The wisdom tooth was cut in half. Wisdom tooth extraction

How to place commas in the title? What do you need to know, what to be guided by when deciding whether to keep or remove these problematic teeth from the point of view of dentistry? Let's try to figure it out.

"Wisdom teeth" or "eights" usually appear in a person closer to 20 years, plus or minus a few years (much more often plus than minus) ... Not everyone really grows wiser by this age, but people began to call them that, hinting at their late appearance. At the same time, despite the name, they don’t add 8s to us, but we’ll get tired of listing the hassle. Why is this happening?

It is so inherent in nature: everything that she does not need gradually disappears. A person has long been getting his food not in the forest, but in a supermarket, eating not raw tough meat and plant roots, but a refined Big Mac ... Therefore, we no longer have a great need for so many chewing teeth and in such large massive jaws that our ancestors had. And that is why we are evolving in the direction of reducing the jaws and the number of teeth. Even now, there are quite a few “advanced” individuals in terms of evolution, who generally lack the rudiments of the 8th teeth (and not only them, but, sometimes, both incisors and canines, which is less pleasant). Although still, at the moment, this is rather an exception to the general rule. But the lack of space in the jaws for all 32 teeth, on the contrary, is rather the rule. And since it is wisdom teeth are the latest to appear, then they usually lack this very place in the dentition. That's why we have so many problems with them. This is just one of the factors, but perhaps one of the main ones.

Now we will analyze what kind of problems “wise teeth” can deliver to us.

1. Complete tooth retention.

Retention is a condition in which a tooth, for various reasons, could not erupt at the right time and in the right place. Well, with full retention, respectively, the tooth does not show outward at all and remains lying inside the jaw.

The red arrows show the wisdom teeth, which lie completely in the thickness of the lower jaw. This is a complete retraction. This patient also received a completely retained upper central incisor (shown by the blue arrow) as a "bonus" by nature.

Such an arrangement could be considered quite good. Because the tooth lies inside its jaw, does not touch anyone, does not bother ... it would seem that God is with him. In general, the way it is. To run as fast as possible to pick it out of the jaw, perhaps, is not worth it. In this form, he can lie there all his life and not cause trouble. Or maybe not quite so. Around such a tooth, the so-called. follicular cyst. Therefore, it is best to observe such unerupted teeth by doing an orthopantomogram at least once a year *. Well ... or remove all the same such a tooth, forever forgetting about it and about the need to monitor it. After all, there are many other things in life that you have to constantly think about and remember.

2. Partial retention.

By analogy, here we are talking about cases where the wisdom tooth was still partially able to erupt, but not completely. What bothers him the most? Either a powerful bone protrusion of the jaw, or an incorrect position of the rudiment, or the neighboring 7 ... in general, there can be many reasons, the essence remains unchanged - part of the uncut tooth remains inside, and part sticks out. This is the most common situation and it is she who most often leads to various really tangible problems. Which one exactly?

- pericoronitis- perhaps the most common complication of a partially erupted wisdom tooth. This is inflammation in the tissues surrounding this most problematic tooth - in the gums and bones. Manifested by pain, swelling and redness of the gums, difficulty swallowing, fever.

In the farthest corner of the lower jaw, you can see a partially erupted 8-ku and an inflamed gum above it.

Often, patients try to self-medicate in such situations - they rinse their teeth with various drugs that are at hand (from chamomile decoction to five-star cognac), swallow painkillers uncontrollably, or, worse, antibiotics. Indeed, from such activities (especially from antibiotics), inflammation can subside. But the unresolved cause will sooner or later lead to a relapse. Moreover, any inflammation in the area of ​​the wisdom teeth can easily develop into an abscess or cellulitis of the face and neck, and these are serious, life-threatening surgical problems. And they are treated, including by conducting external incisions on the face and neck. And it's really serious. I will not insert unappetizing pictures here, a query in any search engine will help create additional motivation for any unbelieving Thomas.

I hope I scared enough that there was no desire to self-medicate in such cases. Be sure to visit the dentist-surgeon. If he does not see problems in the further eruption of the figure eight, then he will simply remove the gum hanging over the tooth (“hood”) and prescribe the necessary medicines. If the tooth objectively can no longer erupt normally, then it will need to be removed. This is the only way to eliminate the cause and save yourself from relapses of inflammation, as well as from serious purulent complications of an initially trifling problem.

- root caries adjacent 7th tooth. Often, when the 8 is "stuck" and has no chance to cut through further, but does not bother, patients do not even think about contacting a doctor, because. "does not hurt". In fact, such a semi-erupted tooth makes it difficult for normal hygiene in this area and this leads to caries in the adjacent tooth. Moreover, the most unpleasant thing in this variant is that caries develops near the very base of the tooth, develops imperceptibly, the cavity can remain invisible for a long time. As a result, a huge “hole” grows, going deep under the gum, and it is not always possible to restore such a defect qualitatively later. As a finale - the loss of a good neighbor due to a “wise tooth” not removed in time. Moreover, it will be possible to make up for the lost 7-ku only with an implant (which is not cheap), or a removable prosthesis (which is inconvenient to use and significantly reduces the quality of life)

On the x-ray, the arrow shows a carious cavity that arose on the 7th tooth due to its negligent wise neighbor. On the right is about the same, only in a live photo. Green shows a stuck figure eight, blue - caries that arose because of it on a 7-ke.

- resorption(resorption in a simple way) root adjacent 7th tooth. In general, the situation is similar to the previous one, with the same consequences. The only difference is that, resting on its neighbor, the “wise tooth” can turn out to be very persistent and, by its pressure on the 7th tooth, cause the resorption of its hard tissues.

On the x-ray, we see a wisdom tooth resting on the top 7. In the photo on the right - the same seven, after removal. Such a root resorption can be caused by a stubborn wisdom tooth with its pressure.

Bone loss from the side of the neighboring 7th tooth ... this is the third variation on the theme that behind a problematic, but apparently not disturbing wisdom tooth, an innocent, good and necessary neighbor can easily suffer. An incompletely erupted wisdom tooth resting on the 7 can create a space in which food debris will accumulate. This will cause periodontal pocket formation and bone loss between the 8th and 7th. And the result is still the same - the removal of both teeth, bone grafting and implantation of the 7-ki.

Here, wisdom teeth decided to create problems for their owner for a couple. The lower one collapsed and rested on the 7th, causing bone loss. The top one, deprived of his partner, crawled down to meet him. What happens from this - read on.

Chronic mucosal injury. Often crookedly erupted wisdom teeth (especially the upper ones) during chewing cause chronic trauma to the buccal mucosa and gums on the opposite jaw. This is unpleasant both in itself and in terms of prognosis - any chronic injury to the same place can lead to malignancy.

Growing out of alignment towards the cheeks upper (grey arrow points to its tubercle) causes chronic mucosal injury (yellow arrow)

Blockage of normal movements of the lower jaw with the possible development of problems of the temporomandibular joint. This is a rarer problem, but it still happens. Each tooth in the dentition has its own pair on the opposite jaw - the antagonist tooth. And 8's are no exception. At removal or missing one wisdom tooth from a pair, the other, the opposite, comes forward. As a result, it can block the movements of the lower jaw, cause it to shift to an unphysiological position during chewing. This can be completely asymptomatic until the manifestations in the joint begin - clicks, crunch, pain ... etc.

Here the top eight has lost its antagonist "thanks" to natural forces...

And here thanks to the forces of the dentist. True at removal one eights you should immediately think about removing the antagonist. Well ... or immediately put an implant and a crown in place of the removed wisdom tooth ... if life seems too simple and insipid to you.

Well, now a few words about what could be with wisdom teeth, which nevertheless managed to erupt in their place and quite evenly. Can they really cause inconvenience even in such a situation? It turns out they can.

3. Erupted wisdom teeth.

The main problem with correctly grown 8s in spite of everything is their inaccessibility ... both for hygiene measures and for quality treatment. Laziness, haste, increased gag reflex - these are the most common reasons that wisdom teeth hygiene, as a rule, is insufficient to prevent the occurrence of caries on them. For the same reason, quality treatment is also difficult. Poor visibility, difficulties with applying a rubber dam, the frequent “exclusive” structure of the canals, which makes them difficult to pass even for well-trained and equipped endodontists, difficult opening of the patient’s mouth (and even with a normal opening it is not so easy to get close to the figure eight with a tool), the same increased gag reflex in the patient… All these objective difficulties often force a decision to remove outwardly safe 8-ok. For it is better to remove it well once and forget about the problem than to redo the same tooth many times, and then ... remove it anyway.

There are doctors unreasonably expanding indications for the treatment of the 8th teeth, That. they seem to show genuine concern for the patient's teeth, but in reality ... But in reality, it turns out first the treatment of a small caries, after a short time - a recurrence of caries, then pulpitis, then periodontitis ... and, finally, a regular removal after a few years. It seems that nothing has changed, except that the doctor manages to remove several "crops" from the same problem before actually solving it. This does not always happen maliciously, some really believe that they are prolonging the life of 8-cams for the benefit of the patient. Moreover, patients themselves often ask for it. At the same time, one often heard from opponents of the removal of the 8th teeth that “there will always be time to remove it”, “I have my own and I won’t give it away for anything”, “then, if it happens with the 7th, it will be possible to put a bridge based on the 8th”. I think all the previous examples speak quite eloquently about the fact that they do not always “manage to delete” on time. If it is so pitiful to part with your teeth in favor of the dentist, then you can take them away to make a stylish decoration for a long memory ... and your health will benefit, and your wisdom will always remain with you.

As for the 8-ok as a support for bridges, the time has already passed when it was possible to talk about it seriously. Today, implantation solves the problem of the absence of any tooth without the need to "sharpen" the neighboring ones. In addition, wisdom teeth, in principle, should not bear the load for their more functionally loaded colleagues (6s and 7s), because they are not at all fit for the job. Try a podium model, who has been dieting all her life, to force not just to lift the barbell, but to set a new world record in women's weightlifting ... I'm afraid she will simply be crushed by a sports equipment that is easily pulled by trained female athletes. For to each his own ... So it is with the teeth. The 6th and 7th teeth have 3 or even 4 multidirectional powerful roots that nature has composed to withstand large chewing loads. And in the eighth teeth, the roots almost always grow together into a single monolith, which has a conical shape and is not at all so stable - God forbid it could hold itself in the jaw. And if some irresponsible orthopedic dentists try to put an additional load on such a root, then this 8-ke comes to an end quite quickly, just like a “weightlifting” model ... Another trouble that orthodontists often have to face ... 8s can grow ... and seem to grow correctly and well, but at the cost of the fact that the rest of the teeth will be completely shamelessly moved, and the doctor states you have.

And since this process is not momentary, it is usually noticed too late. The cost of such carelessness deleting 8-ok and wearing braces.

So, to summarize, in the vast majority of cases, eights are a real headache, both for patients and dentists. Modern man (if he does not live in the forest the life of our distant ancestors) really needs them insofar as. Those. if your wisdom teeth have grown evenly and in their place, you are able to groom and cherish them on an equal basis with everyone else, then, thank God! Let them chew. Although I can confess from my own experience, such lucky ones are an overwhelming minority. If there are signs of one of the above problems, then there is no need to hesitate, be afraid and regret losing a part of yourself ... Wisdom teeth are far from the most valuable thing in us. And without them, life does not get worse, but rather the opposite. I wish you this "on the contrary"! .. With or without wisdom teeth.

The eruption of the wisdom tooth begins quite late. At about the age of 16-25, a person notices this process in himself, which rarely passes without a trace, pain in the gums appears.

Why, when a wisdom tooth is cut, do they experience discomfort?

• pain in the jaw;
• edema formation;
• difficult to chew food.

Pain when teething wisdom teeth?

Considering that such teeth do not have milk predecessors, their eruption is accompanied by pain, as in children during the period of the appearance of the first teeth. This is because in an adult, the bone tissue of the jaw is formed. Also, the cause of pain is the lack of space on the jaw.

In ancient times, wisdom teeth were really needed by a person. However, over time, we switched to eating softer foods, the jaw has significantly decreased. Eighth molars were no longer needed. That is why some G-8s do not appear at all or not completely.

When a wisdom tooth grows in a person, this process is accompanied by complications and pain, swelling and fever. What to do in such situations?

The main provisions of the wisdom tooth

If the eruption process occurs vertically, then the person is lucky. Often the "eights" go wrong: horizontally, towards the cheek or tongue.

If the tooth goes vertically, then it does not interfere with neighboring teeth, does not cut into the cheek and does not scratch the tongue. The greatest problems are caused by a horizontal position, when the tooth cannot go out, but grows inside the gums and grows into the roots of its “neighbor”. In such a situation, you should remove it.

Most often, wisdom teeth erupt at an angle towards the cheek or tongue. If the deviation from the norm is insignificant, then nothing can be done. But the eighth molar injures the oral cavity, resulting in ulcers. Then you have to remove it.

What is an impacted wisdom tooth?

There are situations when the "eight" is not completely cut through. Then the gum is constantly inflamed and sore. In most cases, impacted teeth are removed, they entail an inflammatory process that lasts for a long time.

Symptoms of teething wisdom

The main features include:

• pain when swallowing (due to inflammation of the gums);
• an outgrowth from the "hood" that covers the wisdom tooth trying to break out;
• swelling of the gums;
• swollen lymph nodes under the jaw.

If a wisdom tooth is cut, the above symptoms appear, you should not leave the process without being examined by a dentist. This is fraught with serious complications (abscess, phlegmon). Therefore, at the first suspicion of a deterioration in the condition, consult a dentist. At first, it is enough to remove the "hood", which blocked the exit of the tooth to the outside.

What are the complications?

The wisdom tooth is actively growing, what should be feared? First of all, the G8 will be impacted. With successful eruption, the eighth molar will appear already with caries.

This is due to the special arrangement of the wisdom teeth, when their hygiene is difficult. If partial retination is added to caries, the result will be inflammation of the gum hood, under which food debris and bacteria accumulate. A tooth not cured in time (or not removed) forms complications in the form of periostitis or osteomyelitis.

Problems will appear if the tooth is fully impacted. In this case, the person experiences severe pain in the gums, face, ear, throat, temple, head. The situation is fraught with the appearance of neuralgia. A cyst appears at the site of the impacted tooth. After the successful removal of the "eight" - it will resolve itself.

How to alleviate the condition when teething a wisdom tooth?

To speed up the process of eruption, the doctor excises the gum over the crown. This happens if the eighth molar almost appeared outward. Only a dentist makes such a decision after a thorough examination of the inflamed area.

If a wisdom tooth grows, anesthetic gels are used to alleviate the condition.

Folk methods:

1. Dry sage herb infusion, which is sold in a pharmacy. Three Art. pour spoons with hot water, leave for 40 minutes. Strain and rinse the inflamed area of ​​the gums with warm broth, the pain will gradually subside.
2. Decoction of oak bark. The recipe for use is simple - pour 6 tablespoons of the bark with 0.5 liters of boiling water, put on the stove until it boils. Add sage to the broth - 3 tablespoons. Rinsing with such a remedy quickly relieves inflammation and symptoms, but does not remove the focus of the infected area, therefore it is used only as pain relief.

Medical treatment

After the examination, the dentist will prescribe medications, these include local painkillers - Ketorol, Ketanov. With severe pain, you can not increase the dose of drugs, otherwise poisoning of the body cannot be avoided.
Help relieve the pain of rinsing with chlorhexidine.

The Angilex solution is effective. It is used for eruption of milk teeth in children, and it helps with pain during the appearance of a wisdom tooth.

Extract or save a tooth?

The final decision is made in the dentist's office who will determine whether there are inflammatory processes, prescribe an x-ray and give the patient accurate recommendations.

Everyone who cuts a wisdom tooth wonders how long this process takes? The average eruption of the "eight" is 1.5 months. But the tooth will be fully formed only after 3-4 years, when the development of the roots ends. Their growth does not cause such discomfort, unlike the eruption of the crown, but you can not relax. The roots do not always grow correctly, so it is recommended to take an x-ray from time to time.

There are situations when the eighth molar is cut within a few months. To alleviate the patient's condition and speed up the process of eruption, the doctor excises the inflamed hood. If it grows again, the procedure has to be repeated several times. In such a situation, the only way out is to remove the tooth.

hood) above the wisdom tooth

Difficulty opening the mouth during wisdom teeth erupting

Sore throat and lymph nodes with wisdom teeth

Consequences of removing wisdom teeth. Possible Complications

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

What are wisdom teeth? Why are they called that?

Wisdom tooth- this is the eighth tooth in the dentition ( the starting point is from the central incisor). Wisdom teeth are also called "figure eights" or "third molars". They are large multi-rooted teeth, however, due to anatomical features, their shape and number of roots can vary significantly from person to person. In total, a person has 32 teeth, of which 4 are wisdom teeth. They have a large number of features that distinguish them from other teeth.

Wisdom teeth begin to develop only at the age of 4-5 years, while other teeth are laid in utero or during the first year of life. Wisdom teeth erupt last, upon reaching the age of 18 or even at a later age. Sometimes the eruption of wisdom teeth is difficult due to lack of space in the dentition, as a result of which they can erupt at the age of 30 or 40 years. Finally, in some cases, they may be completely absent or may be all their lives in the thickness of the bone tissue of the jaws. Therefore, modern medicine considers the absence of wisdom teeth to be a variant of the norm, and not a pathology.

Eighth teeth today are almost always called wisdom teeth. Previously, it was believed that by the time of their eruption, a person passes into adulthood and becomes wiser than in adolescence. Naturally, the eighth tooth itself does not give wisdom to a person, just as its removal does not make a person dumber. However, this name was fixed in the Russian language and public consciousness and became widespread.

Unfortunately, wisdom teeth are of low value for the dental system, however, at the same time, they can lead to various diseases. In addition to the possible development of caries and pulpitis, the eighth teeth are characterized by difficult eruption. Almost everyone is familiar with the unpleasant sensation that occurs when they erupt. In some cases, their eruption may be accompanied by inflammation with periodic exacerbations. For a combination of these reasons, wisdom teeth are most often removed.

How many wisdom teeth are there?

Normally, a person has 4 wisdom teeth, upper right, upper left, lower left, lower right. However, not always all 4 wisdom teeth can be found in the oral cavity. Among all teeth, it is the eighth teeth that are characterized by the greatest anomalies and normal variants. In some cases, some of them erupt into the oral cavity, and some remain in the thickness of the bone and erupt at a later age or not erupt at all. They can only be detected by X-ray examination or computed tomography.

There are different options for the number of wisdom teeth. Most often, due to the decrease in the size of the jaws of a modern person, one can observe the complete absence of the rudiments of one or more eighth teeth. In this case, a person can have from 28 to 31 teeth. It is much rarer to find additional wisdom teeth ( 33rd, 34th tooth). They can be observed in representatives of the Australoid race.

At what age do wisdom teeth erupt?

The average period of wisdom teeth eruption is 17-25 years. In females, the eighth teeth erupt somewhat earlier. This is due to the faster development of girls. After 25 years, the chance of eruption of the eighth teeth decreases significantly. It can be assessed using an X-ray image of the thickness of the bone that separates the rudiment of the eighth tooth from the oral cavity. However, the eighth teeth can erupt at 30 and 40 years. The chance of eruption of the eighth teeth increases after the removal of the seventh teeth, in case they have been destroyed by a carious process. Eighth teeth can be slightly shifted towards the center, taking up free space.

The structure of the wisdom tooth

The wisdom tooth is no different in structure from other human teeth. It consists of a coronal part ( which is normally found in the oral cavity) and roots located to the thickness of the bone. The shape of the crown and the number of roots differ significantly between the upper and lower wisdom teeth. It should be noted that wisdom teeth have a very large number of shape options.

The wisdom tooth consists of the following structures:

• Enamel. A thin layer of enamel covers the outside of the entire coronal part of the wisdom tooth. The enamel is very durable harder than bone) and the most resistant to caries.
• Cement. Covers all surfaces of the roots of wisdom teeth and provides reliable attachment of the ligamentous apparatus of the tooth, holding it in the bone socket.
• Dentine. It is covered with enamel and cement and represents the thickest layer of hard tissues of the tooth. The strength of dentin is less than that of enamel, but higher than that of cement. Dentin is destroyed by the carious process faster than tooth enamel. It contains nerve endings that signal the development of caries.
• Pulp. It is located in the very center of the tooth and is a tissue rich in blood vessels and nerve fibers. The pulp performs a nourishing and sensory function for the tooth.

These tissues are part of all teeth, not just wisdom teeth. This is due to the fact that the formation of tissues of the wisdom tooth takes place along the standard path, but begins somewhat later than other teeth.

Characteristics of wisdom teeth in the upper jaw

Wisdom teeth in the upper jaw have a variable shape. Molars are closest to them in shape ( large multi-rooted teeth) of the upper jaw. Most often, wisdom teeth in the upper jaw have three tubercles, due to which their crown, when viewed from the chewing surface, has a triangular shape. The next most common variant is the four-tubercular form. At the same time, they resemble the sixth and seventh upper multi-rooted teeth in miniature. Finally, in the most rare cases, the upper wisdom teeth may have two or one cusp, which brings them closer in shape to the incisors. Very often there is a deviation of the teeth in the buccal side, because of which they do not come into contact with the teeth of the opposite jaw.

The eighth teeth in the upper jaw can have from 1 to 5 roots, most often there are 3. Due to the wide variety of canal shapes, the treatment of these teeth is difficult. The roots are short and usually straight, but may be located in the maxillary ( maxillary) sinus. In this case, the extraction of teeth should be carried out by a specialist in the field of maxillofacial surgery, since it may be accompanied by the creation of a message with the maxillary sinus.

Characteristics of wisdom teeth in the lower jaw

The lower wisdom teeth are a smaller version of the lower multi-rooted teeth, their neighbors. However, they are larger than the upper wisdom teeth. Most often they have 4 or 5 tubercles, a rectangular shape when viewed from the chewing surface. The lower molars have only 1 - 2 roots, but they can have a variety of bends, which makes the extraction of such teeth much more difficult. Wisdom teeth in the lower jaw are more likely to cause problems during eruption, as they are limited by bony formations that are not present in the upper jaw. The lower wisdom teeth may have a horizontal, lingual, buccal slope. A feature of the lower wisdom teeth is their proximity to the nerve passing in the body of the lower jaw.

Do modern people need wisdom teeth?

The functional value of wisdom teeth is minimal. Today it is believed that due to changes in the diet of modern man ( food becomes better processed, softer) the dentoalveolar system has undergone certain changes. They are expressed in a decrease in the size of the jaws and a reduction in the length of the dentition. That is why wisdom teeth are considered a rudimentary organ ( lost their meaning in the course of evolution), and their absence does not harm human health. That is why, if there are problems associated with wisdom teeth, doctors in most cases decide to remove them.

What are the dangers of wisdom teeth?

Wisdom teeth are the last in the dentition. They appear in the oral cavity later than others, and their value in the act of chewing is the least. At the same time, many dental problems and diseases are associated with wisdom teeth. Wisdom teeth can be harmful to human health, causing pain, discomfort, being a source of chronic infection. Therefore, if there are problems associated with wisdom teeth, doctors recommend their immediate removal.

Wisdom teeth can cause the following problems and diseases:

• caries and its complications pulpitis, periodontitis). Wisdom teeth, like other teeth, can be destroyed as a result of a carious process. The predisposition of the wisdom tooth to caries is due to its inconvenient position for cleaning with a toothbrush. If caries reaches the pulp ( nerve), then there is severe pain. As the infection progresses, an abscess may form ( flux), for the treatment of which they always resort to surgical intervention.
• Eruption difficulty. The process of teething wisdom teeth is long and quite painful. Due to the lack of space in the jaw, wisdom teeth often occupy an unnatural position. As a result, they can be turned towards the cheek, tongue, adjacent teeth, causing soft tissue injury and caries of adjacent teeth.
• Local damage to periodontal tissues. The periodontium is the collection of tissues that surround the tooth. Due to the incorrect position of the wisdom tooth and its incomplete eruption, a gum pocket can form, into which food enters. The gum area next to the wisdom tooth is injured by the teeth of the opposite jaw, which leads to its chronic injury and inflammation.

Naturally, wisdom teeth do not always lead to the development of diseases. Sometimes they develop quite normally and function fully. In order to prevent the development of possible problems associated with wisdom teeth, it is necessary to undergo diagnostics and treatment in advance. dentist ( enroll) .

What is an impacted wisdom tooth?

Tooth retention is a delay in the eruption of a formed permanent tooth. A tooth that is in bone tissue and has a low chance of erupting is called an impacted tooth. There are full retention, when the tooth germ is completely covered with bone, and partial retention, when part of the tooth crown is in the oral cavity, while most of it is covered with mucous membrane. Due to the lack of space in the dental arch, wisdom teeth are very often impacted.

Impacted teeth do not cause pain and discomfort until the moment when the process of their eruption is activated. Impacted wisdom teeth are most often an incidental finding on a panoramic x-ray of the jaws. About 40% of wisdom teeth are fully or partially impacted. Quite often, the retention of wisdom teeth is combined with their incorrect position in the jaw.

Incorrect position of the wisdom tooth. What is a dystopian wisdom tooth?

Dystopia is the incorrect position of the wisdom tooth outside the dentition. It can be moved in various directions. Dystopia of the wisdom tooth can be determined both after its eruption, and with the help of an x-ray before its eruption. With wisdom tooth dystopia, wisdom teeth are almost always removed, since such teeth cannot normally participate in the act of chewing. The sharp edges of the tubercles of dystopic teeth can injure the soft tissues of the oral cavity. Dystopia of the tooth can be combined with retention. This implies a tilt of the tooth in the thickness of the bone, which does not allow it to erupt into its place in the dentition.

Depending on the position of the wisdom tooth, the following variants of dystopia are distinguished:

• medial slope. The tooth is tilted forward towards the seventh tooth.
• Distal slope. The tooth is tilted back, directed towards the branch of the lower jaw.
• Angular position ( lingual or buccal). The wisdom tooth is tilted towards the tongue or cheek, respectively.
• Horizontal position. The axis of the wisdom tooth is located at right angles to the axis of the second molar ( large molar).
• Reverse position. The root part is located at the top, and the coronal part is located below, in the thickness of the bone tissue. This situation is very rare.

Horizontal wisdom teeth

Horizontal tooth tilt is relatively common, especially in the lower jaw. This situation deserves special attention. In a horizontal position, the crown of the wisdom tooth rests with tubercles against the root of the adjacent tooth. In this case, the eruption potential of the eighth tooth is not directed vertically upwards, but horizontally. This can lead to crowding of the teeth in the frontal area and a violation of their position. In addition, this position of the wisdom tooth can cause caries of the root of the seventh tooth. The only solution to these problems is the removal of a dystopic tooth.

Causes of diseases of the wisdom teeth

Wisdom teeth do not differ from other teeth in structure and structure. They also possess innervation and blood supply. That is why, with their carious destruction, exactly the same toothaches can appear as from any other teeth. However, in addition to caries, other diseases are also associated with wisdom teeth, mainly due to their eruption.

The cause of pain and discomfort from wisdom teeth is irritation of nerve fibers. They are located in the dentin and pulp of the tooth, gums, bones, ligaments of the tooth. Irritation of nerve endings can be caused by infection or mechanical damage. Both causes can be eliminated only by local action, therefore, various painkillers for toothache bring only temporary relief.

wisdom teething process

Wisdom teeth eruption is a complex process, which is the movement of a tooth from the place of laying and development before appearing in the oral cavity. The eruption of wisdom teeth occurs under the influence of various factors. With insufficient action of one or more of them, a violation of eruption, retention or dystopia of the tooth occurs.

The following factors are involved in the eruption of wisdom teeth:

• Root growth. The elongating root rests against the bottom of the bone hole and pushes the tooth vertically in the direction of the longitudinal axis.
• Periodontal traction. The tooth germ is surrounded by collagen fibers, which are the ligamentous apparatus of the tooth. The contraction of the collagen fibers creates traction for eruption.
• Bone remodeling. Teething is always accompanied by bone remodeling. The bone that is above the rudiment is absorbed, and below it is deposited. It is assumed that the bone growing at the bottom of the hole is able to push the tooth into the oral cavity.
• Increased hydrostatic pressure at the root tip. This factor is the most important. The increase in pressure in the region of the root apex is associated with the organization of the dental pulp. The accumulation of fluid between the bottom of the alveoli and the root pushes the tooth towards the oral cavity.

Why is it difficult to cut wisdom teeth?

Unfortunately, very often wisdom teeth erupt incorrectly. In some cases, this is due to incorrect laying of the wisdom tooth germ. In other cases, this is due to insufficient force of teething. However, all problems with eruption rest on the lack of space for this tooth. It is believed that for normal eruption of the wisdom tooth in the lower jaw, the distance between the seventh tooth and the branch of the lower jaw should be at least 15 mm.

Violations of the eruption of wisdom teeth are explained by the following reasons:

• Abnormal position of the wisdom tooth germ. With the wrong position of the rudiment of the wisdom tooth ( dystopias) it practically loses the chance of eruption. If the tooth germ is located horizontally or at an angle, then on its eruption path it encounters obstacles that it cannot overcome ( e.g. adjacent tooth).
• Thick cortical plate of the jaw and gums. Sometimes the wisdom tooth is located deep in the jaw bone, respectively, it is separated by a large layer of bone from the oral cavity. At the same time, the force of eruption and the phenomenon of bone restructuring is not enough to ensure the passage of the entire bone layer. With a bony septum thickness of 3 mm at the age of 25, it is believed that the wisdom tooth has a very low chance of self-eruption.
• Insufficient traction ( force) eruption. In some cases, when there are all the prerequisites for the normal eruption of the wisdom tooth, this phenomenon does not occur. This is due to the insufficient action of eruption factors.
• Lack of retromolar space. The retromolar space is the area behind the second molar. It is in this area that the wisdom tooth erupts. The lack of space is especially acute in the lower jaw, where the ascending branch begins immediately behind the dentition. There are many reasons for the lack of space for wisdom teeth to erupt.

The lack of space for the eruption of wisdom teeth may be due to the following reasons:

• evolutionary reduction in the size of the jaws;
• inheritance from parents of jaws of small sizes and large teeth;
• discrepancy between the size of milk and permanent teeth;
• premature removal of milk teeth;
• underdevelopment of the jaws;
• bad habits ( chin rest when at the table and others).

Why does the gum become inflamed when wisdom teeth erupt?

When wisdom teeth erupt, inflammation of the gums and soft tissues of the oral cavity can occur. This is observed with partial eruption of the tooth, when part of the crown is already protruding into the oral cavity, and part is still covered by the gum. As a result of constant injury to the mucous membrane, it becomes edematous and inflamed. Inflammation of the gums persists until the complete eruption of the tooth. Also, the condition can be alleviated by excising the part of the gum that covers the tooth.

When wisdom teeth erupt, a gum pocket or "hood" is formed, in which food debris can linger. Due to the pain of touch, the patient does not clean the area well, resulting in local gingivitis or periodontitis.

Why does a wisdom tooth hurt?

Pain in the area of ​​the wisdom tooth can occur for various reasons. Accurate diagnosis and proper treatment can only be carried out by a dentist. Unfortunately, in most cases, the pain associated with wisdom teeth indicates diseases that require their removal. Pain in the wisdom teeth can be both infectious and non-infectious in nature.

Wisdom teeth can hurt for the following reasons:

• Caries and its complications. Carious tooth decay is asymptomatic until it affects the nerve endings of the dental pulp. In acute inflammation of the pulp, the pain is very strong, it can radiate to the ear, temple, neck. After the death of the pulp of the tooth, the pain disappears, but the infection moves to the area of ​​​​the apex of the tooth. This is dangerous with the formation of pus, an abscess, which again returns pain.
• Eruption activation. The eruption process is characterized by moderate discomfort, but in some cases it is accompanied by a local inflammatory reaction and severe pain.
• Injury to the gums in the area of ​​the wisdom tooth. Pain in the area of ​​the wisdom tooth may be due to inflammation of the gums. This occurs with incomplete eruption and constant trauma to the gums by the sharp edges of the wisdom tooth.

Prerequisites for the development of caries of wisdom teeth

The mechanism of caries formation in wisdom teeth does not differ from the development of caries in other teeth. The main prerequisite for the development of caries in the wisdom teeth is poor hygiene due to uncomfortable brushing. If you pay more attention to these areas when brushing your teeth, you can significantly reduce the risk of caries.

The following factors play a role in the development of caries:

• Microbial factor and dental plaque. Caries develops as a result of the vital activity of bacteria that live in plaque ( plaque). They eat carbohydrates sugars) from food products that end up in the oral cavity. After the processing of carbohydrates by bacteria in the area of ​​plaque, acidity increases, enamel demineralization occurs and a cavity is formed in the hard tissues of the tooth. All of this can be avoided with a quality dental cleaning that removes plaque from the surface of the teeth.
• cariogenic diet. A diet rich in fast carbohydrates promotes the growth of bacteria in the dental plaque. Unfortunately, the diet of modern man ( soft, sticky, sugary foods) especially contributes to the development of caries.
• Low stability of hard tissues of the tooth. The rate of development of caries depends on how high the degree of mineralization of the enamel. The higher it is, the slower caries develops. The enamel of wisdom teeth during their eruption is insufficiently mineralized, therefore it is prone to the development of caries.

Carious destruction and pulpitis of wisdom teeth. Pulsation in the area of ​​the wisdom tooth

Carious destruction can proceed for a long time without symptoms. All that the patient notices is the darkening of the tooth surface and the formation of a cavity. In this case, pain and discomfort in the area of ​​​​the wisdom tooth may be absent. In other cases, the pains are of a short-term nature, they appear in response to chemical or thermal stimuli and quickly pass.

Progression of caries can lead to inflammation of the pulp ( pulpitis). Acute pulpitis is characterized by pulsation, severe pain that radiates to various parts of the face and neck. The pain is aggravated by pressure on the tooth and by chewing. Pulpitis in wisdom teeth is considered irreversible and leads to pulp death. In most cases, pulpitis of the wisdom teeth is treated by removing these teeth.

Flux formation ( pus, abscess) in the area of ​​the wisdom tooth

pulpitis ( inflammation of the dental pulp) can take chronic forms, as a result of which the death of the pulp occurs almost painlessly. As a result, the infection penetrates into the apex of the tooth root and the surrounding bone. This can lead to the formation of an abscess ( abscess). At the same time, the patient begins to be disturbed by pain, which is several times greater than the pain in pulpitis. After the formation of the fistula and the breakthrough of the abscess on the gum, the pain subsides somewhat. It is very important to remove the destroyed wisdom teeth in a timely manner, since the formation of an abscess can pose a serious threat to human health.

Tumors in the area of ​​wisdom teeth

Wisdom teeth are more likely than other teeth to be associated with tumors. Tumors are located in the jaw and surround the germ of the wisdom tooth. Tumor processes are most often asymptomatic and are detected by chance on an x-ray. In other cases, they can deform the oval of the face. Tumors in the area of ​​wisdom teeth are formed due to various embryonic disorders or disorders acquired after birth. Diagnosis and treatment of tumors associated with wisdom teeth is carried out in specialized medical institutions.

Symptoms of dental diseases associated with the eruption of wisdom teeth. Diagnosis of the state of wisdom teeth

Teething of wisdom teeth is a long and sometimes painful process. In most cases, the eruption of wisdom teeth is very different from the process of eruption of other teeth. It may be accompanied by pain, discomfort when opening the mouth, bad breath, worsening of the general condition. These unpleasant symptoms disappear on their own over time, however, if the wisdom tooth does not occupy a normal place in the dentition, then it has to be removed to avoid complications.

Teething of wisdom teeth may be accompanied by the following symptoms:

• swelling and redness of the gums;
• bad breath from the mouth;
• difficulty opening the mouth;
• inflammation of the lymph nodes;
• deterioration in general condition fever, malaise, headache).

Pain during eruption of wisdom teeth. What to do with jaw pain in the area of ​​\u200b\u200bthe wisdom tooth?

Pain during teething of wisdom teeth occurs as a result of irritation of nerve endings located in the bone, gums and neighboring anatomical regions. The eruption of wisdom teeth occurs against the background of bone tissue restructuring and local inflammation, in which certain chemicals are released ( mediators) that cause pain. These substances change the pH in the interstitial fluid, which irritates the nerve endings. The pain in this case can spread not only to the jaw area, but also to the ear, temple, submandibular region. Fortunately, the pain persists only as long as the tooth erupts into the oral cavity. However, this may take from several days to several months. In this case, the pain appears at the moments of the most intensive growth of the tooth.

In some cases, the pain is caused by infection in the area of ​​the erupting tooth. This phenomenon is observed, unfortunately, quite often, since in the posterior parts of the jaws, oral hygiene is, as a rule, defective and insufficient. Various suppurative processes of a tooth that has not yet erupted are always a source of pain and require surgical treatment.

If the patient is concerned about pain in the area of ​​the wisdom tooth, it is recommended to seek qualified help from a dentist. To temporarily relieve pain and reduce inflammation, you can take various pain medications ( e.g. ibuprofen, ketorolac). With difficult eruption without infectious processes, they greatly facilitate the "acute" period in the eruption of wisdom teeth.

Deterioration of the general condition during the eruption of wisdom teeth. Can the temperature rise during the teething of wisdom teeth?

Eruption of wisdom teeth can lead to a number of violations of the general condition of the body. At first glance, the eruption of wisdom teeth is in no way connected with the state of the heart and other internal organs, but in fact all organs are interconnected with the help of the nervous system, which carries out the highest regulation. For this reason, the pain that occurs during the teething of wisdom teeth can cause irregular heart rhythms and other problems.

When teething wisdom, the following complications of the general condition of the body can be observed:

• chronic gastritis;
• prolonged rise in temperature;
• headache;
• change in heart rate;
• changes in the cellular composition of the blood;
• speech disorder;
• general lethargy;
• increased fatigue.

An increase in temperature indicates the presence of chronic inflammation in the body. During teething, body temperature can be maintained at 37 degrees ( slightly above normal) long time. An increase in temperature, like other pathological impulses, can be triggered precisely by the wisdom tooth. Such phenomena disappear immediately after the removal of the guilty teeth.

Swelling of the gums in the area of ​​the wisdom tooth. Pericoronitis ( hood) above the wisdom tooth

During the eruption of any teeth, local inflammation of the gums occurs, due to its rupture and the exit of the crown part of the tooth into the oral cavity. However, for wisdom teeth, this phenomenon becomes more serious and therefore bears the special name of pericoronitis. Pericoronitis implies incomplete eruption of the wisdom tooth, partial rupture of the mucous membrane above the tooth and infection of the spaces created between the tooth and the mucous membrane.

Initial pericoronitis is characterized by the following features:

• slight pain behind large molars;
• redness and swelling of the gums in the area of ​​the wisdom tooth;
• secretion of a small amount of serous fluid, sometimes with an admixture of blood.

If the gums are irritated during teething of wisdom teeth, it is recommended to perform rinses and mouth baths with antiseptics. In most cases, this helps relieve pain. However, in some cases, the correct and complete eruption of the wisdom tooth is impossible, which is why the gum is constantly injured. This leads to chronic pericoronitis. In this case, the infection of this area causes the separation of pus or the formation of abscesses, which forces the removal of wisdom teeth.

Bleeding around wisdom teeth

A little bleeding during teething is normal. It is due to rupture of capillaries located in the submucosal layer. Despite this, persistent bleeding in the back of the dentition during the eruption of wisdom teeth is a symptom of pericoronitis. It can be observed when chewing, biting the gum hood between the upper and lower teeth, while brushing your teeth. Bleeding may be accompanied by pain or be independent of them.

In order to reduce bleeding gums around the wisdom teeth, you need to reduce the inflammation associated with their eruption. Mouth rinses with antiseptics can help with this. High-quality cleaning of the back of the dentition with a toothbrush helps to remove food debris and bacteria living in plaque under the gum hood. If the bleeding persists for a long time, then it is necessary to remove the wisdom teeth, as they are its root cause.

Bad breath due to wisdom teeth

During the teething of wisdom teeth, many notice that the smell from the mouth changes somewhat. This is due to the fact that with improper eruption of wisdom teeth and pericoronitis ( inflammation of the gums) creates favorable conditions for the retention of food and the reproduction of bacteria. Even the most meticulous hygiene does not allow you to properly clean the undercuts that form under the gingival hood. Cleaning your teeth is difficult because of the pain associated with inflammation of the gums.

The retention of food residues, as well as the multiplication of bacteria, leads to an imbalance in the microbial flora in the oral cavity. Bacteria produce special waste products that have a specific smell. In addition, the composition of saliva changes, which can also affect the smell emanating from the oral cavity.

Unpleasant odor can only be eliminated with the help of rinses and special toothpastes. The microflora usually returns to normal after the complete eruption of the wisdom tooth. However, sometimes, to prevent complications in the form of infection, prophylactic removal of wisdom teeth is recommended.

Difficulty opening the mouth during wisdom teeth erupting

Difficulties in opening the mouth are observed quite often during the eruption of wisdom teeth. They appear as a result of reflex contracture ( cuts) masticatory muscles. This symptom indicates the inflammatory process of the gums in the area of ​​the wisdom teeth ( pericoronitis). Opening the mouth may be so difficult that the patient cannot speak or eat normally.

Difficulty opening the mouth is a reflex mechanism. Pain impulses are transmitted along sensory fibers to nerve centers in the brainstem, where excitation is transmitted to motor neurons. As a result, the nerve impulse is transmitted along the trigeminal nerve to the masticatory muscles and causes their constant contraction.

In some cases, the contracture is so pronounced that doctors have to perform anesthesia only in order to carry out an intraoral examination. When a contracture of the masticatory muscles occurs, painkillers in the form of tablets have a weak effect.

Sore throat and lymph nodes with wisdom teeth

Inflammation of the lymph nodes lymphadenitis) is quite common when teething wisdom teeth. It is characterized most often by the formation of swelling at the angle of the lower jaw from the side of difficult eruption. There are submandibular lymph nodes, which are normally not palpable. An enlarged lymph node is firm, mobile, and most often painless. Unfortunately, inflammation of the lymph nodes indicates the need to remove wisdom teeth, since only in this case can the source of chronic inflammation be removed.

The lymphatic system performs the function of outflow of lymph from various parts of the maxillofacial region. It also includes the pharyngeal tonsils. With difficult eruption of wisdom teeth, their inflammation sometimes occurs. This condition is specifically called "dental sore throat". Symptoms of this disease are pain when swallowing on the corresponding side, swelling and redness of the palatine arches. Treatment of this condition without the removal of wisdom teeth is impossible. That is why the cause of incessant sore throat can be wisdom teeth that have not erupted, which is sometimes overlooked by otolaryngologists.

Temporary relief of pain in the area of ​​wisdom teeth

The process of eruption is characterized by the fact that it takes place gradually, stepwise. At certain moments, the tooth "activates" and begins to erupt with more energy. With its incorrect position or lack of space, this leads to pain and inflammation. Violation of speech, swallowing, mouth opening, fever - all of these symptoms appear with difficulty in the eruption of wisdom teeth.

At certain intervals, the wisdom tooth, on the contrary, temporarily stops or slows down its eruption. At the same time, pain, inflammation and discomfort temporarily disappear. At this point, a period of relief begins for the patient. It is this period that is most favorable for the removal of wisdom teeth, since sooner or later it will reactivate and continue to cause discomfort. Dentists recommend removing wisdom teeth in advance to improve the body and prevent possible problems in the future.

Diagnosis of the state of wisdom teeth

Before starting the treatment of wisdom teeth, it is very important for the doctor to diagnose their condition based on the patient's complaints, clinical data, and x-ray data. Based on the totality of all the information, the doctor judges the functionality of the wisdom tooth, the feasibility of its treatment and preservation, as well as the complexity of its removal. Only after the diagnosis is made, the possibilities of further treatment are evaluated.

When examining a patient, the doctor pays attention to the following points:

• Condition of the soft tissues surrounding the tooth. The color of the mucous membrane, density, presence of secretions, the condition of the gingival hood are evaluated. The depth of the gingival pocket is assessed by probing.
• The position of the antagonist teeth. mucosal injury ( hood) with an antagonist tooth significantly worsens the conditions of tooth eruption and complicates the course of the inflammatory process.
• Position and condition of adjacent teeth. When the first and second large molars are destroyed, they are sometimes removed, while the wisdom tooth is preserved. Subsequently, it is used as an abutment for a prosthesis that replaces the absence of adjacent teeth. If the wisdom tooth is horizontal or tilted towards the adjacent tooth, it must be removed as soon as possible, as over time it destroys the alveoli of its neighbor.
• Bone condition. Assessed by x-ray. The presence of bone loss behind the wisdom tooth crown indicates a source of chronic infection. In this case, there is a risk of developing periodontal cysts, which requires the removal of the wisdom tooth. Also on the x-ray, you can detect pathological processes in the area of ​​​​the root apex, which cannot be determined in other ways.
• The value of the retromolar space ( area behind the seventh tooth). It is assessed visually and by x-ray and provides information on the chances of a correct eruption of the wisdom tooth. If this space is less than 15 mm, then there is not enough space for the wisdom tooth and it is recommended to remove it.

Before use, you should consult with a specialist.

Author: Extraction of a tooth with one-stage restoration. procedure technique. Indications, contraindications and possible complications

Wisdom teeth are the extreme eights of the upper and lower rows. Their appearance completes the formation of the jaws. The time of their eruption stretches for more than 20 years. For some, they appear after 20, for others, they grow only by the age of 40. The well-known phrase that the eighth teeth are a sign of life experience and a manifestation of a wise attitude to life is rather a beautiful legend. However, let's not forget that legends and traditions give hints and lessons. Consider the features of the structure and eruption of the extreme molars, the causes of pain and the rapid destruction of erupted molars, the features of their removal and possible treatment.

Before their eruption, molars go through a long process of formation inside the gums. An uncut apex sitting in the gum is called impacted. Often the molar is hidden inside the gum for many years. Its eruption is hindered by the wrong direction of growth, incomplete formation of the upper part (crown) or roots, and the lack of need for chewing extreme molars.

Incomplete formation often refers to the roots of eights. As a rule, the crown of eights is formed inside the gum at the age of 12, by this age the top of the crown is already fully developed. Roots remain underdeveloped. Their slow formation is completed by the age of 25, when the molar has already partially erupted. In the photo - an x-ray of the extreme molars, where you can see that the root is small, is in the process of formation.

The impacted wisdom tooth is considered by official medicine to be a rudimentary organ. Often he does not have enough space to crawl out through the gum and participate in chewing food. This fact is associated with a change in the nutrition of the human community. The abundance of soft thermally processed food does not give the gums a full load. As a result, smaller jaws are formed than nature intended. Anthropologists confirm the fact that over the past 2 thousand years, the human jaw has become shorter by 4 mm. In archaeological burials of an older period - burial mounds of 6 thousand years ago, the remains of jaw bones were found longer than modern ones by 10-12 mm.

Extreme eighth molars appear after 20 years, when the bones are already formed. Often they do not find a place for themselves. At best, the outer molars remain impacted; at worst, they turn in different directions.

Features of the structure and symptoms of eruption

Features of the structure and eruption of the extreme indigenous eights often form pain during the period when the wisdom tooth climbs. We list the main differences between eights and other molars, premolars, canines or incisors:

• They do not have a milky precursor, so the process of eruption is difficult (compared to the front incisors and canines), it is often accompanied by painful symptoms.
• The extreme molars are multi-rooted. Often they have 4 or 5 root processes. If the roots grow together, a rare single-rooted wisdom tooth is obtained.
• Their roots are often very curved, which makes it difficult to carry out treatment (if it is necessary to fill the carious cavity or canal after the removal of the nerve).
• They do not have enough space, so various pathologies of their location are formed.
• Chronic calcium deficiency, inherent in representatives of a technically advanced society, forms weak tops that are prone to chipping, destruction and development of caries. Therefore, often, when the wisdom tooth is still climbing, its enamel is already mineralized, the tip is fragile, and painful symptoms are felt.
• Eights are little used in chewing food, so the mechanisms of possible self-purification do not work.
• The remoteness of the extreme teeth makes it difficult to clean them, as a result of which the surface of the eights often becomes a place for the accumulation of food residues, the development of carious bacteria and infection of the entire oral cavity. Therefore, often the symptoms of caries development appear soon after the eruption of the eight.
• With a lack of space in the gums, when a wisdom tooth is cut, a number of molars, canines and incisors are compressed, nerve endings are compressed, causing pain in the jaw.

The above factors explain why the eighth teeth in modern people often begin to deteriorate before they erupt. To remove the pain that has appeared is initially possible with analgesics. In the future, pain symptoms increase.

Not everyone has such a sad picture. Quite often, when a wisdom tooth is cut, a person does not experience discomfort and discovers the tip of a new tooth by accident. But some people experience painful symptoms during teething: fever, intestinal upset, weakness, pain.

A wisdom tooth is being cut: possible pathologies of eruption

Possible pathological positions of the extreme molars during eruption are any deviations from the vertical direction that make it difficult or impossible for independent eruption of the top of the molar. Apex deviations from the vertical axis are called the following terms:

• medial tilt (with forward tilt to the seven);
• distal tilt (tilted back);
• buccal;
• language.

There is also an inflammatory disease associated with prolonged eruption of the apex - pericoronitis. It appears with a long eruption of eights, when a wisdom tooth climbs for a year or more (two to three years). The gum is injured by the emerging tip, due to constant painful pressure, the gum tissue thickens and forms a “hood” or “pocket”, in which food remains accumulate and inflammation forms.

Pain symptoms in the jaw are determined by the pathology present. What to do if there is pain when a wisdom tooth is cut? What to do - delete, treat or wait?

When is wisdom tooth extraction necessary?

Extreme molars are best pulled out in the presence of the following factors:

• incorrect position in the gum;
• injury to neighboring teeth and tissues, change in their position;
• the impossibility of treating caries or pulpitis due to the inaccessibility of the roots;
• the wisdom tooth is the cause of inflammation (the medical term is an abscess) and suppuration (fistula or phlegmon) of adjacent tissues; this requires not only removal, but also treatment of the inflammation zone;
• cyst or granuloma on the roots of the figure eight;
• pericoronitis;
• osteomyelitis of the jaw in the zone of the wisdom tooth.

With severe pain, inflammation and suppuration, urgent measures are needed (such treatment begins with removal).

When is wisdom tooth extraction contraindicated?

We list several factors when treatment is necessary without the removal of the last molar:

• Absence of the seventh or sixth tooth. In this case, the figure eight will fill the existing gap in the gum. Over time (several years), she will move the dentition and take up free space. At the same time, a person will retain a full chewing surface. Also, if prosthetics are needed, the preserved eighth teeth will be the supports for the bridge.
• The possibility of treatment, confirmed on the x-ray: normal, not bent roots, the cavity of the spread of caries is accessible to the medical instrument.
• Healthy root, located vertically, making it possible to install a crown on the top of the eighth tooth.

There are also general contraindications for removal:

• severe inflammation of the gums - in this condition, it is necessary to first remove the inflammation (with antibiotics and antiseptics), and only after that - remove its cause;
• cardiovascular diseases;
• acute infections (flu, hepatitis, oral stomatitis);
• the initial and last months of pregnancy (you can pull out a tooth only with special indications);
• mental illness.

Is it painful to remove a wisdom tooth?

Extraction of teeth should occur with high-quality anesthesia. The patient and the doctor must be confident in the effectiveness of the pain medication. Modern anesthetics allow you to qualitatively and permanently reduce the sensitivity of the gums and oral cavity. Fear of whether it is painful to remove a wisdom tooth should not fetter the patient and complicate the operation.

High-quality anesthesia is provided by preparations based on articaine (ultracaine, ubistezin). Their duration is up to 6 hours.

After the specified period (for other drugs it may be less), when the action of the analgesic ends, pain may occur. Moreover, if the removal was difficult, the doctor pressed on the gums, lips, or neighboring tissues were damaged, pain appears in the tissues adjacent to the cut, as well as at the site of the gum injection (with a syringe needle during injection). Analgesics help relieve postoperative pain. The pain usually goes away after one or two days.

Pain after the removal of a wisdom tooth lasts longer and is often accompanied by fever, chills. Which once again confirms the fact that the eighth teeth are special, and they need to be removed only if there are valid indications.

If there was no abscess in the gum, then the hole after the removal of the wisdom tooth heals within two weeks, but remains soft and painfully reacts to pressure. Only after a few months, the gum acquires hardness and the ability to painlessly respond to squeezing food.

If the operation was extensive, the gum was cut, then sewn up, then within a few hours after removal, edema occurs with a visual increase in half of the face. Such edema lasts for several days (one or two, sometimes three), and then gradually subsides.

In the first days after removal, you can not rinse your mouth. The hole after the removal of the wisdom tooth is filled with a blood clot, which is necessary to tighten the resulting cavity. If necessary, oral baths are performed instead of rinsing (an antiseptic infusion or preparation is kept in the mouth without internal movement).

Prolonged non-growth of the hole after the removal of the wisdom tooth indicates the presence of remnants of dental tissue (chipped enamel, broken off parts of the apex). If the upper tooth was removed, the remnants often come out on their own, under the influence of gravity, within a few days. If the lower molar was to be removed, then such a hole must be cleaned for further healing.

Antibiotics after tooth extraction, as a rule, are not used, except in special cases when significant inflammation of the gums or periosteum is being treated.

Why in folk medicine try to save the wisdom tooth?

According to Slavic legends, wisdom teeth grow in those who have gained spiritual strength and protection of their ancestors - the guardians of the family. Their removal does not affect physiologically, but deprives a person of spiritual strength and the patronage of ancestors. That's what the legends say. Therefore, the old Russian healers, when teething wisdom teeth, “talked” them from damage (in modern methods, such an effect is called structuring water to treat a certain disease or exposure at a wave level). In order to relieve toothache, doctors used antiseptic rinses.

According to Zoroastrian views, the eighth teeth are not formed in those people who had related marriages in their family.

From the point of view of modern physiology, the research of Dr. Voll is interesting. He says that each organ of the human body is connected to several other organs. In the studies of Dr. Voll, wisdom teeth are associated with the psyche and its disorders.

Upper wisdom teeth and sinusitis

When the wisdom tooth hurts constantly, it is necessary to visit the dentist and take an x-ray. The dentist examines and sanitizes the wisdom tooth. To treat or remove is a complex issue that is decided jointly by the patient and the doctor. An X-ray image will give a clear picture of the location of the apex and roots in the jaw, and will determine the possibility of treatment. The decision to "treat or tear out" is determined by how expedient it is to preserve and treat the figure eight.

Removing a wisdom tooth is more difficult than other multi-rooted molars for two reasons. Due to the extreme location, these molars are the most distant from the center, for the operation the patient needs to open his mouth wide. The second reason for the complexity is curved roots. The most difficult removal falls on figure eights with significant hook-like root bends.

It is also difficult to remove the upper wisdom tooth. Near their roots is the cavity of the maxillary sinus. If the roots are long, they can penetrate into the maxillary cavity. Painful symptoms occur if pulpitis develops or it is necessary to pull out the upper tooth.

The difficult removal of the wisdom tooth from above consists in the possible perforation of the maxillary sinus. Treatment of a perforation requires surgery. The patient is cut from the inside of the gums and the perforated canal between the oral and maxillary cavities is sutured.

An untreated upper molar often causes sinusitis. The appearance of the disease is accompanied by symptoms characteristic of sinusitis: headache, nasal congestion, pulsating sensations in the area of ​​the diseased tooth root. Treatment of such sinusitis begins after the removal of the wisdom tooth, which supplies toxins and causes inflammation.