Needing a tooth extracted can certainly feel nerve-wracking. But likelihood is, thoughts of dying during routine dental extractions seems overblown.
Otherwise, the vast majority of removals prove uneventful. Very rarely do serious complications like death occur. But what are the actual odds?
According to a 2017 study of 148 dental deaths across the US over a period of several years, the researchers found that the primary cause of death was anesthesia-sedation-medication-related complications.
Previously, there had been a couple of incidents where healthy young people died during a routine wisdom tooth extraction. And, indeed, this was due to an adverse reaction to the sedatives or anesthetics administered to manage discomfort during the procedure.
Broadly, death associated with dental extractions is extraordinarily rare, with rates around 2.6 deaths reported per year. The risk also increases if the procedure is undertaken in a non-hospital setting, as in a 2021 case where a patient dies from cardiac arrest and brain injuries.
The risk of death with general anesthesia is estimated at:
- 1 death per 100,000-200,000 simple extractions
- 1 death per 2,000,000-5,000,000 for low-risk individuals
So in general, the average patient undergoing a routine extraction in a dental office has an extremely tiny risk of mortality. However, certain factors can increase danger.
Causes of Extraction-Related Deaths
In exceptionally rare cases, deaths can occur from:
- Adverse reactions to anesthesia or medications.
- Uncontrollable bleeding from blood clotting disorders.
- Cardiac health events like heart attack or arrhythmia.
- Airway obstruction leading to asphyxiation.
- Sepsis from serious infections spreading.
However, with proper health assessment and monitoring, even these severe events become very preventable today.
Let’s look at some complications that can put your life at risk during tooth removal:
Extractions of Impacted Teeth
Surgical extractions of impacted or unerupted teeth like wisdom teeth do pose slightly higher risks than simple, erupted extractions. Mortality rates with impacted teeth involve:
- Around 1 death per 500,000-1,000,000 third molar removals
- Higher rate of 1 in 10,000-30,000 for those over 25 years old
But modern techniques continue improving safety. Older studies cited higher death rates of 1 in 5,000-10,000.
Overall, while impacted wisdom teeth carry more risks than standard extractions, deaths still remain unlikely, especially if performed by trained oral surgeons.
Risk of Hypoxia
One potential risk of wisdom tooth removal is hypoxia, a condition where the brain is deprived of oxygen due to a blocked airway while under anesthesia.
However, it’s crucial to note that the chances of critical problems like brain damage or death occurring during anesthesia are exceptionally low, approximately 1 in 365,534, according to the American Association for Oral and Maxillofacial Surgeons.
Furthermore, when administered by a properly trained professional, anesthesia has a remarkable safety record, as highlighted in a comprehensive review sponsored by the FDA and the NIH.
Risk of Nerve Damage
Another risk associated with wisdom tooth removal is nerve damage. During the extraction process, the inferior alveolar nerve or the lingual nerve, both located in the lower jaw, can be injured, leading to temporary loss of sensation, discomfort, or tingling in the tongue, chin, teeth, gums, or lower lip.
In most cases, this type of nerve damage is temporary and resolves over a few weeks or months. Permanent nerve damage is exceedingly rare, but it is a possibility that patients should be aware of.
Complications during extraction of upper molars
During the extraction of the maxillary molars located in the upper jaw, there is a risk of damaging the sinus cavity, which is an air-filled space behind your cheekbones and forehead. This can happen because the roots of these teeth are often close to the sinus floor. If these roots are large or curved or if the sinus is unusually positioned, there is a higher risk of sinus perforation.
Sinus perforation can lead to complications such as sinusitis, an infection caused by bacteria entering the sinus cavity through the gap; Oroantral Fistula, which is associated with difficulty in breathing through the nose; and pain and discomfort; and delayed healing.
To prevent sinus damage, dentists often take preventive measures such as conducting imaging studies (like X-rays or CT scans) to assess the proximity of the tooth roots to the sinus, using specialized techniques to elevate the tooth gently, and sometimes using bone grafts to support the sinus floor if it’s too thin.
If a sinus perforation occurs, dentists usually take steps to repair it, which may involve stitching the membrane, using a barrier material, and prescribing antibiotics to prevent infection, but it shouldn’t be fatal.
Incomplete tooth extraction
There are also some instances where a portion of the tooth or its roots remains in the jawbone. Incomplete tooth extraction increase the risk of infection, pain and discomfort, gum issues, difficulty chewing, cyst formation, and even bone damage.
To prevent these complications, dentists may use imaging techniques like X-rays to thoroughly assess the tooth and its roots before extraction. If a fragment is left accidentally, it should be promptly addressed through a follow-up procedure to prevent complications.
Factors Affecting Extraction Complications Risks
Variables that heighten mortality statistics include:
- Patient age – The elderly have higher chances of extraction death.
- Medical health – Those with uncontrolled diseases like heart disease or diabetes are most vulnerable.
- Provider skill – Oral surgeons have less complications than general dentists.
- Use of anesthesia – Intravenous sedation increases risks versus local numbing.
- Procedure complexity – Surgical extractions of full bony impactions raise dangers.
Talk to your dentist about your health profile to understand specific risks. But for most healthy individuals, needed extractions prove safe and uneventful in skilled hands.
While extractions theoretically pose life-threatening dangers, dental offices take extensive precautions to prevent any medical crises.
It’s important for individuals considering wisdom tooth extraction to discuss these risks thoroughly with their oral surgeon, ensuring they are well-informed and confident in the procedure’s safety and potential outcomes.
Weigh your specific health profile and options with your dentist. But avoid refusing needed extractions solely out of disproportionate mortality fears. The dental team wants you to understand realistic risks so you don’t delay essential care.