Complications from a Horizontally Impacted Wisdom Tooth
I'm a 39-year-old male, standing at 6 feet 6 inches and weighing 260 pounds. I don't take any medication, don't smoke, and I’ve never had any notable health problems or allergies. However, an issue has arisen since July. A few months back, I discovered a bump on the left side of my jaw. After getting an x-ray, the results indicated the presence of a cyst. My doctor recommended a biopsy to determine if it was a tumor or simply a cyst. Two weeks ago, I underwent this procedure under general anesthesia, and the findings revealed it is indeed a benign cyst. Yesterday, during my follow-up appointment, the doctor explained that the cyst is being caused by my impacted wisdom tooth, which also needs to be extracted alongside the cyst. He noted that the adjacent tooth has minimal root support due to the cyst's presence and may need to be removed as well, along with potentially another neighboring tooth. It was alarming to hear that there’s a risk of losing sensation in that area due to potential nerve damage during the extraction. What worried me even more was the possibility of having to break my jaw to complete the removal of the wisdom tooth, which would require wiring my jaw for four weeks. The doctor also proposed installing a tube between my tooth and gums for a period of nine months; this would need to be maintained three times daily but might decrease the likelihood of complications. Feeling extremely anxious about the entire situation, I'm considering seeking a second opinion.
Answers (1)
9/9/2025, 11:01:49 AM
OpenHealth AI
It’s understandable to feel anxious given the complexity of your situation regarding the impacted wisdom tooth and associated cyst. Here’s a summary of your concerns and step-by-step guidance moving forward.
Main Points
- You have a benign cyst related to an impacted wisdom tooth, which may require extraction.
- There's a risk of nerve damage and potential jaw surgery needed for the extraction.
- You are considering seeking a second opinion due to anxiety about the procedure.
Explanation
Impacted wisdom teeth can lead to complications like cysts, as you've experienced. While the cyst is benign, it can affect neighboring teeth and jaw structure, leading to the recommendations for extraction. The concerns about nerve damage during extraction and the possibility of more extensive surgery, like breaking the jaw, are valid and should be discussed thoroughly with your healthcare provider.
Next Steps
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Communicate Your Concerns:
- Before making any decisions, have an in-depth conversation with your dentist or oral surgeon. Ask them to explain the procedure in detail, including the reasons for considering multiple extractions and the likelihood of needing jaw surgery.
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Discuss Risks and Benefits:
- Clarify the risks of nerve damage versus the benefits of removing the impacted tooth and cyst. Understanding the necessity of each part of the procedure can help alleviate some anxiety.
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Consider a Second Opinion:
- If you remain uncertain or anxious after your discussion, seeking a second opinion from another oral surgeon can provide reassurance and potentially alternative treatment options.
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Prepare for the Procedure:
- If you decide to proceed with the extraction, ask about the anesthesia options and post-operative care to ease your concerns.
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Self-Care:
- Focus on your overall health and nutrition in preparation for surgery. Hydration and a balanced diet can aid recovery. Also, consider relaxation techniques such as deep breathing or mindfulness exercises to manage anxiety leading up to the procedure.
It's completely normal to feel anxious about dental procedures, especially when surgery is involved. Take your time to gather information, and prioritize your comfort and understanding in whatever decision you make. Let me know if you have more questions!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 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