The agony of choice: to remove or treat a wisdom tooth if it causes concern. Should I remove or treat my wisdom tooth? All the pros and cons Can wisdom teeth be treated or pulled out if it hurts?

A wisdom tooth is the most common eighth tooth in a person that grows after age 20. There are many legends associated with it among different nationalities. The Slavs, Germans and North American Indians believe that with the appearance of these teeth a person acquires life wisdom and spiritual maturity and has the protection of his ancestors. When teeth are removed, he loses this protection and can easily be offended.

There are cases when the “eight” does not bother a person at all throughout his life, and sometimes becomes the cause of a severe inflammatory process in the oral cavity. The eighth tooth, like the others, can hurt; there may be a hole and pulpitis in it.

Many people, after these teeth appear, immediately remove them, believing that they are not needed. But most people don't delete them, and maybe they're right.

There are various difficulties at the moment when these teeth erupt:

• severe pain in the gums;
• difficult to brush the tooth;
• food gets stuck in it;
• The mucous membrane of the hood often becomes inflamed.

These teeth have their pros and cons. Due to their structural features, such teeth are very difficult to treat; the root of the tooth is crooked and difficult to fill. The eighth tooth erupts in a not very comfortable position; the limited opening of the mouth does not make it possible to fill it well. However, a qualified dentist will successfully cope with this, and the preserved wisdom tooth will serve as a support for the bridge during prosthetics.

Should wisdom teeth be removed or is it better to treat them? Let's look at the recommendations of dentists. There is a clear indication for wisdom teeth removal when it is simply pointless to treat it. Such indications include:

• if it came out across the vertical axis;
• when a tooth injures the mucous membrane of the cheek;
• when it destroys a tooth in front;
• if it is very destroyed and cannot be restored;
• he doesn't have enough space to cut through.

In addition, there are contraindications for removal. Under no circumstances should teeth be removed if you have hypertension. If the 6th and 7th teeth are missing, it is not advisable to remove them; this tooth will become the basis for a crown in the future. If there is an antagonist located on the opposite jaw, when removed, the one standing next to it will move forward. It is better not to touch the even, healthy figure eight; it helps chew food.

Diseases of wisdom teeth, pulpitis and caries are treated according to the standard scheme, just like regular teeth. Treatment includes:

• tooth depulpation;
• root canal cleaning;
• filling the canals and the tooth itself;
• restoration of cusps and fissures of the crown.

The quality of canal filling will depend on whether the root has correct form or it is bent.

Often during pregnancy, women experience pain in their wisdom teeth, and they put off visiting the dentist. Should wisdom teeth be removed or treated for pregnant women? According to dentists, postponing dental treatment for postpartum period it is forbidden. This is sometimes very dangerous, since caries can develop, and by the end of pregnancy the tooth will simply collapse. The inflammatory process in the gum of this tooth can spread to other nearby organs, which is very undesirable during pregnancy.

A woman with a position that cannot be treated must have her wisdom teeth pulled out. If there are indications for removal, the problem cannot be ignored; it can only worsen the situation. In this case, the dosage of anesthesia is selected by the doctor separately, and it will be safe for the unborn baby.

During pregnancy, the need to treat teeth increases as the condition of the oral cavity worsens. This can be explained by certain factors:

• many useful material, and especially calcium, is taken up by the growing baby;
• the composition of saliva in pregnant women changes;
• caries on wisdom teeth develops from changes in diet and excessive consumption of carbohydrates;
• toxicosis increases acidity in the mouth, which causes plaque to accumulate;
• changes in circulatory system lead to changes in blood circulation in the gums.

E If a wisdom tooth is cut and hurts during pregnancy, and there are no indications for its removal, you can use folk remedies. Rinse very well with herbal decoctions and baking soda solution. If they do not help, then you can reduce inflammation of the gums around the wisdom tooth with dental gel or Paracetamol, but only after the doctor’s permission.

Elena Malysheva talks in more detail about wisdom teeth in the program “Live Healthy,” which you can watch on video.

If there are no indications for removal, and if wisdom teeth do not bother you, then there is no need to remove them, because in the future they may be useful for prosthetics. Whether such a tooth should be treated or removed is, of course, up to you to decide. But before you remove it, think carefully, take a photo, consult with your dentist, and then only make a decision.

First, let's figure out what a wisdom tooth is. Why does it cause so much pain, why is this particular tooth the question of this article? And anyway, what does wisdom have to do with it? Are wisdom teeth treated or removed?

What it is?

It stands apart from other human teeth. The wisdom tooth is the eighth in the row; the official dental term for it is the third molar, the so-called figure eight. It is easy to guess that the wisdom tooth received its common name precisely because it appears in people in mature age. The age at which it erupts falls on average between 18-25 years. But these are very approximate boundaries. Often it appears much later, and sometimes it does not appear at all. Why is this happening? In fact, this tooth is an example of a vestigial human organ in the body. This means that it has lost its function. Very often, many people do not even have the beginnings of it in their gums. Nevertheless, it is this tooth that often brings people a lot of pain symptoms during teething, which can even cause complications and cause significant harm to a person’s health and condition.

The eruption of wisdom teeth can occur one after another, or they can all appear at once. The process may be fast or slow, or may never even happen. Sometimes eights can erupt and stop growing, but still deliver painful sensations.

The question often arises: “Treat or remove wisdom teeth?” More on this later.

Difference from others

Here are the main features of these teeth:

• he is only a native baby tooth there is no wisdom;
• when teething, pain is very common;
• Maintaining its hygiene is complicated by the fact that it is located in a place that is difficult to reach with a toothbrush.

Pain, and often severe pain, is a very common companion to the process of teething. Why? This is explained by the fact that it grows in a hard-to-reach place. Since eruption begins in adulthood, the bone tissue already has a fairly strong, well-formed structure. In children, the bones are elastic, and breaking through the gums does not cause as much pain. It's different for adults. The gums are difficult to break through. That's why wisdom teeth hurt. To treat or remove is not an idle question.

Complications of the process

The following complications are known when teething:

• Pericoronitis (pericoronitis). This is an inflammatory process of the crown of the gum mucosa. When a tooth erupts, and at that moment there is free space between the tooth itself and the gum, food debris gets there. A favorable environment for the proliferation of bacteria arises. Inflammation begins. Acute pericoronitis is accompanied by swelling, temperature, severe pain. Suppuration begins, which causes bad smell from mouth. In such a situation, the dentist makes an incision in the gum so that teething occurs more freely.

• Since the tooth erupts in adulthood and much later than the others, it may not have enough space in the row, and in the process of growth it begins to rest against the cheek, thereby injuring the mucous membrane. Or it starts to push against the neighboring tooth. In this case, deformation of the entire row occurs.

• Sometimes the tooth may take horizontal position in the gum, which in turn harms the roots of the “neighbors”. This causes pain, inflammation can begin, and even the condition of the teeth located nearby can worsen, even to the point of losing them.
• Caries. If the wisdom tooth and the adjacent tooth are in too close contact, a cavity is formed between them, which is absolutely inaccessible for cleaning. It’s easy to guess that caries flourishes there. Both the neighbor and the wisdom tooth itself begin to deteriorate. Treat or remove? Let's figure it out.

It can take a long time for a wisdom tooth to erupt.

Dentists' recommendations boil down to never ignoring pain during teething or trying to find ways to self-medicate. After all, as we discussed above, pain sensations are not only physiological in nature, but also inflammatory. It is impossible to independently determine what exactly causes pain. Incorrect actions at random lead not only to tooth loss, but also to the fact that the tooth begins to decay in such a way that it becomes more and more difficult to remove it over time. And the surgeon’s job of removal will also be complicated.

Should a wisdom tooth be treated or removed?

Let's return to the main question of the article - remove the eight or treat it. This issue is discussed very often among both patients and dentists. Above we looked at the reasons why wisdom teeth cause many problems to people. Visits to the dentist to treat these teeth can often be a painful ordeal.

Let's consider cases when it is advisable to remove a wisdom tooth, and when it is possible and necessary to preserve it.

There are no universal recommendations. Dentists make decisions on each individual case. Everything is at the discretion of the doctor. There are many individual factors. But the decision is always up to the doctor when considering each specific case. There are no identical situations. What suits one person will cause irreparable harm to another patient. Some people believe that it is better to treat and preserve the tooth, while others, on the contrary, insist on preservation.

Whether wisdom teeth are treated or removed is of interest to many.

Factors for maintaining the eight

These include:

• The place of the neighboring tooth is empty, there is no sixth and seventh. Or their removal is planned. If prosthetics is planned, a prosthesis will be attached to the wisdom tooth. If you remove the eighth tooth, chewing functions will be impaired, since at the end of the row three teeth will be missing: 6, 7 and 8.
• If the position of wisdom teeth is normal, if they do not interfere with the functioning of neighboring ones.
• In the case where the opposite upper tooth wisdom tooth is the wisdom tooth on the lower jaw. Thus, they will form a closing pair, everything is harmonious. When one of them is removed, the tooth will move out of the jaw on the opposite side. It will be destroyed.
• If the wisdom teeth are in good condition, have erupted painlessly, are in a healthy condition and are not damaged by extensive caries.

Treating or removing a wisdom tooth is a reason for doubt among many.

Filling a carious cavity

If the doctor insists on filling a carious cavity, there is no need to question it. If the root canals are located correctly, then filling will avoid further problems.

We mentioned earlier in the article that it is impossible for the patient to determine at random what is causing the pain during teething. Only a dentist will determine whether a wisdom tooth should be treated or removed.

Cutting through the figure eight is a painful process. He may well demand immediate medical care. You cannot decide for yourself what to do with your tooth.

Indications for figure eight removal

These are, first of all, the following circumstances:

• Inflammation of the gums, accompanied by pericoronitis. Pericoronitis leads to swelling of the hood (the part of the gum above the molar) and the gum itself. The cheek may also be involved in the inflammatory process. Cavities can develop under the hood.
• If gum excision does not help or the tooth is severely damaged, it is removed.
• If wisdom tooth caries - treat or remove? Therapeutic measures ineffective or impossible. Treatment is carried out if the tooth is positioned correctly in the row. Otherwise there is no point in it.
• Pulpitis has developed, and there is no point or possibility to treat it. Caries leads to the fact that through the cavity, infections penetrate deep into the dentin. The pulp becomes inflamed and acute pain occurs. In this case, the inflamed pulp leads to the fact that a person experiences pain when the temperature of the food he eats and when he eats acid-containing foods. Your temperature may rise. If the tooth is positioned correctly, treatment is possible. If done incorrectly, treatment becomes a waste of time and money.
• Inflammation of the root and tissues surrounding it has developed - periodontitis. He calls sharp pains in the dental area, it is impossible to touch the tooth, the pain intensifies. The tooth is movable. Often accompanied by suppuration. In such conditions, tooth extraction is advisable.
• If the wisdom tooth is positioned incorrectly and causes deformation of the entire row.
• A decision was made to correct the bite.
• The tooth took a horizontal position.
• Inflammation trigeminal nerve. It is difficult to confuse it with something else. The main symptoms are pain attacks in facial area, muscles twitch. Attacks of pain can be triggered by any physical activity, even insignificant. Once the wisdom tooth is removed, the symptoms all go away.
• Jaw cyst. It is the slow growth of the eight that serves main reason cyst formation. A cyst may form and not grow. Then there will be no pain, there will be no symptoms. As the cyst grows, pain appears. The cyst is dangerous because fluid accumulates in it, which aggressively acts on the walls of the tooth. And if an infection penetrates into the cavity of the neoplasm, the tooth begins to fester. This is for many known disease– flux. The tooth is removed without a doubt.

Should wisdom teeth be treated or removed for pregnant women?

During pregnancy

During pregnancy, minimal interventions in the body of the expectant mother are generally recommended. And accordingly, tooth extraction is also undesirable. There are risks of infection; prescribing antibiotics is also undesirable, but if there are acute indications, the tooth is removed.

Wisdom tooth removal

So, the answer to the question is whether it is better to remove a wisdom tooth or treat it. The dentist analyzes information about the patient's health. Factors such as the absence or presence of chronic diseases, allergies. It is advisable to take an x-ray of the tooth. And then the surgeon removes the tooth. Anesthesia measures are also carefully taken.

Very often, patients are afraid to have a tooth removed. This is a kind of mini-operation. However, you cannot act on your fears; untimely tooth extraction is fraught with deterioration in health, oral diseases and prolongation of intolerable painful sensations. You just need to follow the recommendations before and after removal. And everything will be alright.

X-ray and anesthesia

Radiography to determine the location of the roots is carried out in most cases. This is done to minimize complications.

Local anesthesia for removal. Only for operations in particularly severe cases with a gum incision may a general anesthesia be necessary.

Sometimes it becomes necessary to test sensitivity to certain anesthetics. If the teeth are semi-impacted or impacted, they are removed after incision of the soft tissues. The use of anesthesia allows you to minimize pain and discomfort during surgery. After the operation, the doctor prescribes antibiotics and painkillers. Can also be assigned antihistamines if there is a tendency to allergic reactions. You can treat a wisdom tooth or remove it, now we know.

To avoid complications

To avoid complications, dentists recommend maintaining a state of rest for several days after surgery and avoiding eating too hot and cold foods. This is what can increase the unpleasant pain sensations. Sometimes a possible complication is paresthesia, which is injury to a nearby nerve. The patient may develop numbness of the lips and oral mucosa.

Also, immediately after surgery to remove a diseased tooth, swelling of the extraction site and acute pain are possible, which will be most severe in the first three days. At the site of removal, a postoperative wound. Then they will decline.

How quickly will the recovery proceed?

The speed of recovery of the removal site is different for everyone and depends on the complexity of the operation, as well as its timeliness. Great value has strict adherence to medical recommendations in postoperative period. If the doctor prescribed antibiotics, they must be taken strictly according to the regimen.

So, if pain symptoms associated with teething occur, you need to visit a dentist. Timely medical intervention will help avoid complications without harm to health.

To understand what teeth are and where they are located, you need to mentally draw a diagram of the oral cavity. To do this, you need to divide the paper sheet into four areas (draw one line horizontally and one vertically). What is above the horizontal line is upper jaw, below, respectively, - lower. On the sides of the vertical line - right and left side dentition.

Wisdom tooth mockup

How many wisdom teeth can a person have? The answer "4" will be incorrect. In some people, the formation of wisdom teeth may not have occurred initially during the prenatal period. Because of this, they will not grow in the future. This condition is not considered pathological.

“Eights,” as wisdom teeth are also called, have other differences. The structure of a wisdom tooth consists of a crown, neck and root. In the upper jaw, it may have fewer roots than a similar tooth in the lower jaw. It depends on the size of the jaw: the upper jaw is larger and heavier than the lower jaw, which means there is more space for teeth. In addition, the roots of the teeth can intersect with each other, connecting into one root.

Also, these teeth are minimally prone to caries, since the wisdom tooth comes out later than everyone else and the action pathogenic factors did not have time to have a significant impact on its structure.

When does a wisdom tooth grow?

It is impossible to give a clear answer to this question. U certain people The growth of eights is observed at 16 years old, while for others - at 26-28. There is also such a term as retention - this is a delay in the eruption of an already formed tooth. This pathology is one of the most common in relation to wisdom teeth. By the way, the process of growth of eights has a whole complex of symptoms, which will be discussed further.

Wisdom teeth eruption problems

Often, the growth of a wisdom tooth is accompanied by severe symptoms. It is rare that this process can go unnoticed without causing discomfort to the patient. Almost everyone turns to dental clinics precisely because they are bothered by pronounced pain and difficulty chewing in the area where the tooth grows. The nature of the pain can be different: permanent, aching, pulling, acute, spontaneous. Pain indicates the passage of a tooth through the gums and alveolar tissue, touching nerve endings and disrupting the integrity of tissues.

In addition to pain, there may be other symptoms:

When diagnosing the oral cavity, you can identify a hyperemic “hood” - this is a reddened and swollen area of ​​​​the gum above the erupting tooth.
Under the “hood,” upon palpation, an infiltrate is found (an accumulation of fluid mixed with leukocytes). It can occur due to the penetration of bacteria and food particles under the “hood”.

Inflamed hood over a wisdom tooth

So the immune system struggling with foreign bodies and tries to stop the inflammatory process from other tissues. Therefore, swelling of the gums is not transmitted to other organs of the oral cavity, but is local in nature.

If a person has a strong immune system, an increase in the jaw lymph nodes can be noted. This process is called lymphadenitis. When you feel this pair of lymph nodes, you feel a compacted, round formation. If the lymph nodes are motionless, that is, they have grown together with nearby tissues, this is a cause for serious concern. This feature may indicate the presence of tumors.

Against the background of local symptoms of wisdom teeth growth, general changes in the body appear: an increase in temperature to 38.0 C and above, weakness, loss of strength, loss of appetite and ability to work, headaches. This set is called intoxication syndrome, which quite often occurs along with inflammation.
The eruption of wisdom teeth can lead to a number of complications. Among them:

• Abscess (local accumulation of pus);
• Phlegmon (purulent inflammatory process);
• Osteomyelitis (inflammation of bone tissue);
• Pericoronitis (inflammation of the “hood”);

Wisdom tooth: remove or treat

Typical cases and examples of their solutions are described below.

Impacted eights

“Eights” have one advantage, because of which some patients strive to keep them. Appearing after the rest, wisdom teeth can act as a support for a bridge and replace damaged teeth. Without figure eights, such permanent prosthetics becomes possible only with the help of implants.

Wisdom teeth may definitely be required for a prosthetic procedure if:

• the seventh tooth is missing;
• the sixth and seventh are missing at the same time.

Wisdom teeth are undoubtedly needed if they have an antagonist tooth and are involved in chewing, taking correct position in the dentition. The correct position is especially important - it happens that the tooth does not come out completely, is bent in one direction or another, or is even tilted towards the cheek.

Impacted wisdom tooth

If we are talking about the lower right wisdom tooth, then its antagonist is the upper right tooth with which it connects. Removing one of this pair will lead to the movement of the other from the jaw down or up, and the loss of this tooth in the future. Therefore, if a tooth occupies its normal place in the jaw, then it is not recommended to remove it.

Development of caries

Any type of caries must be eliminated, or the infection will spread throughout the oral cavity, spreading to healthy teeth. For this reason, the appearance of caries cannot be ignored, even if it affects an inconspicuous wisdom tooth.

Contact the dentist in a timely manner and get a filling. Before your visit to the clinic, rinse your mouth with antiseptics:

• chlorhexidine;
• soda-salt solution;
• chamomile decoction.

Pulpitis

In any case, pulpitis indicates the need for root canal filling. If the canals have good throughput and can be filled without problems, then it is more rational to cure such a tooth than to remove it. Here, too, you need to decide: is the tooth needed for prosthetics, does it have an antagonist tooth, does it occupy the correct position, does it participate in the chewing process.

Tooth decay

As described above, wisdom teeth often grow at an angle. Sometimes they rest against the front cusps of the crown against the body of the seventh tooth in front. Constant tooth pressure on the enamel can cause its destruction and the appearance of caries. Preservation of the seventh tooth and its normal treatment is impossible without removing the wisdom tooth.

Other

Inflammation of the hood (pericoronitis)

A fully or partially erupted wisdom tooth is in such a position that part of its crown is covered with a hood of mucous membrane. An area appears between the hood and the tooth in which microbes multiply and the inflammatory process and swelling of the mucous membrane take place.

The disease is called pericoronitis, and in this case, either the hood is removed or the tooth itself is removed. If you first weigh the pros and cons, and also calculate the financial potential, treatment will definitely cost more than removal.

Wisdom tooth is out of position

Examples of incorrect figure eight placement

For example, it lies in a horizontal plane or at an angle to its crown. It is of no value for prosthetics and chewing food. Sometimes the crown of a wisdom tooth has a pronounced slope towards the cheek. This leads to the patient biting the skin all the time. Chronic injury the mucous membrane of the cheek can lead to the development of an oncological process in this area. In this case, it is better to remove the tooth.

Possible complications after removal

Temperature after tooth extraction

An increase in temperature is normal for the body. It can last for 3 days, gradually increasing in the evening. Follow generally accepted hygiene measures and take fever-reducing medications. But if the condition does not improve, then you need to see a dentist.

Pain after tooth extraction

Another common complaint is that after dental surgery, painful attacks are felt in the gum area, adjacent tooth, jaw, and throat. As a rule, these are ordinary symptoms after the procedure. They are provoked by damage to the periodontal tissue and nerves, which go away on their own after a couple of days. For example, if after surgery temporary aching pain- this is the norm. For relax discomfort you can take painkillers.

Bleeding after tooth extraction

This is a completely normal situation, since a rupture occurs during the operation. blood vessel. IN in this case The doctor gives you the help you need. But sometimes bleeding develops several hours after the operation is completed. To stop the bleeding yourself after tooth extraction, you need to apply a small gauze tampon to the hole and lightly bite it.

Hole after wisdom tooth removal

Suppuration after tooth extraction

Suppuration of the sockets and periodontal tissues is caused by infectious reactions. They can happen for several reasons.

Firstly, if you did not follow the doctor’s instructions regarding personal oral hygiene after surgery.

Secondly, the cause may be tooth fragments that remain inside the tissue after surgery.

Thirdly, there is a high risk of pus appearing after a complex wisdom tooth removal, for example. If the inflammation is not eliminated in time, then some time after the operation, suppuration, a fistula on the gum, and even a cyst may occur. If pus forms at the surgical site, you should consult a doctor.

Dry socket after tooth extraction

There should be some remaining blood in the socket after surgery. This is a very important part of the healing process. This clot will protect the bone and nerve endings and serve to form bone tissue after tooth extraction. For this reason, you should not rinse your mouth for 24 hours after the procedure and take hot food - this will only promote the resorption of the clot.

Dry socket is considered a complication. It most often appears after complex removals and is accompanied by noticeable trauma. If there is no blood clot, then the hole hurts, sometimes radiating into the ear. There is often an unpleasant aftertaste in the mouth. The consequence of a dry socket after tooth surgery may be gum inflammation or alveolitis. Therefore, when acute pain in the hole, be sure to consult a doctor.

orthodontist, clinical director of Star Smile

Do we need wisdom teeth?

I use the only compound word. There is such a concept in biology RUDIMENT- a part of the human body that has lost its function in the process of evolution. The most famous rudiment is appendix intestines or appendix. So - a large number of doctors and people believe that there is nothing superfluous in the body and wisdom teeth can serve a person at an older age, when the loss of basic teeth occurs and the doctor can use figure eights to install, for example, a bridge.

Unfortunately, in most cases this is impossible and even wrong!

Most people simply don’t have room in their jaw for eighth teeth, and Mother Nature starts to mock them (and, naturally, us doctors) in every possible way: painful eruption, irregular shape, incorrect size of the tooth itself, poorly developed root system - all of the above leaves no chance for correct use"eights"

How wisdom teeth are formed

Unlike other teeth, the rudiments of wisdom teeth are formed not during intrauterine development, but at 3–5 years of age, when children's body preparing to replace baby teeth with permanent dentition. At this age, you can determine the number of future eights (and there can actually be from one to four). But at this age, detect any possible pathologies development is not yet possible.

It becomes more or less clear a little later, the crown part of the wisdom teeth begins to form. The formation process starts in a child at about 12 years of age, but the development of the root part of the figure eight takes several more years and can continue even after tooth eruption. Considering that the most common age for the appearance of wisdom teeth is 18–25 years, the eruption of eights occurs already in adulthood. It’s not for nothing that I said earlier the phrase “actually from one to four,” since approximately 10–15% have no eights at all. That is why it is normal to consider the number of teeth in an adult to be from 28 to 32. Those are wisdom teeth, right? How unwise they treat us and make puzzles!

Teethingwisdom is a complete headache

The “birth” of a wisdom tooth in the oral cavity is always painful. The main reasons for the painful effect are thick walls of the dental sac, thickened mucous membrane and reduced growth-forming factors. In addition to the painful process itself, teething can cause many other complications. Which ones? Let's talk about this in a little more detail.

The wisdom tooth sometimes does not erupt completely, crowding the surrounding teeth. This situation usually entails local inflammation and pain.

The time during which a wisdom tooth is cut can be quite long, and inflammation can constantly bother you, manifesting itself as an increased temperature of the whole body and sensitive pain, which sometimes makes it difficult to even just open your mouth! This condition is fraught with inflammation of the tissues surrounding the problematic tooth, right down to the bone, and therefore requires immediate intervention by a qualified dentist.

The first problem with teething eights is caries.

Often, while the wisdom tooth is growing, it is difficult to effective cleaning(due to the location of wisdom teeth deep in the jaw). This is how caries occurs. Incorrect positioning of wisdom teeth during eruption also increases the risk of tooth decay on the adjacent tooth due to difficulty accessing the spaces between these teeth. If symptoms of caries appear, you must consult a dentist and carry out appropriate treatment. Very often in this case, it is recommended to remove the wisdom tooth, especially if all other teeth are developed normally.

In practice, it happens that a wisdom tooth erupts already... sick, that is, it becomes infected with caries while still in the gum. In such cases, the figure eight should be removed immediately so that the diseased wisdom tooth does not negatively affect the remaining teeth.

The second problem is a cyst

In rare cases, a cyst and tumor may develop in the tissues surrounding an erupting wisdom tooth, which requires immediate surgical intervention by a dental surgeon.

The third problem is malocclusion

If the position of a wisdom tooth is incorrect during eruption, there is a high probability that such a tooth will significantly affect the position of the remaining teeth, which causes a change in the bite. And aesthetic problems arise - the teeth begin to stand crooked in the mouth. And this entails orthodontic treatment, bringing the dentition in order.

The fourth problem is tongue dysfunction

In addition to aesthetic problems, this can also cause functional problems. For example, if a wisdom tooth is displaced towards the vestibule of the oral cavity, serious injury to the mucous membrane of the cheeks, lips or tongue can occur, causing the appearance of erosions and ulcers.

Fifth problem - the wisdom tooth wanted to come through, but could not erupt

Rarely, a situation occurs when, due to a lack of space in the dentition or in the case of an incorrect inclination of the wisdom tooth itself, an anomaly develops, called a “submerged wisdom tooth.” Such “sunk” teeth are usually removed.

It is possible that the wisdom tooth does not erupt at all. Despite its absence, such a tooth is dangerous due to its complications. It can damage the roots of neighboring teeth or provoke neuralgic pain. In this case, you need to contact a surgeon and, most likely, the figure eight will have to be removed.

The sixth problem is pericoronitis

At the moment of eruption of the lower (!) wisdom teeth, when only part of the tooth has appeared, acute inflammation and even accumulation of pus in the formed hood between the gum and tooth can occur. This causes this serious illness, as pericoronitis (pericoronitis).

The main symptoms of the inflammatory process during pericoronitis are pain and swelling of the gums surrounding the wisdom tooth, bad breath and an unpleasant taste.

If these symptoms appear during the eruption of a wisdom tooth, you should urgently consult a dentist.

The seventh problem of wisdom teeth is periodontitis

When the figure eight erupts quite smoothly, due to its inconvenient location during brushing, the wisdom tooth is not properly cleaned of plaque. Removing tartar and plaque on this tooth in dentistry is also problematic. Because of this, bacteria begin to accumulate around the wisdom tooth, causing inflammation of the gums - periodontitis, which can then develop into osteoperiostitis. In this case, the tooth must be removed.

Total - seven wisdom teeth problems. What conclusions do we draw?

Dentists have a saying that if a patient does not notice his wisdom teeth erupting, then he is very lucky. In many ways, this statement is true, since according to statistics, for most of us, the appearance of “eights” does not occur without complications.

Treat or remove eights?

Now regarding orthodontic treatment and wisdom teeth. Believe me, it is very unpleasant for us doctors, as well as for patients, to make radical decisions. But there are good reasons! These are your own stories. Stories of patients who adolescence underwent treatment for bracket system, achieved excellent results and...

All the beauty of straight teeth, especially lower incisors(just started to rejoice beautiful smile) - it disappears at 20 years and beyond. It is when most of us fully develop these “eights”. Two, three and even four years of therapeutic “torment” to correct crooked teeth, transform them into a beautiful/sweet/courageous smile, as they say, down the drain... Yes, yes - the only option to become the owner of beautiful teeth again is repeated orthodontic treatment. It doesn’t matter whether it’s aligners or braces again, the important thing is that there is a good saying: forewarned is forearmed! No one is immune from mistakes and relapse.

Our body is beautiful and magical in that it almost always adapts and compensates for almost any pathology. Therefore, the “eights” are difficult, but they cut through and follow them deform there are very important teeth in front!

So what do we do with eights?

The moral of this story is this: trust qualified and educated doctors, not kind and humane “neighborly” advice. Be wise. Especially at such crucial moments in life, when wisdom teeth make themselves felt. And in general, I wonder who was the first to call them “wisdom teeth”?

Moreover, an interesting point from medical practice: if you (what if?) decide to delete eights, it is not a fact that they will be deleted for you. The reason is banal - the removal of wisdom teeth must be carried out exactly according to indications. A normal doctor will never remove a healthy tooth just because you want it.

You have decided to remove your wisdom teeth. How traumatic is this?

If the wisdom tooth has grown normally, its roots are not intertwined, removal usually takes place without any complications. The edges of the tooth socket after extraction are often not even sutured.

What is the most important thing after removing the figure eight - just letting the hole heal? extracted tooth wisdom. Quite a big wound.

What is absolutely impossible to do? You should not rinse vigorously, even with such seemingly beneficial solutions as chamomile or calendula.

What needs to be done. To get rid of food debris, you need to carefully take water into your mouth and do short oral baths without intensive rinsing. Instead of water, you can use a solution of chlorhexidine, miramistin or analogs specially sold in pharmacies - they disinfect the oral cavity. And so - for at least three days. If this recommendation is neglected, the hole may become inflamed. Then the dentist prescribes treatment medicines, even antibiotics.

What if the roots of an insidious wisdom tooth are intertwined or fused?

Unfortunately, in this case complications cannot be ruled out - they may be damaged. soft fabrics. If deleted inflamed tooth, in rare cases injured neurovascular bundle(!) lower jaw. In this case, separate treatment may be required.

When is it advisable not to remove wisdom teeth?

There are situations when the “seventh” or “sixth” chewing teeth subject to removal. And in this situation, a wisdom tooth that has grown correctly may still be useful. It will become one of two supports for the future bridge. However, in this case, a healthy sixth (or fifth) tooth will suffer, because it will have to be treated for an abutment crown.

Now a little about sad things. 10-15 years will pass, the bridge will “work out” its required operating time. And sometimes it will no longer be possible to insert an implant - the atrophied jaw bone under the bridge will not allow it: in the absence of teeth, any person develops edentulous bone tissue. Thus, on the horizon of life there appear removable jaw dentures and newfangled gels that make them easier to wear.

Now a little about the positive. In such situations, dental implantation may initially be considered. specialized medical centers, where they will help restore bone volume and take control of the dental situation.

What do we do after removing the eights?

We evaluate the possible damage that figure eights could cause to neighboring teeth. If adjacent teeth are deformed, then the pathology may spread like a domino principle, and here it is already necessary to carry out systemic orthodontic treatment aimed at correcting the malocclusion.

The most gentle and aesthetic type of dental correction today is aligners. The site provides a lot of information on aligners, but I would like to mention one undeniable advantage, namely, the patient can see the result of his treatment with aligners without even starting it! How so, you ask? The answer is simple - all future treatment of the patient is calculated using modern computer technology. The example below shows a real clinical case, a patient with crowded teeth caused precisely by the pathological effect of “eights” on neighboring teeth.

Let's see how wisdom teeth led to crowded teeth

And how crowded teeth are eliminated with Star Smile aligners

The video shows how the 3D setup is done. I am commenting on the video, orthodontist Alexander Spesivtsev, clinical director of Star Smile, a doctor with many years of experience successful application aligners in orthodontic practice. To restore straight teeth, the wisdom teeth themselves - the eights - had to be removed.

In the Star Smile company - or more precisely in the clinics of its partners (which are more than 70 cities in Russia) any treatmentbegins with diagnostics and drawing up a virtual setup. The doctor takes photographs of the patient’s face, teeth, and x-rays and dental impressions. Using a special software the obtained data is processed and a three-dimensional model of the patient’s dental system is obtained. And this already allows you to calculate the trajectory of tooth movement, treatment time, and the required number of sets of mouthguards. Also, the final result of the treatment will be visualized - the patient will be able to evaluate the aesthetics of the smile after treatment. Patients really like this approach - they can see their future smile, their straight teeth. The 3D setup forecast for teeth straightening with aligners comes true in almost 100% of cases. You see, this is completely different from correcting a “blind” bite, as is usually the case with braces. Everything is clear here, without any guesswork or assumptions.

Gevorkyan Oscar Vladimirovich

Candidate of Medical Sciences, Maxillofacial Surgeon, Central Scientific Research Institute, scientific consultant Star Smile

" If you are faced with questions :

• To remove or not to remove wisdom teeth?
• How dangerous is it to remove wisdom teeth?
• When do wisdom teeth interfere with orthodontic treatment?
• and most importantly, is it possible to avoid the removal of “eights”?

Feel free to contact the doctors at Star Smile, they will help you understand this sometimes complex, but very important life problem for many. Don't delay your decision to avoid possible complications in future"

Since the Star Smile company is represented in all federal districts, large and medium-sized cities of Russia and interacts with many clinics and orthodontists, we offer you the opportunity to undergo free consultation with high-quality orthodontists in your city, where you can discuss the problem of wisdom teeth and determine the optimal solution for you. To do this, you need to fill out the following form, medical specialist Star Smile company will contact you and help you by scheduling a consultation at a convenient time or providing your doctor’s contact information.

Don’t put off the problem of wisdom teeth “for later”!

You can get a quality consultation on wisdom teeth in your city

A competent medical specialist will carry out necessary research growing or erupting wisdom teeth and will answer your main question - “Is it better to remove the eights or can they be preserved without harm to the health of your teeth?”

Active growth of wisdom teeth (“eights”, third molars) is accompanied by painful sensations, pathological processes requiring therapy. The reason for the unpleasant symptoms is the strength of the formed bone tissue, the inaccessibility of the eruption site, and the unnatural directions of growth.

Expert opinion

Biryukov Andrey Anatolievich

doctor implantologist orthopedic surgeon Graduated from Crimean Medical University. Institute in 1991. Specialization: therapeutic, surgical and orthopedic dentistry including implantology and implant prosthetics.

Ask a question to an expert

I believe that you can still save a lot on visits to the dentist. Of course I'm talking about dental care. After all, if you carefully look after them, then treatment may indeed not come to the point - it won’t be necessary. Microcracks and small caries on teeth can be removed regular paste. How? The so-called filling paste. For myself, I highlight Denta Seal. Try it too.

The appearance of pain and discomfort is a reason to consult a doctor and conduct a diagnosis. Dentist examining clinical picture, taking into account all factors and assessing the degree of risk of complications, will be able to determine whether the tooth must be removed or limited to therapeutic and preventive procedures.

In what cases should wisdom teeth be treated?

Therapy is carried out for:

• The absence of the first, second molars (“sixes”, “sevens”) or their removal. It becomes possible to use the eighth tooth as a basis for types of dentures.
• Painless eruption, absence of extensive carious damage, signs of mobility.
• The normal position of the “figure eight”, which does not interfere with neighboring dental units, forms a closing pair with the third molar, which is located on the opposite jaw.

For caries, treatment procedures are limited to sanitation, drilling of affected areas, antiseptic treatment, installation of fillings, and grinding.

A common problem that dental therapists have to deal with is limited access. Sometimes, due to lack of working space, it is impossible to use a drill and carry out high-quality filling of canals and carious cavities.

When should a wisdom tooth be removed?

Wisdom tooth removal is performed when:

• The need to correct the bite.
• Severe destruction of the molar, coronal chips.
• Horizontal position of the tooth, negative consequences in the form of damage to the “seven”, deformation of the dentition, malocclusion, injury to the mucous membranes of the mouth.
• Active development of inflammation, pericoronitis, swelling of the gums, gingival hood, cheeks.
• Purulent complications (phlegmon, abscess, osteomyelitis, periostitis, periodontitis), accompanied by sharp pain attacks. In case of suppuration, immediate extraction is indicated.
• Caries affects the part of the tooth hidden under the gum.
• Lack of opportunity to carry out full-fledged therapy for progressive caries due to limited access to the “eight”.
• Severe forms of pulpitis, accompanied by high-intensity pain, increased body temperature, and the inability to perform high-quality canal filling (for example, with canal obstruction).
• Inflammation of the trigeminal nerve, accompanied by muscle twitching and pain in the facial area.
• Jaw cyst. The fluid accumulating in the cystic cavity destroys the walls of the molar, causing suppuration.

If an erupted molar is highly likely to become a potential cause of deterioration in health and many complications, then removal is performed even in the absence of pathological symptoms.

How painful is it to have wisdom teeth removed?

Painkillers that are safe relieve the patient from discomfort. The exception is psychological discomfort, the appearance of which is explained by the specificity of the procedure. Short-term pain accompanies the process of administering the anesthetic.

The duration of action of local anesthetic drugs is optimized: the period of numbness is sufficient to carry out all necessary manipulations; a short time after leaving the office, sensitivity is restored.

Anesthesia is resorted to in exceptional cases due to the increased complexity of the entire operation, the presence of an impressive list of contraindications, destabilization of the patient’s condition in the postoperative period (from general anesthesia it’s hard to “go away”).

Considering the traumatic nature of the operation, exacerbations of pain after the cessation of the anesthetic are inevitable. Drug therapy helps to minimize unpleasant symptoms, speed up recovery.

You should contact your dentist if:

• Acute pain, severe swelling, which does not disappear 4-5 days after surgery.
• Presence of signs of dislocation, fracture of the jaw (explained by the development of the roots of the removed “eight”).
• Numbness of the tongue, cheeks, chin due to damage to nerve endings (it is necessary to visit a doctor if sensitivity does not recover within several weeks).

What is better: removal or treatment?

To answer this question unambiguously, it is necessary to familiarize yourself with all available clinical information and weigh the potential risks.

Experts recommend removing the “eights” if they are incorrectly positioned, pain occurs regularly, or there are symptoms of purulent, inflammatory processes, caries, pulpitis, the full treatment of which is impossible. Extraction is indicated before the installation of orthodontic structures aimed at correcting the bite.

It is advisable to treat a wisdom tooth in cases where it is planned to be used as a basis for dentures, as well as in the presence of an antagonist tooth and the absence of pathologies regarding the location and direction of growth of third teeth.

How to remove a wisdom tooth

The operation is preceded by a thorough examination and radiography, supplemented, if necessary, by the creation of panoramic, three-dimensional jaw photographs. First of all, it is taken into account mutual arrangement dental units, features of their growth. Information about chronic diseases, sensitivity to drugs, the patient’s medical history is studied.

In most cases, specialists performing extraction limit themselves to local anesthesia. General anesthesia used before complex surgical intervention accompanied by gingival incisions.

Impacted arrangement of molars is a phenomenon in which a preliminary incision of soft tissues, allowing access to the tooth to be removed, is required. Depending on the anatomical features In addition to the incision, the bone tissue is drilled out.

After extraction, it is necessary to make sure that there are no root, bone remains, sawdust, perform antiseptic manipulations, apply the required number of sutures, and conduct a control x-ray examination.

The total operation time for removing uncomplicated upper eights is on average 10-15 minutes. Mandibular wisdom teeth, which have an extensive, powerful root system, are the most problematic. The procedure for extracting the lower “eights” lasts from half an hour to several hours.

Before the end of the appointment, the time for the next examination is set, a course of taking painkillers, antibiotics, anti-inflammatory, and antihistamine complexes is prescribed.

In order to prevent complications in the postoperative period, it is necessary to exclude intense exercise, refrain from eating hot or chilled food, hygienic manipulations, follow all medical recommendations.

Discomfort, pain, swelling, elevated temperature, hypertension - symptoms the appearance of which is explained by damage to the tissues of the oral cavity. As the resulting wound heals, the unpleasant manifestations subside.

Do you feel nervous before visiting the dentist?

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Treatment and removal of wisdom teeth during pregnancy

During pregnancy, it is important to minimize any interventions in the body, so treatment and tooth extraction are carried out only in cases where there are serious indications and postponing the procedure is not possible.

Therapy can be carried out exclusively in the second trimester. For local anesthesia medications are used that do not pose a threat to the developing child.

As for the removal of eighth teeth during pregnancy, the operation is contraindicated due to the high likelihood of complications.

Surgery should be postponed until after the baby is born and, if possible, until the end of the period. breastfeeding. In case of painful sensations or active development of purulent-inflammatory processes, exceptions are allowed.

An erupted (and especially troublesome) wisdom tooth is a reason to visit the dental office.