Features of wisdom teeth removal. How to remove a wisdom tooth in the upper jaw

Removal of a wisdom tooth is indicated when it is incorrectly positioned, which negatively affects the condition of neighboring teeth. It can be simple or complex (with impacted and semi-impacted teeth).

A wisdom tooth is a molar, indistinguishable in structure and purpose from other teeth. It is called the “eight” because it is the eighth from the central incisor. Theoretically, a person can have 4 such teeth - 2 each in the upper and lower jaw.

However, during the process of evolution, the size of the human jaw decreased (by 10-12 mm), which is due to the use of softer, thermally processed food. There was a decrease in the chewing load, which resulted in a decrease in jaw size. The number of tooth germs remained the same. This is why in some people the “eights” erupt (in some cases incorrectly), while in others they do not.

"Eights" appear at the age of 18-21 years. If by the age of 27 they have not made themselves felt, then most likely they will not cut through. Although there are cases when wisdom teeth appear at an older age (after 40 years). Molars got their name because they “grow” during human maturity.

A wisdom tooth is considered a rudiment. With proper development and good condition, it successfully performs its functions, and in old age (when the remaining teeth are destroyed) it becomes a support for dentures.

However, most often the “eight” is the source of problems - teething causes many complications. The only way to deal with them is to remove the tooth.

Indications for removal of eighth molars:

a crown protruding in or out of the gums, which injures the oral mucosa;
destruction of enamel, dentin or pulp (caries or pulpitis) of the “eight” or adjacent molar, the treatment of which is impossible;
abscess (purulent inflammation);
lack of space on the alveolar process, which causes the tooth to grow in a horizontal or vertical direction.

In most cases, problems with wisdom teeth are due to the fact that there is simply no room left for it. Starting to erupt, the “eight” rests on the adjacent molar. This causes pain and swelling.

Contraindications

Contraindications to removal are:

problems with blood clotting;
1st and 3rd trimesters of pregnancy;
chronic diseases of the gastrointestinal tract, heart, kidneys in the acute phase;
mental disorders.

Removal of upper wisdom teeth

Removing a third molar is not an easy process, since it strongly cuts into the gums and has extensive root and vascular systems. The upper jaw is less massive than the lower jaw, so the upper wisdom tooth is surrounded by a thinner bone plate and has less branched roots. Removing the top “eight” is easier and safer.

There are simple and complex removal. Simple is indicated if the molar is completely or 90% erupted above the gum. Moreover, it has short straight roots (or a single fused root).

Simple removal does not involve excision of the gums or other surgical manipulations with a scalpel. Hand or elevator forceps are used; curved S-shaped forceps may also be required. The latter allow you to reach the removed molar. When it is destroyed by caries, as well as to extract root fragments, there are bayonet-shaped or bayonet forceps. They have completely closing cheeks, unlike the cheeks of other types of forceps.

An x-ray is taken before the removal procedure. This is necessary for the doctor to evaluate the structure of the tooth and the location of the roots.

Removal is carried out in several stages:

Apply forceps to the crown so that it is captured entirely.
Deepening the cheeks of the forceps under the edge of the gum.
Tool fixation.
Rocking, dislocation of the tooth from side to side, this process is called luxation.
Removing the figure eight from the alveoli is traction.

Immediately after extraction, a cotton swab is placed into the resulting space to stop bleeding for an average of 7-10 minutes.

Each stage has its own characteristics. So, the tooth should be rocked in the direction of the cheek. Extracting the figure eight is done using a rotational or pendulum-like movement. The doctor’s task during a simple extraction is to pull out the tooth completely with its roots at one time.

Impacted and semi-impacted wisdom teeth

An impacted tooth is one that has formed but has not erupted. Visually, it looks hidden in the gum. Any tooth can be impacted, but most often it is the “eight” tooth. If 1-2 cusps of a wisdom tooth appear from under the gums, then they speak of its semi-retention.

The impacted molar is usually removed. Indications for surgical procedures are:

inflammatory process;
pain, swelling in the gums;
location of the tooth in the follicular cyst;
malocclusion, impossibility of quality dental treatment;
incorrect location of the impacted “eight” (inclination towards the cheek or adjacent tooth, reversal, “upside down” position).

In other cases, if the impacted tooth does not bother you, it is not removed.

Semi-retinated teeth often cause the development of pericoronitis - inflammation of the gingival hood. This is due to the fact that food debris and bacteria accumulate underneath it.

As a result, inflammation develops, the symptoms of which are throbbing pain radiating to various parts of the face, the inability to chew or simply open the mouth, an increase in body temperature to 39°C, and a general deterioration of the condition.

The problem can be solved by removing the semi-impacted tooth or excision of the hood.

Removal procedure

If it is necessary to extract impacted and semi-impacted teeth, they speak of “complex” extraction. It is also accompanied by x-rays and anesthesia.

Stages of “complex” removal:

Incision of the gum with a scalpel, separation of the gum flap.
If the molar is located under the bone layer, it is sawed out (resection) using a drill.
Removing the figure eight (in whole or in parts after preliminary sawing).
Cleaning the hole with a curette (an instrument that resembles a spoon) and treating it with an antiseptic solution.
When drilling bone tissue, it becomes necessary to fill it. For this purpose, synthetic analogues are used, for example tricalcium phosphate, hydroxyapatite.
Returning the gum flap to its place. Stitching.

The procedure lasts 40-50 minutes. After 2 days, the patient must return for a follow-up appointment. Bone resection should be performed at low drill speeds with cooling to prevent bone death.

In case of pericoronitis and there is no indication for removal, they resort to excision of the gingival hood. First, the doctor examines the X-ray data, then performs local anesthesia. The dissection procedure involves removing excess gum using a scalpel so that nothing covers the molar area. If even a small area of gum tissue remains, re-inflammation will begin. After excision, the wound is treated with antiseptic and a healing composition is applied.

Anesthesia - what type of anesthesia to choose?

When removing wisdom teeth, local anesthesia is usually used - injections of Lidocaine or Articaine. 2 injections are given - on the outer and inner (palatal) sides. Thanks to this technology, a more reliable analgesic effect is achieved, which occurs within 5 minutes after the injection.

When removing 2 “eights” on the upper jaw at once, the doctor may suggest general anesthesia. It is also indicated for dental phobia, intolerance to anesthetic components. Despite all the attractiveness of tooth extraction under general anesthesia, this procedure is contraindicated for a number of diseases. It is not performed on children, pregnant women, or the elderly. It should be understood that anesthesia is always a risk. Finally, the cost of removal increases markedly.

Modern pharmaceuticals offer many painkillers that replace each other. The dentist, having studied the anamnesis and familiarized himself with the patient’s health characteristics, will select the optimal anesthetic. This is why it is so important to listen to your doctor’s recommendations when choosing a pain reliever.

For example, for diseases of the cardiovascular system, analgesics containing adrenaline are excluded. Drugs that have a vasoconstrictor effect are contraindicated for pregnant women.

Most often, an infiltration injection with an anesthetic is performed, in which the solution is injected into the transitional fold of the gum. If the first technique fails, palatal or tuberal anesthesia is performed.

To increase the exposure time of the articaine anesthetic, adrenaline or norepinephrine is added to it. Having a vasoconstrictor effect, they reduce the rate of resorption of the anesthetic, that is, they increase the time of its concentration in the working area. The use of adrenaline together with an anesthetic allows for painless removal within 1 hour.

The quality of anesthesia depends not only on the type of drug, but also on the condition of the patient. Thus, the patient’s strong fear and anxiety become the reason that the “freezing” does not work.

Consequences and complications

One of them is alveolitis, or inflammation of the socket. It will appear the very next day after removal and will manifest itself as aching pain, swelling, bad breath, and an increase in temperature to 38-39°C.

If the crown is strongly compressed, especially if the tooth is susceptible to caries, a fracture is possible. In this case, the dentist will have to remove the debris piece by piece. A fracture is characterized by a cracking sound. By the way, the neighboring tooth can also break. This usually happens when the dentist is inexperienced or if the supporting tooth is too weak and does not have a subsequent “neighbor”.

If the forceps are applied too deeply and force is used, a fracture of the alveolar process is possible. In this case, the sharp parts at the fracture site are polished to avoid the development of inflammation. The resulting wound will require more attention during treatment and care, and the patient is prescribed antibiotics.

Excessive force at the time of tooth extraction can cause perforation of the bottom of the maxillary sinus. An unpleasant, but quite rare complication in which a perforation (hole) occurs between the jaw and the maxillary sinus.

Operation price

Wisdom tooth removal is included in the list of procedures that are performed free of charge in public clinics under the compulsory medical insurance policy. You will probably have to pay for anesthesia - on average 100-500 rubles, depending on the composition.

In private clinics, the removal procedure will cost 3,000-4,000 rubles, and for complex extirpation of impacted and semi-impacted teeth - 10,000-15,000 rubles.

Conclusion

A rudiment such as a wisdom tooth may not bother a person or may cause inflammation or malocclusion. In the latter case, the “eight” must be removed.

If the removal technology and postoperative care are followed, no complications arise.

This video shows the process of removing a wisdom tooth in the upper jaw.

According to dentists, the very prospect of removing the eighth upper tooth often causes people to panic. Patients with Soviet experience in dental treatment imagine in the dental office a hammer, a chisel and a surgeon who will chisel the roots for an hour, pulling them out in parts from a torn, blood-stained hole...

There is some truth in these fantasies, because the upper eight of each person is unique in design and location, and this often makes their resection very difficult. And yet this procedure today is not as scary and complicated as some people imagine it to be.

Since the “wise” tooth on top is one of the last to erupt, there is no longer room for it in the row. If the teeth are tightly spaced and the jaw is neat and small, the 8th tooth may not show itself, since its crown will rest against its neighbor. Such a delay in teething is accompanied by pain, a swollen cheek, and such symptoms, of course, complicate the operation. When compared with the lower eights, complications with the eruption of their counterparts from above are rare, and for an experienced surgeon the operation is not particularly difficult.

Standard surgical treatment algorithm

Removing the top 8 is a standard procedure; we can talk about regular removal with forceps if:

it has only one or 2-3 roots fused together;
the root system is straight and not very long;
the crown is located to a greater extent above the gum, which allows you to completely grasp it with forceps.

The design of the forceps intended for the “wise” tooth is specific; the instrument is made taking into account difficult access to the dental unit. Sometimes the bone tissue is damaged by caries; such roots are loosened with bayonet-shaped forceps. Compared to conventional forceps, which are used for surviving crowns, bayonet forceps have fully closed sharp cheeks, convenient for extracted molars - eights, molars, premolars, and sometimes capricious incisors and canines.

Before the operation, the surgeon will send you for an x-ray, this will help him assess the degree of difficulty of the removal and possible complications from neighboring teeth or maxillary sinuses. Next, the doctor will collect an anamnesis, specifying all concomitant diseases, examine the tooth, prepare a set of instruments necessary for a particular case, remove plaque from the unit being removed and treat the oral cavity with an antiseptic. Preventive measures prevent suppuration of the hole after removal.

After treatment, the surgical area is numbed.

Algorithm for a standard operation to remove top eights.

After the operation, the dental surgeon will advise you on how to care for the wound, what painkillers can be used, and how long it will take for the hole to heal.

Features of resection of impacted upper eights

Due to the fact that there is always little space for wisdom teeth, doctors observe dystopia every day - their non-standard location. In reality, it looks like this: the erupting tooth deviates to the free side, injuring the cheek when chewing with sharp edges. In adulthood, with diabetes or simply low immunity, such wounds do not heal for a long time. Forming ulcers can become the beginning of oncological problems, which is why it is so important to remove the problematic tooth in time. Sometimes, when there is a lack of space, the figure eight erupts partially, bending strongly and resting against the seven (the so-called semi-impacted wisdom tooth) or does not erupt at all (impacted version).

Do impacted teeth need to be removed? From the point of view of professionals, if they do not cause discomfort, there is no risk of complications, then they are left under observation. Once every six months you need to come to the doctor for examination. If pain occurs, a follicular cyst forms near the problem tooth, such a tooth must be urgently removed. During the examination, the doctor will analyze the x-ray to determine the limits of the maxillary sinus: the closer it is to the roots, the easier it is to pierce or perforate.

Algorithm for surgery to remove impacted eights.

The oral cavity is locally anesthetized.
The gums are cut with a scalpel and the strip is peeled off.
Bone resection is carried out to avoid necrosis; tips and cutters are used at low speeds with constant cooling (if the problem tooth is not surrounded by bones, it will not have to be sawed).
Using elevators or forceps, the tooth is extracted (entirely or in fragments).
The hole is curetted and washed with antiseptics.
Bone tissue is treated with biomaterials.
The cut piece of soft tissue is placed in place and sutures are applied.

Stop the bleeding by inserting gauze swabs soaked in hemostatic agents.

It may be easier to remove a tooth piece by piece, but there is a danger of debris getting into the maxillary sinuses, from where it is more difficult to remove them. After the operation, the doctor must advise on proper care of the wound.

Video - How tooth extraction occurs

Anesthesia or local anesthesia?

Everyone who is about to have a “wise” tooth removed is concerned with the question: what type of anesthesia is more suitable for such an operation? Anesthesia has one advantage: all fears can be turned off along with consciousness. But such anesthesia also has disadvantages: special preparation, high price, unpleasant consequences. In clinical practice, cases have been described when patients did not wake up at all after anesthesia: with some diseases there is always a risk of developing a resuscitation situation during surgery.

All of the above arguments speak in favor of local anesthesia. Modern anesthetics of the Articaine group almost always provide high-quality “freezing”.

The eights on the upper jaw, when compared with the lower ones, grown into the massive jaw, have one advantage. They are surrounded by a thin cortical plate with openings for the exit of nerve processes, and it is not difficult to “freeze” them.

Typically, infiltration anesthesia is performed when the drug solution is injected into the transitional fold - the projection of the root system onto the soft tissue.

If this is not enough, tuberal anesthesia is used. For a prolonged effect, vasoconstrictors such as adrenaline and its analogues are added. By accelerating the constriction of blood vessels, they contribute to the slow absorption of the anesthetic, which remains in the surgical area for a long time. An adrenaline concentration of 1:100,000 makes it possible to work with a tooth without pain for at least an hour.

If there are contraindications for local anesthesia (intolerance to the components of the drug, mental disorders, panic fear from the sight of instruments and blood, high trauma, duration of the intervention), then the operation is performed under anesthesia.

Possible complications after removal of the top eight

In general, the upper eighth tooth does not cause any major problems when removed, but in some cases there are undesirable consequences. This is due to the negligence and inexperience of the dentist. Brute force in such manipulations is unacceptable, so an elegant young lady surgeon copes with her duties no worse than a sporty man. Dental surgeons claim that the tooth is pulled out by hand. The forceps are part of the doctor's hand, but the head must also be involved. When removing, it is not effort that is important, but leverage plus competence. When the tooth does not give in, it is foolish to increase physical impact, since such acceleration increases the risk of developing undesirable consequences.

Table. Complications when removing the upper eights

Type of complication	Description of the problem	Prevention
	In case of severe caries damage, when the forceps are compressed with inadequate force, the patient hears the crack of a tooth falling apart and spits out its fragments	Carefully control the force of the forceps and the depth of immersion of the cheeks - the deeper, the better
	When using elevators, if a single unit is chosen as a support, it may turn out to be weak	Near the reference seven with this technique there should be a normal six
	If the tooth is of increased complexity, and all attention is focused on its extraction, the gums are injured when the forceps slip. To improve access, you can also tear the patient’s mouth	The surgeon must have maximum control over his every step.
	If you work roughly with the elevator, you can push part of the root under the gums, which then need to be cut	Use the tool carefully and with utmost care
	If you roughly grab the crown with forceps, you can also grab the process	In order not to infect the wound, it is necessary to align the sharp edge of the array
	They pierce the bottom with excessive loads on the root and a poor understanding of the anatomy of the jaw	Preliminary X-ray of the tooth, control of forces aimed at the root or tooth

To avoid such consequences, monitor the chosen dentistry - advice from friends, reviews on thematic sites, long-term results of patients who have been there. This will help you find a professional without pathos and inflated prices.

Video - Atraumatic removal of the upper eight

Many patients are faced with the need to have their wisdom teeth removed. Often the reasons for this are improper eruption, insufficient space on the gums, injury to the oral mucosa, or complications in the jaw. Due to the fact that the number eight is the last to erupt, it often does not have enough space at the end of the gum. If the teeth are closely spaced and the upper jaw is small, this molar may not erupt for a long time, resting its crown part on the adjacent seventh.

This is why serious problems arise, such as pain, swelling of the gums and cheeks, which can lead to complications in the process of removing such a tooth.

The fact of the upcoming removal of the eighth molar wisdom often causes people to panic and want to understand whether it hurts. However, a professional removal procedure performed by a good dentist rarely causes negative consequences.

In fairness, it should be noted that there is some truth in patients’ fears, since each person’s upper wisdom teeth have their own unique location in the jaw and structure, which sometimes makes their removal very difficult.

Is it painful to remove a wisdom tooth in the upper jaw?

Dentists, those with extensive experience say that that removing the figure eights from above does not bring the patient any particular pain, provided there is no purulent process. This operation is always complicated and therefore requires the use of anesthesia.

If the effect of the pain medication is insufficient, then after removal the patient is given a pill to eliminate severe pain. During the operation, pain may also be observed, it all depends on the individual characteristics of the client.

How are top eights removed?

Removing the eighth tooth on top is much easier than getting rid of the same one on the bottom. Since the roots of such molars have a less strong and tortuous structure.

Before removing any tooth, an x-ray must be taken to obtain the correct picture of its location. After studying the image, the doctor examines the patient’s oral cavity, determines the presence of allergic reactions to medications, and becomes familiar with contraindications and concomitant diseases.

This is done to select the method and drug for anesthesia. The effect of the painkiller begins 4-5 minutes after administration of the medicine.

The wisdom tooth is removed from the socket using special instruments. The procedure time is usually 10 minutes and if there is an inflammatory process in the gums, the wound is treated with an antiseptic.

If we are talking about a simple operation removal of the 8th tooth from above, then the indications for it are:

The presence of one or more tooth roots connected to each other.
The root has a straight and short shape.
The crown part of the tooth is almost completely located above the gum level.

Then the removal of the upper wisdom tooth occurs using forceps, which have some features. Bayonet forceps are used by surgeons quite often, as they have a special configuration that is convenient for removing the most difficult roots.

The cheeks of these forceps have a pointed shape for better fixation of the removed root and close completely, unlike other instruments.

Steps to simply remove the top eight:

After completion of the removal procedure, the doctor offers recommendations to the patient on caring for the postoperative wound.

Features of removing semi-retinated and retinated upper eights

Any dentist in practice observes the phenomenon of an unusual arrangement of the upper wisdom tooth - the so-called dystopia. This is usually expressed in a strong deviation of the tooth towards the cheek.

This phenomenon is especially dangerous for older people, since the tooth injures the inside of the cheek. And wounds that do not heal for a long time turn into ulcers and cause the development of tumors. For this reason, it is important to diagnose the deviation in time and immediately get rid of such a tooth.

Sometimes a lack of free space in the jaw or improper placement of the upper eighth molar leads to it being partially erupted (semi-retinated) or not showing on the gum surface (impacted).

Question about removing semi-impacted and impacted wisdom teeth from above is always decided strictly individually. If the number eight does not cause concern and does not pose a threat of complications, then it is not touched, but is left under regular observation.

Important! An impacted tooth must be removed urgently if an inflammatory process, pain occurs, or a follicular (tooth-containing) cyst begins to form around it.

Stages of removing impacted upper wisdom teeth:

Upon completion of all procedures, the surgeon gives recommendations for postoperative wound care.

About anesthesia

Local anesthesia is injected into the gums directly next to the problem. Surgeons use modern fast-acting drugs Ultracain, Ubistezin and Septanest.

It happens that anesthesia is used to remove eights. Unlike local anesthesia, it makes it possible to undergo the most complex manipulations with a switched off consciousness. But this method has a number of disadvantages:

Specific preparation.
High price.
Unpleasant sensations after the procedure.

The likelihood that a patient will end up in intensive care is associated with certain individual characteristics of the body and a number of diseases.

For this reason, most often the upper wisdom tooth is removed using local anesthesia. Anesthesia is used only in cases individual intolerance to anesthetics, patients with mental disorders, the presence of panic fear before surgery, as well as long-term and increased trauma of the upcoming operation.

What to do after wisdom tooth removal?

What can you eat after tooth extraction?

You should not take food for 2–3 hours after undergoing surgery to remove a wisdom tooth from above. Warm drinks are allowed during this time. .

After the stitches are removed You can eat any food, but without touching the operation site. It is better to avoid solid and spicy foods until the surgical site has completely healed.

When to start brushing your teeth?

You should not brush your teeth during the first 24 hours after a complicated figure eight removal. If you neglect the doctor’s recommendations and injure the surgical site, then a blood clot may fall out and the stitches will come apart, after which the wound will bleed and heal for a long time.

You can touch the extraction site no earlier than 3 days after surgery, and brush the remaining teeth carefully with a soft paste.

Complications

The upper eights are not particularly difficult to remove, but serious problems cannot be excluded that lead to complications during the operation or postoperative period. As a rule, these cases are directly related to the low professionalism of the dental surgeon.

When removing any tooth The use of brute physical force by the doctor is strictly prohibited. Competent dentists with extensive experience know that removal is done primarily with their hands, and not with forceps.

The forceps should be an extension of the surgeon's hand, and the hand should be an attachment to the competent head. The removal process should not involve excessive force, but use the known principle of leverage, coupled with care and experience.

If a tooth cannot be removed, there is absolutely no point in using forceps. Nowadays, there are other optimal ways (besides forceps and elevators) to safely extract a tooth without the risk of complications.

Possible complications, arising during the operation and after removal of the figure eight on the upper jaw:

When will the gum heal and how long will it hurt?

The anesthesia wears off after about three hours and pain appears in the gums, which can last constantly or occur from time to time for 4 days. Painkillers will help relieve it.

If the figure eight was difficult to remove, then the surrounding tissue takes a little longer to recover; on average, pain can last up to ten days.

The amount of time for a wound to heal is always individual, but if the molar is large with gnarled roots, it takes more than one month. As the wound heals, swelling, redness and bleeding often appear, which should subside within 5-6 days. If the discomfort continues to bother you longer, then you should immediately consult a doctor.

The healing period is increased by incorrectly selected anesthesia for the operation, as well as damage to the gums or unprofessional work of the surgeon.

On average, healing time ranges from 7 to 30 days, and the stitches are removed exactly after a week. Overgrowth of bone tissue at the removal site occurs no earlier than after 4 months.

Removal of wisdom teeth, or more simply put, “eight” teeth, is quite common. And it is usually a rather difficult task for an ordinary dentist. This is done by a dental surgeon. So what is the difficulty in removing eights? Let's consider two options. Wisdom teeth can be found both above and below; the most difficult part is removing the lower ones - we’ll start with them)

First of all, the difficulty lies in the fact that the wisdom tooth is the last of all to erupt, and by this time the bone has already formed and is very dense in itself, especially in the lower jaw, and there is not enough space for these teeth in the jaw in the row, so They grow with displaced and curved roots, usually on the side of the cheek, less often on the side of the tongue, since the angle of the lower jaw is in the way from behind. This is still the best case scenario, but as a rule they either erupt halfway or remain in the bone altogether, resting against the upcoming seventh tooth. Next, let’s imagine that this is the farthest tooth, and it has been hurting for several days, will the patient be able to open his mouth as wide as necessary? Will the doctor be able to clearly see the entire surgical field? I doubt it... This is where the difficulties come from.

So, okay, we administered anesthesia, numbed the pain so that half of the face was numb, and we proceeded to the actual removal. Let's consider a more complex option when the tooth is hidden under the gum - an incision is made, the gum is opened, the coronal part of the tooth is released, and the entire coronal (upper) part of the wisdom tooth is cut off at the root using a straight tip with a cutter. After that, the roots are removed individually using a straight or corner elevator. If the root is fused, then there is only one. Wells are produced. It is at the discretion of the doctor. Stitches are applied. Be sure to apply ice after removal! Keep for 15 minutes with breaks for about an hour. If you ignore this manipulation, you risk becoming the owner of significant swelling. Appointed: antibiotic 1 capsule 2 times a day ( Rulid, amoxiclav, lincomycin- one of three) antihistamines drugs 1 tablet 3 times a day ( diazolin or suprastin) rinsing (chlorhexedine baths). Required inspection on the next or second day after the operation. Dressing the wound.

For a clearer idea of how all this happens, you can watch a short video about the technique of removing the lower wisdom tooth: (don’t be alarmed, there won’t be a sea of blood there, this is just a schematic video)

If we are considering removing the figure eight that is not hidden under the gum, then it is quite possible to get by with the removal using one elevator or even beak-shaped forceps. It all depends on the skill of the doctor)

You should pay attention to the fact that, as a rule, after the removal of the eighth teeth, swelling develops from below the next day and lasts approximately two to three days; on the fourth day, the swelling begins to subside. The fact that the swelling subsides or “slides” down is a good sign, meaning that you are on the mend :). If the swelling begins to creep up, you urgently need to see a doctor. Pain in the area of extraction lasts up to three days, and the more time has passed since the tooth was removed, the less painful the hole becomes, but if, on the contrary, the pain increases, you should immediately consult a doctor. The next day, the temperature may rise to 37. Girls, as a rule, may experience a bruise on the skin in the area of removal and swelling.

Removal of the upper wisdom tooth is less painful, less traumatic, and much faster)). The bone in the upper jaw is less dense compared to the lower jaw. It is more pliable, and in the back there are no obstacles like on the lower jaw, so the doctor tries to remove the upper eight as if from behind, since the upcoming seventh tooth will most often interfere with us in front, and the cheek is located very close to the side. The tooth is most often removed using a straight elevator or special forceps for the upper eights. But this does not mean that removal is simple and any doctor can easily do it. The doctor must be extremely careful when removing wisdom teeth, since there is a high risk of breaking off part of the tooth root, which is very curved. Be sure to take a targeted photo, or even better, a panoramic one, for a complete overview of the situation, as well as other teeth.

In Russia there is no strict sequence of reception and tactics for removing eighth teeth. Very often, doctors take patients and charge them high prices for complex removals, without knowing whether they can help the patient or not. If they can remove it - good, if not - they will send you to another clinic or maxillofacial surgery, or even leave the roots, sew them up and say that “everything is fine” I have met such abandoned people more than once. Well, you don’t know how - where are you poking around? Right? As they say: “If you call yourself a milk mushroom, get into the back.” I remember one case, it was probably already about 21 o’clock, and I was leaving work in disguise when a doctor from a neighboring competing clinic ran up to me with a patient and asked me to remove a tooth. Judging by his appearance and the dried blood on his lips, I realized that the man had been tortured for more than 3 hours. A colleague who was twice my age could not refuse, and agreed to help, since we have the same goal - to help the patient, and not to fill his pocket wider and abandon the person. They did everything successfully, despite the fact that the patient was simply unable to even open his mouth. In general, the outcome is favorable)

But in Germany, for example, where medicine is famous not only for technological progress, but also for doctors, the situation with wisdom teeth is much simpler.
They are removed from everyone, arguing that they were needed much earlier, when people hunted animals and used rougher food for food, three chewing teeth were needed, but now, food is thermally processed, softer and does not require such thorough chewing like before. And the fact that eights in general are rudiments and they are absolutely unnecessary - they only cause problems.
And the procedure itself goes like this: you come for removal, and then only a week later for examination and removal of sutures. If a tooth hurts or aches, or swelling develops, no one cares there. This is just the norm!) But calling the clinic and complaining to the doctor about persistent pain after its removal will cost you a later invoice in EUROS.

The most important thing, my dears, is to take responsibly both the procedure itself and post-operative measures, and even more importantly, the choice of a doctor.

The 8th tooth or wisdom tooth erupts at the age of 18-25 years. It received its name in connection with popular beliefs. It was believed that as a person approached 30 years of age, he became wiser. A total of 4 wisdom teeth appear: 2 on top and 2 on the bottom. In 8% of people they do not grow. The ancestors believed that this was due to the fact that a person had not accumulated enough life experience: wisdom never came to him. Modern dentists talk about evolution. The food people eat has changed. It became softer and more processed. The size of the jaw has decreased, and there is simply not enough space for wisdom teeth. This is a rudiment that was inherited from our ancestors.

Features of the G8

Wisdom tooth or 3rd molar ends the line of dentition. Its root is complex and can have up to 4 branches. This is one of the features of the 3rd molar.

Possible pathologies during teething

The extreme molars do not always erupt correctly and begin to grow upright. Dentists often encounter oblique tooth growth:

Pathology will be considered not only the incorrect inclination of the last molars, but also their insufficient appearance. Dentists determine full or partial retention wisdom teeth With complete retention, the molars do not erupt. They remain inside the jaw.

This may not be perceptible to a person. If he does not experience pain, no changes occur on the gums and other teeth, then the “eight” is not touched. Dentists recommend doing an orthopantomogram, a panoramic photo of the jaw, once a year. A complication of complete impaction of 3 molars can be the formation of a follicular cyst, which forms around the bones.

Partial retention of a wisdom tooth, when it has not fully erupted, is considered more dangerous. Wherein The following complications may develop:

inflammatory process in the gums and bones - pericoronitis: swelling of the gums, severe pain, fever, difficulty chewing and swallowing food; an abscess or purulent inflammation of the intercellular space of the face and neck, phlegmon may develop;
hygienic procedures around the “seven” are difficult: caries begins at the base, which is difficult to notice; it affects the root, although the crown may appear white; The 7th tooth has to be removed;
resorption of the hard tissue of the adjacent molar, resorption: leads to the loss of the “seven”;
formation of a periodontal pocket: inflammation of the jaw bone occurs;
injury to the mucous membrane of the gum or cheek: the injury becomes chronic and leads to the formation of a tumor;
protrusion of a paired tooth: it lengthens and disrupts the process of chewing food; the mandibular joint is blocked: the patient feels crunching, clicking and pain in the joint;

In some cases, wisdom teeth are removed, but dentists do not always make this decision. There are indications for treatment of the “eight” and contraindications for extraction.

Indications for removal

Despite all the prejudices associated with the wisdom tooth, it is recommended to remove it in the following cases:

Removing a wisdom tooth will prevent the development of unwanted inflammatory processes in the oral cavity, destruction of adjacent teeth and jaw bone. If a patient goes to the dentist with acute pain, then removal of a molar is inevitable.

Contraindications for surgery

Sometimes the doctor postpones the operation to remove the “eight”. In some cases, tooth extraction is contraindicated. The cause may be diseases:

periodontitis, if gum inflammation progresses; prescribe antibiotics, painkillers, reduce the inflammatory process; wisdom teeth are removed after gum treatment; gingivitis is not a contraindication;
heart disease;
inflammatory process in the oral cavity caused by a fungus or infection;
acute respiratory infections, influenza, ARVI;
1st and 3rd trimesters of pregnancy: tooth extraction only in extreme cases;
patient refusal to undergo surgery;
psychological imbalance or mental illness;

The dentist may decide to begin treatment of the wisdom tooth, if necessary. certain reasons:

absence of the “seven”: the “eight” can, over time, move the dentition and move to a free space; the linearity of the teeth will be preserved;
the patient wants to make a bridge in the absence of a “seven”: the 3rd molar can serve as a support for the “bridge”;
correct location of the wisdom tooth on the gum, simple structure of the roots;
caries develops on the upper surface of the crown, which is easy to reach with instruments;
the tooth grows without pathologies, the patient wants to install a crown on it;

Treatment or removal of a wisdom tooth without diagnosis is impossible. The dentist will definitely prescribe an x-ray or orthopantomogram: the image is digital and more accurate, the process does not affect the human body. Diagnostics allows you to determine number of eight roots, their linearity, location. From the image, the doctor will see whether there are any abnormalities in the adjacent tooth. After analyzing the orthopantomogram or x-ray, the dentist decides to remove the 3rd molar or begin treatment.

Removal of the 8th tooth

The operation to remove a molar is performed by a dental surgeon. He studies the patient’s condition, X-ray images, and selects an anesthetic to avoid the development of allergic reactions and anaphylactic shock. Upper molars are most often simply removed. The surgeon uses special forceps to grab the tooth, loosen it and pull it out of the gums.

The procedure for removing the 8th tooth

The lower jaw is more massive than the upper, the bone is denser, the roots of the teeth are stronger, which complicates the operation.

The area of the oral cavity where it is planned to remove the figure eight is treated with an antiseptic solution.
The patient is injected with an anesthetic using a syringe: wait 5-7 minutes for the painkiller to take effect: the cheek and tongue become numb, the patient does not feel anything. The anesthetic will have a bad effect if a person uses drugs, alcohol, or constantly uses painkillers in large doses. In some cases, the tooth is removed under general anesthesia.
If the tooth grows straight, the roots are not curved, then the surgeon grabs it with forceps, loosens it, and removes it from the oral cavity.

An impacted tooth requires some manipulation: it hidden under a layer of bone and soft gum tissue. After treating the patient’s oral cavity and injecting him with anesthesia, the surgeon must open access to the tooth. To do this he needs:

Removal of a recumbent or partially impacted wisdom tooth is performed in a similar way. To grab it with forceps or an elevator, it is necessary to open access for tools. The operation involves making incisions in the gums and drilling out the bone.

The duration of the procedure is about 30 minutes. During the removal of the figure eight, the patient will not feel pain. In place of the molar a big bloody hole. The surgeon will close it with a gauze pad, which is soaked in hemostatic and antiseptic agents. The doctor will definitely warn you about the consequences of the operation and give certain recommendations. The dentist can issue the patient a sick leave for 3-4 days for rehabilitation.

Consequences after removing the “eight”

The body will definitely react to a violation of the integrity of the tissue in the oral cavity. After removal of a wisdom tooth in the lower jaw consequences are inevitable.

3 days after tooth extraction, the patient visits the dentist for inspection and probing of wounds. If the gum tissue is restored without pathologies, then the sutures are removed on the 5th day.

To reduce complications

You can eat food 4 hours after the procedure: food should be fresh, soft, semi-liquid consistency; You can drink plain water right away: it should be at room temperature;
drinking alcohol and smoking is allowed the next day;
the patient will have to refrain from taking a hot bath;
physical activity must be avoided;
For the first 4 hours, ice should be applied to the cheek to reduce swelling and avoid hematomas: keep the ice for 5 minutes, break for 10 minutes;
Do not rinse your mouth or brush your teeth for a day;
You can take painkillers and other medications only on the recommendation of a dentist;

Wisdom tooth removal will take place without consequences if you follow all the doctor’s recommendations during and after the procedure. Cost of a simple operation - from 1500 rub. A complex procedure for removing the lower 3rd molar - from 3000 rubles.

Expert opinion

Removing a wisdom tooth in the lower jaw is one of the most difficult operations in dental surgery. European dentists have developed a technique that allows one to avoid complications during wisdom tooth removal and make the healing period more comfortable. This method is called ultrasound wisdom tooth removal using the PIEZOSURGERY system. Using this technique, the dental surgeon carefully separates the wisdom tooth without causing thermal injury to the bone tissue, which speeds up healing by 2 times and reduces pain in the postoperative period by 70%! Our specialists completed an internship in Germany in 2015 and since that time, more than 2000 lower wisdom tooth extractions using ultrasound have been performed at the Bionic Dentis clinic. This modern method is not yet widespread in Russia, but has received worldwide recognition as gentle and prevents complications.

Ozerov Petr Vladimirovich, chief physician of the Bionic Dentis clinic in Moscow, expert in the field of wisdom teeth removal.

Read on our website, an expert on wisdom teeth removal, in which you will learn about modern methods of teeth removal.