In this material we will try to discuss how to prepare for wisdom tooth removal, basic recommendations, what is and is not possible before wisdom tooth removal, the postoperative period and possible consequences.
All this will help you prepare mentally and make it easier to endure the operation itself.
- When is it better to delete
- What you can do before tooth extraction
- What not to do before tooth extraction
- Recommendation before tooth extraction
- Recommendations after tooth extraction
- Postoperative period and possible consequences
Remember, you are the one who makes the decision to preserve or remove a tooth; if you don’t understand something, ask questions and don’t be shy with the doctors, because you are also responsible for the decision.
Removal of wisdom teeth due to caries
Why are wisdom teeth most often affected by caries?
Most often, caries of wisdom teeth develops due to the fact that they are located far enough away and do not participate in the act of chewing.
And if the teeth are not involved in the act of chewing, then it is extremely difficult to clean them due to the fact that the teeth are cleaned not only during hygiene, but also during each meal - on their own. On the picture
– what caries looks like on the bottom eight.
You can see how the lower wisdom tooth is removed due to caries HERE. By the way, there, in clinical cases, you can see how the removal of an upper wisdom tooth occurs.
Often the patients themselves neglect these teeth, brush the eights less carefully and caries develops quite quickly, the wisdom tooth begins to hurt, so it will be easier to remove such a tooth than to treat it.
Can caries cause wisdom tooth removal?
Should wisdom teeth with caries be removed? Yes. Removal of the figure eight, if there is caries, is carried out due to the inappropriateness of its treatment.
In most cases, we do not chew with these teeth, and treating wisdom teeth is quite difficult and problematic. And most importantly, this makes absolutely no sense.
Removing the bottom eight can be seen HERE
There is also a situation when the wisdom tooth is strongly inclined, “lying” and covered with caries. In this case, there is also absolutely no point in treating wisdom teeth.
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If your wisdom tooth gets injured: chipped or cracked?
Should it be removed? A chip, crack, or injury to a wisdom tooth is a 100% indication for removal
wisdom tooth There is absolutely no reason to fight to save him.
Tooth with severed roots: features of the operation
If a tooth located in the lower jaw row is to be removed, the roots of which have bends directed inwards or diverge in opposite directions, then the procedure is carried out using an angular elevator.
The surgeon places the instrument into the periodontal fissure, pressing it between the root and the socket, and gradually moving it deeper. At the same time, the root is displaced and pulled outward. A similar scheme is done with another branched root.
If the manipulation is carried out correctly, then complications do not arise and the rehabilitation period passes quite quickly.
Wisdom teeth during orthodontic treatment
Removal of wisdom teeth before orthodontic treatment
During the period of orthodontic treatment, when the bite is being corrected, the figure eights are also most often removed. Why?
Before orthodontic treatment, we need to remove teeth that are preventing all the remaining teeth - 28 teeth - from moving into place. As a rule, wisdom teeth do not provide freedom for such activities. We remove them and then perform orthodontic treatment.
In what cases are wisdom teeth not removed during orthodontic treatment?
In the case of large jaws, when the wisdom teeth are in an absolute row and they close correctly, in the correct occlusion, we do not need to remove them. We can leave them, we can also treat them, take care of them, like other teeth.
How to remove complex teeth: basic techniques
In dentistry, various methods are used to eliminate a complicated tooth, the essence of which depends on the instruments chosen for manipulation:
- removal using forceps. Compared to other methods, this is considered the most gentle. This technique is used in cases where the integrity of the crown is preserved. The surgeon grabs the crown with forceps and loosens it in a circular motion until the tooth root ruptures from the alveolus, after which he pulls it out;
- elevator extraction. If it is located outside the dentition, it is impossible to pull it out with ordinary forceps, then this technique is used. The instrument is inserted into the periodontal fissure and rotated, as a result of which the ligaments are torn. The tooth is not pulled out of the hole, but squeezed out;
- removal with a drill. This method is used to pull out teeth with multiple roots. First, the roots are separated using a drill and then each piece is removed separately. If a resorcinol-formalin filling is installed on a tooth, then a drill is also used to pull it out.
Which method is the best? Each has certain characteristics and is selected based on the condition of the tooth, the number and depth of its roots.
Impacted and dystopic wisdom teeth
Impacted wisdom tooth
- this is a tooth that has not erupted; it is located in the bone tissue, in the gum. The general practice is that few dentists decide to remove an impacted figure eight, since it is a complex procedure.
In the clinics of the German Implantology Center, removal of impacted wisdom teeth is carried out as planned; our experience allows us to perform surgery of this level.
Why don't wisdom teeth erupt?
The wisdom tooth does not erupt due to the fact that it is dystopic: there is a neighboring tooth in front of it, which is in the way.
This wisdom tooth is usually tilted. Or there is absolutely no room in the jaw, it is located at the corner of the jaw: there is no place for it to cut through, there is no way.
Dystopic tooth
A wisdom tooth is a tooth that is erupting or has erupted incorrectly. Or it cannot erupt and occupies the wrong position in the jaw.
Typically, such teeth displace other teeth, deforming the jaw. It is impossible to treat them, and straightening them is also extremely difficult. In these cases, we remove the dystopic wisdom tooth. As a result of dystopia, cheek injuries may also occur due to chronic biting. Therefore, it is better not to postpone the removal of the dystopic eight “for later”.
Removal of wisdom teeth in pregnant and lactating women
Removal of wisdom teeth in pregnant and nursing mothers
Is it possible to remove wisdom teeth during pregnancy? Pregnant and lactating women can have their wisdom teeth removed only in case of exacerbation of one of them or necessity, when it is impossible to solve this problem conservatively. In a planned manner, it is better to remove wisdom teeth after the end of the feeding period.
Are there any special features of removing wisdom teeth during pregnancy?
We try to perform tooth extraction on all our patients as carefully, comfortably, and carefully as possible. Therefore, as a rule, there are no technical features. But if any intervention in the form of wisdom tooth removal is urgently required (because there is no other alternative), we must consult with the attending physician - a gynecologist and, accordingly, coordinate all our actions.
What anesthesia is used when removing wisdom teeth in pregnant and lactating women?
In pregnant and lactating women, after consultation with a gynecologist, we, as a rule, perform anesthesia with a reduced level of adrenaline, so as not to provoke the onset of labor in the later stages, and not to provoke a miscarriage in the early stages.
Contraindications to tooth extraction
Of course, if the situation is urgent and tooth extraction is inevitable, the doctor will perform the procedure immediately after the patient seeks help. But if the operation is planned, then in some cases it is recommended to refrain from it. Contraindications include the following conditions:
- acute viral disease, pneumonia;
- oncology;
- some blood diseases;
- recent myocardial infarction;
- tumors and other lesions in the oral cavity.
In addition, tooth extraction is a procedure undesirable for pregnant women. But if it cannot be avoided, then doctors recommend, if possible, to carry it out in the second semester.
Removal of a wisdom tooth near the maxillary sinus
If the wisdom tooth is located near the maxillary sinuses, there is a certain difficulty in such removal. Why?
If a wisdom tooth is located close to the maxillary sinus, there is a risk that during removal the tooth can be pushed into the maxillary sinus. If you make incorrect technical movements when removing a tooth, or work roughly in some way, you can harm the person and, accordingly, you will then need expensive long-term treatment to remove this tooth.
Indications for removal of all teeth
Dentists recommend complete tooth extraction in very rare cases. This is usually caused by periodontal disease, which is characterized by excessive mobility of the teeth. Also, all teeth must be removed before orthopedic treatment.
With periodontal disease, doctors remove all teeth if they begin to move in all planes, i.e. with periodontal disease of the 3rd degree.
Complete removal of teeth for orthopedic reasons is carried out before installing removable dentures and before restoring the integrity of the dentition using dental implantation.
Are there any specifics to removing wisdom teeth?
Of course, there are some peculiarities when removing wisdom teeth. The doctor’s task is to make the removal process as accurate as possible, as atraumatic as possible - in principle, like the rest of the teeth. But in the case of a wisdom tooth, there are some peculiarities of anatomy.
The peculiarities are that the figure-eight tooth is located quite far away and quite well hidden. But at the same time, using modern equipment, modern materials and having experience, you can remove wisdom teeth quickly and accurately enough without consequences or injuries.
What methods of tooth extraction are used?
In modern dentistry, different methods of tooth extraction are used. In most cases, the choice of one method or another depends on the characteristics of a particular situation.
Simple method
In this case, we are talking about removing a tooth with a well-preserved crown, which is located in an accessible place. And although extraction is carried out exclusively by surgeons, such manipulation, especially in public clinics, is often performed by dental therapists.
During tooth extraction, a specialist uses different instruments. First of all, these are tongs. They vary depending on what teeth they are used for. For example, there are S-shaped forceps that are used to remove premolars and molars in the upper jaw, or forceps that are used to remove exclusively lower molars. In addition to forceps, luxors and elevators are also used, which perform the functions of lever tools.
Direct tooth extraction can occur in different scenarios. So, when extracting a single-rooted tooth, the doctor uses a technique called rotation. It involves rotating the tooth around its axis, which allows you to quickly remove the element. If the tooth is multi-rooted, then luxation or rocking is necessary. Thanks to gradual loosening movements, the doctor gradually extracts the tooth along with the root.
Complex method
Complex extractions are usually performed on multi-rooted teeth. The fact is that sometimes even prolonged swinging of the tooth does not produce results. In such a situation, the specialist uses a drill and saws the tooth, separates the roots and gradually removes all the parts. A similar procedure is also often used when the crown of the tooth is severely damaged or there are other serious problems, for example, the root system is too thin and fragile. The situation is even more complicated if the tooth is completely or partially impacted or is in an incorrect position. In particular, this often happens with wisdom teeth. In such a situation, it is necessary to first cut through the soft tissue and only then saw the tooth itself.
Piezosurgery
This method is innovative, so it is not yet widespread. Piezosurgery is usually used to remove complex teeth. In this case, the tissue incision is made with an ultrasonic scalpel. This method is much less traumatic, since ultrasound in no way directly comes into contact with tissues. Thus, the patient recovers much faster than after conventional surgery.
Laser tooth extraction
As in the case of piezosurgery, in this case the tooth is removed not with conventional instruments, but with the help of a laser beam. This is also a non-contact technique associated with less blood loss and less risk of injury. In addition, the pain of the procedure itself when using a laser is much lower, so this option is suitable for people who suffer from allergies to anesthetics. Unfortunately, both piezosurgery and the use of laser are quite expensive manipulations, so they are not yet performed widely.
Competent removal of wisdom teeth
How to remove a wisdom tooth in the least traumatic way?
The wisdom tooth is removed atraumatically after carefully evaluating the computed tomography scan, talking with the patient, and assessing his clinical case. The tooth is separated - divided into parts if it has any bends, slopes, or several roots. And, accordingly, with the help of elevators, luxators - special dental instruments, it is carefully and carefully dislocated.
There is no need to worry about the appearance of some blood after wisdom tooth removal. The removal is carried out under the full supervision of a doctor; the wound after tooth extraction is sutured and sutures are applied. What follows is a standard rehabilitation protocol without any surprises for the patient. The only thing is that after the removal of a wisdom tooth (wisdom teeth), swelling of the mucous membrane is possible.
Why is atraumatic tooth extraction more preferable?
With this removal, the doctor takes care of the health of the patients. So that the healing takes place as comfortably as possible, so that there are no consequences after this, so that the patient in the near future, after 7-10 days, forgets that he had his wisdom tooth removed. It is after this time that possible swelling and pain after removal are completely removed.
Preparing for tooth extraction
For many people, tooth extraction is a very unpleasant and even frightening procedure. In fact, such fears are a consequence of those times when this manipulation was done without anesthesia using rough instruments. Today dentistry has stepped far forward, so removal takes place in much more comfortable conditions. You should not be afraid of the procedure, because the right psychological attitude is also one of the important conditions for the success of the operation.
To ensure that no incidents occur during tooth extraction, you must inform the surgeon about your state of health. If you have allergies, chronic or acute illnesses, be sure to tell your doctor. The same goes for the medications you take. Avoiding complications will also help avoiding alcohol and cigarettes the day before the procedure.
It is important to remember that you will not be able to eat or drink for some time after tooth extraction. Therefore, it is recommended to eat well before the procedure.
Anesthesia for tooth extraction
Tooth extraction is a rather painful procedure, so it is almost never performed without anesthesia. The exception is people with allergies to anesthetic drugs. Most often, when extracting teeth, local anesthesia is used using an injection. Usually we are talking about the so-called conduction anesthesia, which is injected directly into the nerve and has an increased concentration of the active substance. Naropin, ultracaine, ubistezin, etc. are used as the latter.
In addition to local anesthesia, general anesthesia may also be used during tooth extraction. Today, sedation is the most popular. This is a procedure in which the patient is given a strong sedative. He is in fact conscious, but does not feel pain and remains as if in a dream. Anesthesia is a more serious procedure that involves complete loss of consciousness, which in turn entails a longer recovery period.
General anesthesia for tooth extraction is used if the patient is intolerant to drugs for local anesthesia. In addition, it is used if a person has mental disorders, as well as if he experiences severe fear of the procedure. It is also justified if several teeth are to be removed at the same time. For example, sedation is often used when wisdom teeth are extracted. The procedure is done under the supervision of an anesthesiologist. Before the manipulation, the patient undergoes tests, performs a cardiogram and other procedures to diagnose the condition of the body.
Pain after wisdom teeth removal
How long does pain last after wisdom tooth removal?
Pain after the removal of wisdom teeth lasts differently, depending on the sensitivity of the person and how the healing proceeds in general. It hurts after removing the figure eight from several days to, maximum, 7-10 days. Naturally, all pain, all painful symptoms from wisdom tooth removal subside over time.
What should you do if the wound hurts for a long time after wisdom tooth removal?
If you experience prolonged pain after wisdom tooth removal, you should contact your doctor as soon as possible, and he will adjust his prescriptions. If any problems arise, he will solve them.
When should wisdom teeth not be removed?
What can serve as a contraindication to wisdom tooth removal? A contraindication to wisdom tooth removal may be a person’s health condition, as a result of which we cannot subject him to such a surgical intervention.
For example, if the patient suffers a heart attack in the near future, within six months. Or he has some kind of uncompensated disease. In these cases, we first prepare the patient, consult with related specialists, and after that, as planned, we carry out removal procedures.
Cases when complex surgery is necessary
It often happens that the only possible way to get rid of a defect formed by a complex tooth is to remove it.
Indications for this type of procedure are as follows:
- the formation of periodontal tumors and edema, accompanied by soreness of the mucous membranes and gums;
- numbness of the face resulting from damage to the nerve endings of a diseased tooth;
- with an increased risk of curvature of adjacent teeth;
- in the presence of diseases caused by improper positioning of the tooth.
Surgeries to remove problematic teeth are contraindicated for those who suffer from pathologies of the cardiovascular system, with poor blood clotting, patients who have undergone a hypertensive crisis, in the presence of infectious or viral processes in the body, as well as other individual contraindications.
Complications after wisdom tooth removal
What may be the cause of complications after removal of figure eights?
Complications after removing the figure eight - yes, they exist. Complications are different: they occur directly during the removal procedure, there are delayed ones, blood vessels may be damaged, and bleeding may occur. There may be a fracture of the jaw, a breakage of a section of bone tissue that is located in close proximity to the wisdom tooth.
Long-term complications – for example, wound infection in the case of unsterile instruments. If the doctor did not warn the patient that he needs to take antibiotics prophylactically for an impacted wisdom tooth.
What are the complications after wisdom tooth removal?
After the removal of a wisdom tooth, there are complications of different etiologies: they can either arise immediately or be delayed. Bleeding may immediately occur, your jaw may break, a piece of bone may break off (both small and large) - then your jaw will begin to hurt. You can tear the mucous membrane, injure a neighboring tooth, break a neighboring tooth, etc. Your gums or throat may begin to hurt.
Delayed complications are oral infection, periostitis, alveolitis, inflammation of bone tissue.
Can the temperature rise after wisdom tooth removal?
After the removal of a wisdom tooth, the temperature may rise in people who are very nervous or have suffered a lot of stress. This will be a vegetative-vascular reaction, and once the temperature can rise to 38.5-39 degrees. Once. It can be brought down by the use of antipyretic drugs and, accordingly, it should no longer be present. There may be a low-grade fever of 37 degrees, 37.1-37.2, for several days after removal. This does not have any consequences, this is normal, but you should, of course, inform the doctor about this so that he takes this fact into account and adjusts his prescriptions.
Can gumboil appear after wisdom tooth removal?
After wisdom tooth removal, gumboil may appear. This can happen as a result of a wound becoming infected. For example, the use of non-sterile instruments, non-sterile materials. This can also be a result of the removal of an impacted wisdom tooth, for example, if the doctor “sutured it in tightly”, and there are a lot of bacteria in our oral cavity, and did not prescribe antibiotic prophylaxis. In this case, flux is likely to occur.
Dry socket syndrome during wisdom teeth removal
Dry socket syndrome in wisdom teeth
The wisdom tooth refers to the concept of dry socket, or more precisely, dry socket syndrome. A dry tooth socket is alveolitis. Dry socket syndrome after the removal of figure eights can occur in this area, especially in the area of the lower wisdom teeth due to the fact that as a result of swallowing, as a result of opening the mouth, muscles tense, which aggravate the occurrence of alveolitis.
What can dry socket syndrome lead to and what to do?
A dry socket after the removal of figure eights can lead to very severe pain that radiates to the temple and ear. This is a very great torment: a person cannot, even if he is not sensitive, he cannot tolerate it, he will definitely take painkillers 4-5 or 6 tablets. And as a result of this, he will still go to the dentist. A dry socket, if it has formed after removal, will not go away on its own. Alveolitis can only get worse - up to inflammation of the jaw. There may be dire consequences.
Recommendations after wisdom tooth removal
What medications should you take after wisdom tooth removal?
The following medications are used after wisdom tooth removal: painkillers, mouth rinses - special, with a strong antiseptic content. Often, an antibiotic is prescribed as therapy after the removal of the figure eight, and we also prescribe probiotics to restore the intestines after taking antibiotics.
Recommendations after wisdom teeth removal
In general, the recommendations are the same as in the case of removing simple teeth. But they should be performed more carefully.
Physical exercise
–
exclude
. Try not to disturb the extraction site, because the wisdom tooth is located in an awkward/unfortunate area where swallowing and opening the mouth will affect the surgical site.
Of course, wisdom tooth removal is incompatible with subsequent alcohol consumption for several days. Smoking is also strictly not recommended.
Brushing your teeth after wisdom tooth removal
Is it necessary to brush your teeth after wisdom tooth removal or can you wait a few days? You should definitely brush your teeth after removing a wisdom tooth. This needs to be done quite carefully, but at the same time carefully. It is not recommended to rinse your mouth after wisdom tooth removal. That is, the question “what to rinse your mouth with” in this case disappears. Using an irrigator is also not recommended.
Removing 2 wisdom teeth at the same time
Removal of two wisdom teeth from one side of the jaw. Pros and cons of this approach.
Two teeth at once on one side is a very good technique. In this case, we immediately remove two teeth and the healing process takes place only once. Accordingly, the pain also disappears once. The healing is in no way burdened by the fact that we remove two of them at once. It’s a good, even excellent approach, and that’s what we do in most cases if the patient doesn’t mind.
An example of removing two wisdom teeth at once - HERE
Implantation in the wisdom teeth area
Is implantation performed in the area of wisdom teeth?
In the area of wisdom teeth, implantation is not performed in any cases. Due to the fact that there is no space in the jaw to install implants in this area. And, if we look at the jaw, it opens more in the anterior section, and in the posterior section it opens least. If we place an implant, we will not be able to make a normal-sized crown and, accordingly, use these implants for chewing.
During implantation, in case of bone tissue deficiency, the tubercle of the upper jaw or the retromolar space in the lower jaw is used to fix the outermost implants. If there is an impacted eighth tooth in this area, it is removed regardless of the complexity of the operation, since it interferes with the installation of the implant.
Tooth extraction procedure: what is important to know?
The removal of each tooth can take place according to a different scenario. To predict it, the doctor conducts an examination and also takes an x-ray. In most cases, removing teeth from the upper jaw is easier and faster, but teeth on the lower jaw can create certain problems. This is explained by the fact that the lower chewing teeth have a much more complex root system. In addition, the bone tissue itself is denser here.
Also, before the procedure, it is important for the patient to prepare for how long it may last. As a rule, simple tooth extraction goes very quickly. The doctor needs 5-10 minutes to carry out all the manipulations. However, if we talk about complex removal, then in this case the time spent in the office may last for 20-60 minutes.
Cost of wisdom teeth removal in Moscow
The price of removing one wisdom tooth in Moscow clinics, if we talk about low-traumatic removal of both lower and upper wisdom teeth, can start from a price of 15 thousand rubles
and higher. The fact is that when removing a figure eight, the cost of bone material, which is used for small bone grafting, can be added to the price of the removal itself, since after removing a deep-lying figure eight, a void may form, which, you see, needs to be eliminated due to fears of the development of atrophy bones in this area.
But many doctors, both in Moscow and in the regions, neglect bone grafting and simply suturing the wound, thereby reducing the cost of wisdom tooth removal to 8-10 thousand. The choice of price always remains with the patient, but the patient also needs to evaluate the risks of such removal, look a little into the future and understand that saving 5-10 thousand rubles at this step may result in future problems with the 6th and 7th chewing teeth ... But this is a completely different story.
