Wisdom teeth: treatment features and difficulties of removal

For many people, rotten wisdom teeth pose a real and very serious threat to the health of the entire oral cavity - problematic third molars or, as they are also called, “eights” cause a lot of trouble for their owners. They erupt much later than the rest of the dentition (at about 20-25 years) and often become a problem already at the eruption stage.

What complications can wisdom teeth cause?

Difficulties arising from third molars are primarily associated with the late timing of their eruption and some anatomical features of the jaw structure:

Lack of space for normal eruption. By the time the “eights” begin to cut, a person’s dentition is usually already fully formed, and there may simply not be enough space for the third molars. In addition, during evolution, the human jaw has decreased by about 1 cm, which also does not contribute to the normal growth of “eights”. In this case, tooth extraction is indicated to prevent displacement of the entire dentition.
Incorrect position in a row (dystopia). Leads to soft tissue injuries, destruction and displacement of adjacent teeth.
Incomplete eruption (retention). Impacted “eights” cause a lot of problems and discomfort - often such a wisdom tooth causes inflammation of the gums and diseases of the “neighbors” in the dentition.
Pericoronitis. An inflammatory disease characterized by swelling of the gums near the wisdom tooth followed by suppuration. When teething is difficult, a so-called hood of mucous membrane is formed around the figure eight, which is the optimal place for the accumulation of food debris and the proliferation of bacteria. In this case, the wisdom tooth is cut and hurts due to inflammation of the hood. If nothing is done, gum inflammation develops not only next to the tooth, but throughout the entire jaw - this will require long-term and costly treatment of the gums.
Deep caries of wisdom tooth. Third molars, as a rule, begin to deteriorate quickly, often at the eruption stage. Why do wisdom teeth crumble? This is due to both the peculiarities of its structure and its position: it is simply impossible to clean the “eights” well with paste and a brush, so food debris and bacteria necessarily accumulate there, creating favorable conditions for the development of infectious processes.

In all the described situations, it is better to remove wisdom teeth immediately, without waiting for serious complications to develop, and you will have to spend a lot of time and money on treating nearby teeth, as well as inflamed gums.

Dental roots affected by caries are a dangerous source of infection in the body.

When the carious process has destroyed not only the crown, but also the roots of the tooth, it is necessary to part with them as quickly as possible. Removing the root of a decayed tooth cannot be called a simple surgical procedure, but modern anesthetics and professional skills allow the doctor to carry it out quickly and without significant pain. If this is not done, rotting roots will create a serious health problem for the patient.

Pathogenic microflora will spread to neighboring teeth.
There will be a persistent unpleasant odor from the mouth.
A cyst or granuloma may form around the root tip. Pus from the overgrown local formation will sooner or later release into the gum tissue - a flux will form, which will already capture the entire upper or lower jaw and “swell” the cheek.
A persistent focus of infection will cause a significant decrease in immunity.

When treating gumboil, the patient's gums are first cut under anesthesia to allow the drainage of pus and to disinfect the source of infection. Without this manipulation, it is impossible to remove the tooth root, since it is impossible to inject an anesthetic into the gum tissue filled with pus. When sending a patient home, the dentist cannot even be sure that he will return to remove the root. Unfortunately, many avoid surgical intervention, which means they will soon face a relapse of the disease.

Can third molars be treated?

Wisdom teeth, like any other teeth, can be treated. But only if they erupt correctly, do not threaten the health and position of the rest of the dentition, and there is confidence that the treatment will be successful. If the specified conditions are met, it makes sense to preserve the “eight” for the following indications:

If the sixth and seventh teeth are sick or severely damaged and must be removed, in this case the wisdom tooth is left as “the best of the worst” in order to provide the patient with at least some conditions for chewing, and the doctor - the basis for future prosthetics.
If the six and seven have already been removed and it is necessary to preserve the abutment tooth for installation of prosthetic structures.
In the presence of an antagonist tooth, completely healthy and subject to preservation.

In case of curved roots that complicate endodontic intervention, severe tissue destruction, dystopia or retention, no competent dentist will undertake to treat the “eights” - he will definitely recommend removal.

Symptoms

The patient cannot always see the preserved fragments and fragments of the tooth root. If they are severely damaged, they may be hidden by gum tissue. If the pathological process continues, symptoms occur:

aching pain occurs in the area of a fallen or damaged tooth in the gum;
when pressing on the problem area, sharp pain occurs;
the gums swell, increase in volume, may turn red, and tissue may grow near the socket;
bleeding appears at the site of the destroyed crown (spontaneous or due to mechanical impact);
suppuration occurs and the temperature rises.

If any of these symptoms appear, you should immediately consult a dentist. They indicate a complicated inflammatory process. Without treatment, it can cause serious complications, including blood poisoning. Even if there are no symptoms described, tooth decay or collapse of the walls of the crown is a reason to urgently consult a doctor and undergo an x-ray.

Do you have questions about tooth extraction?

We will call you back within 30 seconds

Why are wisdom teeth needed?

Why does our body need third molars at all? In fact, these are rudiments that not all people today erupt - approximately a third of the entire population of the planet does not even have the rudiments of third molars, although a few thousand years ago absolutely all adults grew wisdom teeth. They practically do not perform the chewing function, since the rest of the healthy teeth usually cope with it.

Today, “eights” are needed only as a “backup option” in case the first and second molars fall out or are severely damaged, and also as a factor preventing the loosening of neighboring teeth. They can also serve as a support for prosthetics - but, again, in all these cases we are talking about healthy and correctly erupted “eights”. In the same case, when a person has rotten wisdom teeth in his mouth, they will not be able to perform any of the indicated functions and it is better to remove them so as not to expose the rest of the dentition to the risk of infection.

Complications after chipping

Restoring a chipped front tooth or a chipped molar (what to do in the case of different types of damage is discussed above) should be mandatory. Firstly, the aesthetic component suffers. A smile looks ugly, a person develops complexes, he is always afraid that others will notice the defect. Secondly, if you neglect medical intervention, you cannot avoid negative consequences (sometimes irreversible). These are problems such as:

malocclusion;
curvature of roots;
increased sensitivity to external stimuli (cold, hot, sour, sweet);
pulpitis, periodontitis and other diseases.

All of these conditions are considered very serious. Most of them often lead to the loss of units and affect the health of neighboring elements.

Oral diseases affect other organs. For example, if a large piece of a back tooth breaks off and the remaining fragment or the entire row hurts, this can later be associated with diseases of the gastrointestinal tract, heart and blood vessels, and urinary system. Even microcracks can lead to such complications. Thus, unpleasant consequences can only be avoided with the help of timely intervention by a dentist.

Indications for removal

Healthy, well-positioned third molars with good oral access for possible treatment do not need to be extracted. There are clear indications for such an operation, and if they exist, it should be removed without waiting for complications:

Deep caries of the wisdom tooth, as well as lack of normal access for full treatment.
Chronic inflammatory processes caused by third molars, including in cases where the wisdom tooth caused inflammation of the gums.
Chronic injuries to the oral mucosa due to incorrectly positioned “figure eight”.
Impacted or dystopic teeth.
The need for orthodontic treatment of bite defects if the doctor believes that the “eights” will prevent the dentition from occupying the correct position.

In all of these situations, it is recommended to remove the “eights” without delay.

What to do if your tooth chipped?

See a dentist.

The doctor will remove the broken wall, take x-rays of the tooth, and evaluate its safety. If the tooth is not broken much, the root is not damaged or almost not damaged, then it can be restored. Then the tooth is prepared (if necessary, dental canals are treated, caries and old filling materials are cleaned), how badly it is damaged is assessed and the best way to restore it is selected (filling, inlay or crown). If the tooth cannot be saved, it is removed and replaced with an implant or other available method.

Removal Features

As a rule, operations to remove third molars are always considered difficult, since these are the teeth that usually cause more problems. The operation can be simple, provided that the “figure eight” is located on the upper jaw and does not have pronounced developmental abnormalities. In all other cases (as well as in situations where the tooth is in the upper jaw, but has strong, curved and branched roots), the operation is considered complex and must be performed by a qualified dental surgeon.

Before performing an intervention, the doctor determines possible contraindications for a particular patient, examines an x-ray of the problem area and determines the optimal tactics for the operation. The duration of the procedure ranges from 1-10 minutes for simple removal and up to 20-120 minutes for complex removal, requiring a series of manipulations and suturing of the hole.

What types of chips are there?

If a wisdom tooth has chipped, the doctor must first determine the type of chip, as well as determine the extent and severity of the problem. All this is necessary to choose the optimal restoration method that can guarantee a long-lasting result. The types of chips are briefly described below:

enamel - this may be a small chipped piece at the corner of the cutting edge, many patients do not notice such defects at first,
dentin - a significant part of the crown is destroyed, as a result of which only one of its walls may remain. In this case, pain appears, the enamel becomes sensitive, especially to cold and hot,
pulp injury – damage to the neurovascular bundle is especially dangerous, because it can lead to inflammation, the development of pulpitis and the need to remove the nerve.

After a visual examination, the doctor sends the patient for an x-ray. Already having a picture in hand, a specialist can make an accurate diagnosis and suggest optimal treatment tactics. If there are signs of enamel demineralization, a course of remineralization and fluoridation must be prescribed. In this case, the patient must undergo a comprehensive examination to find out the cause of the problem and eliminate it.

Removal of wisdom teeth under general anesthesia

Many patients are afraid to remove problematic “eights” because they fear that the process will be painful. However, you should not postpone the operation because of your own fear: modern methods of anesthesia allow the removal to be performed as painlessly and comfortably as possible for the patient.

Doctors usually recommend performing the intervention under local anesthesia, which will be sufficient to ensure the patient is comfortable during the operation. If for some reason a person is not satisfied with the methods of local anesthesia, there is always the possibility of having a wisdom tooth removed under anesthesia. It should be remembered that this option of pain relief is not available to everyone - there are certain contraindications:

Decompensated diabetes mellitus and cardiovascular diseases.
Post-infarction or post-stroke periods for up to 6 months.
Acute inflammatory diseases of internal organs, including the respiratory system.
Epilepsy.
Severe thyroid disease.
Bronchial asthma.
Alcohol or drug intoxication.

The presence of at least one of the listed positions makes the removal of wisdom teeth under general anesthesia impossible. Before the operation, the patient must be examined to identify any contraindications to the use of anesthesia. In addition, you need to remember that certain preoperative preparation will be required, and the clinic itself, in which the wisdom tooth will be removed under anesthesia, must have all the necessary equipment, as well as a team of specialists who will treat and monitor the patient’s condition (anesthesiologists, resuscitators, trained nursing staff).

Prevention

To prevent chips on your teeth you should:

Treat teeth affected by caries.
Avoid putting unnecessary stress on your teeth.
Monitor your general health.
Correct malocclusion.

First aid at home for a chipped tooth:

Apply a cold compress to the tooth.
Rinse your mouth with clean water.
For severe pain, take a painkiller tablet.

The chipped piece of the tooth must be preserved and shown to the dentist, who will be able to determine the degree of destruction from it and prescribe the appropriate treatment.

Treatment or removal during pregnancy

In cases where a wisdom tooth is cut and hurts, causing constant discomfort to the pregnant woman, it can and should be treated regardless of the gestational age. If there is no acute pain and treatment can be postponed, then it is advisable to carry it out in the second trimester of pregnancy or after childbirth.

It is worth remembering that wisdom tooth removal, especially under anesthesia, is definitely contraindicated for pregnant women. Removing third molars is strongly not recommended due to the complexity of such an operation and the risk of developing postoperative complications. As for anesthesia, it cannot be used either for removal or for treatment - during pregnancy, only local anesthesia can be used, and the drugs should be selected very carefully and taking into account the patient’s condition.

Despite their name, wisdom teeth do not bring their owners increased intellectual abilities, but they can cause a number of very unpleasant problems with oral health. Typically, third molars “lead with them” swelling of the gums, purulent inflammation, the development of caries of neighboring teeth, as well as severe pain. Therefore, in modern dentistry they prefer to remove them, without waiting for serious complications to arise and longer and more expensive treatment to be required. In many European countries today, a common practice is to remove the “eights” immediately after their appearance, regardless of their condition and the correctness of eruption.

How to help yourself before visiting a doctor

If the chip occurs as a result of an injury, you should immediately consult a doctor. The damage can be quite serious, so it is better to act quickly so as not to miss the chance to save the tooth. But on figure eights, cracks and chips may not be immediately noticeable, but if the damage reaches the nerve, it will cause severe pain.

Before visiting the doctor, you can rinse your mouth with water

In any of the cases described above, before visiting a doctor, you can gently rinse your mouth with boiled water at room temperature or a light antiseptic solution. If the injury is deep, bleeding begins and swelling appears, apply a sterile bandage to the wound, and a piece of ice wrapped in several layers of napkin to the cheek. If it hurts a lot, take a painkiller tablet. And try to see a doctor as soon as possible.