unsatisfied with her response. Below is some information on tooth roots breaking during extraction.

Why Might Tooth Roots Break During Extraction?

Root fractures can occur during tooth removal, especially in older patients. Extra cementum buildup can make root ends thicker and prone to breakage during removal. It may not be fair to blame the dentist.

What If a Tooth Fragment Is Left Behind?

If a significant piece of the tooth, like an entire root, is left behind during an extraction, the gum can heal over it. The fragment can become susceptible to infection later. If you suspect a root fragment remains, get an X-ray from another dentist or oral surgeon. An oral surgeon can potentially remove the fragment, particularly if the bone hasn’t healed over it yet.

Post-operative infections can occur after tooth removal, but the risk is higher for impacted wisdom teeth where the gum is stitched closed after surgery. If your tooth wasn’t impacted and the socket remains open, a potential infection can drain naturally, and the surgical site can heal without incident.

Management of Broken Roots

The size of the broken root tips after extraction determines the treatment recommendation.

• Small root tips. If small root tips are near nerves or sinuses, removing them can be risky.
• Large root tips. An oral surgeon may recommend removing large root tips. Extracting the root tips may require removing some of the surrounding bone. If your dentist has the skills, they can complete the extraction. Otherwise, an oral surgeon can complete the procedure.

What You Can Do

What can you do if a dentist leaves a tooth root fragment in the socket after extraction?

• Understand that unforeseen complications like root fractures can occur during extraction.
• Ask your dentist for an explanation.
• If you suspect a root fragment remains and your dentist doesn’t admit it, get a second opinion.
• Ask for a refund or partial compensation if you experience complications and you require further care.
• Resolve your concerns before Invisalign treatment to prevent interruptions later.

 

Dr. Brian LeSage, a Beverly Hills accredited Fellow of cosmetic dentistry, sponsors this post.