[ds680]

I had all four wisdom teeth taken out back in April. About four weeks after the extraction, I found what I thought was a bone spicule leftover from my wisdom tooth extraction in April. My family dentist even said it was a spicule and that I would probably need to get it ground down by my oral surgeon. It's basically shaped like a toenail on the bottom left side where my one tooth was taken out.

I saw my oral surgeon about a week ago. He said it's not a spicule, but a "ledge." He said it'll either absorb itself within 4-6 months, or make its way completely through my gums and cause "unspeakable pain." He was not comfortable taking it out, as he said it's pretty close to my nerve.

However, I can't find any literature on what a ledge actually is and I didn't fully understand his explanation. It has caused some pretty significant on-and-off discomfort. Could someone explain what it is?

[Bryanna]

Hi ds680,

It sounds like you are describing the bony ridge. Sometimes the ridge gets a bit displaced, out of place, due to the maneuvering of the bone to remove the tooth. In some cases it is a temporary displacement and it settles down over time. If it does not settle or becomes worse, then intervention may be necessary.

Sometimes what can also occur after wisdom tooth removal is the gum tissue ends up being very thin over this bony ridge area and in some cases the bone can even be exposed.

In either case, some surgeons suggest a wait and see approach to see if the bone settles and the gum tissue thickens up over time. If a surgical intervention is done to reduce the bone, most likely there will not be enough oral tissue to suture over the bone. So tissue will have to be harvested from elsewhere in the mouth to cover the bone.

Because your dentist and oral surgeon have not agreed on what this is exactly or what to do at this time, it may behoove you to seek a third opinion from a different oral surgeon. It would be helpful to have your pre op xrays with you for that new oral surgeon to see what everything looked like prior to the extractions.

Bryanna

Originally Posted by ds680

I had all four wisdom teeth taken out back in April. About four weeks after the extraction, I found what I thought was a bone spicule leftover from my wisdom tooth extraction in April. My family dentist even said it was a spicule and that I would probably need to get it ground down by my oral surgeon. It's basically shaped like a toenail on the bottom left side where my one tooth was taken out.

I saw my oral surgeon about a week ago. He said it's not a spicule, but a "ledge." He said it'll either absorb itself within 4-6 months, or make its way completely through my gums and cause "unspeakable pain." He was not comfortable taking it out, as he said it's pretty close to my nerve.

However, I can't find any literature on what a ledge actually is and I didn't fully understand his explanation. It has caused some pretty significant on-and-off discomfort. Could someone explain what it is?

[ds680]

Thank you so much for the incredibly helpful information. If it were to get to the stage of needing that procedure, what would I be expecting in terms of surgery (procedure, inpatient/outpatient, level of anesthesia, etc.)?

Originally Posted by Bryanna

Hi ds680,

It sounds like you are describing the bony ridge. Sometimes the ridge gets a bit displaced, out of place, due to the maneuvering of the bone to remove the tooth. In some cases it is a temporary displacement and it settles down over time. If it does not settle or becomes worse, then intervention may be necessary.

Sometimes what can also occur after wisdom tooth removal is the gum tissue ends up being very thin over this bony ridge area and in some cases the bone can even be exposed.

In either case, some surgeons suggest a wait and see approach to see if the bone settles and the gum tissue thickens up over time. If a surgical intervention is done to reduce the bone, most likely there will not be enough oral tissue to suture over the bone. So tissue will have to be harvested from elsewhere in the mouth to cover the bone.

Because your dentist and oral surgeon have not agreed on what this is exactly or what to do at this time, it may behoove you to seek a third opinion from a different oral surgeon. It would be helpful to have your pre op xrays with you for that new oral surgeon to see what everything looked like prior to the extractions.

Bryanna

[Bryanna]

Hi ds680,

You are welcome

The surgery to reduce that area of bone and the anesthetic to be used depends on several things:

** The reason it occurred in the first place.
** Is the bone fragile, weak or limited in that area? Is the jaw bone healthy?
** Is the adjacent molar and rest of the mouth healthy?
** Is the patient healthy?
** The severity and extent of the condition.
** The location of it. Is it on the buccal (cheek) or the lingual (tongue) side?
** Has the condition been very progressive and/or is the progression slowing down?
** Will tissue need to be harvested to cover the surgery site, if so, how much and from where will that be taken?

Unless there is a painful bone exposure that is relentless and still progressing, a wait and see approach is sometimes best because in many cases, the body has a way of healing itself. It just takes time. However, in other cases intervention is needed to encourage the proper healing to take place. This is why another opinion from an oral surgeon is warranted.

Bryanna

Originally Posted by ds680

Thank you so much for the incredibly helpful information. If it were to get to the stage of needing that procedure, what would I be expecting in terms of surgery (procedure, inpatient/outpatient, level of anesthesia, etc.)?