What to do after the procedure for removing a wisdom tooth in the lower jaw: how long does it take to heal and how long will the hole hurt? Features of wisdom teeth removal.

Removal of the lower wisdom tooth (“eight”, third molar) is often associated with certain difficulties, which are determined by the location of this tooth in the jaw.

More than 50% of patients experience retention (delayed eruption) of the lower “eights.”

A wisdom tooth can have different locations:

Medial inclination - the crown of the eighth tooth is directed towards the seventh.
Distal inclination - the tooth is tilted posteriorly.
Lingual or buccal tilt - deviation of the figure eight, respectively, to the lingual or buccal side.
Horizontal position - the third molar is located perpendicular to the other teeth.
Vertical position – the tooth is under right angle in the vertical plane, but never cut through.

Indications for the removal of lower third molars have been significantly expanded. So the “eights” are subject to removal:

If they periodically cause pericoronitis - inflammation of the mucous membrane in the area of the wisdom tooth.
For caries, pulpitis or periodontitis and impossibility therapeutic treatment(due to incorrect positioning of the tooth, limited opening of the patient’s mouth, curved canals).
If they injure the gum or cheek.
If it is impossible to cut them evenly.

For orthodontic indications (lack of space in the dentition). Situations are often observed when lower third molars begin to erupt in patients aged 20-25 years, which put pressure on neighboring teeth, which ultimately leads to crowding of teeth in anterior section. Also, an orthodontist can refer for the removal of wisdom teeth in a more advanced manner. early age(15-18 years old).
In case of a jaw fracture, the lower eighth teeth must be removed from the fracture gap.

Anesthesia

Most operations for the removal of lower wisdom teeth are performed under local anesthesia– mandibular or torus. Modern local anesthetic drugs are used - ultracaine, septanest, ubistezin.

If removal of all four wisdom teeth is indicated, they can be removed simultaneously in the hospital under general anesthesia.

Operation technique

Before the intervention, it is necessary to analyze the radiograph.

There are several clinical situations, depending on which the removal process will have its own characteristics:

The tooth has erupted completely, is located exactly in the dental arch or is dystopic.
The tooth has not fully erupted (semi-retention) and has an incorrect location.
Horizontal position of the tooth.

Removal of a fully erupted wisdom tooth

When removing such a tooth, straight wide elevators and special forceps for the lower third molars are used.

The working part of the direct elevator is advanced between the seventh and eighth teeth, with the concave surface directed towards the tooth, and the convex surface towards the wall of the alveolus of the wisdom tooth. Gradually rotating the elevator, the wisdom tooth is dislocated upward and backward.

If the removal was not accompanied by an incision or cutting out the tooth from the bone, antibiotics are not prescribed. Recommendations are the same as for deleting regular tooth– do not rinse or heat the wound for 2-3 days, hold the bandage for 20 minutes, do not eat for 2 hours.

Removal of the lower semi-retinated “figure eight”

Removing a wisdom tooth that has not fully erupted requires making an incision and cutting out a mucoperiosteal flap. When the crown becomes completely visible, the condition of the surrounding bone is assessed, and if necessary, it is removed using carbide burs with a straight tip. After this, the tooth is dislocated using a straight elevator, the socket is carefully curetted, and treated with an antiseptic.

In the empty alveolus they leave bone-plastic material or at least hemostatic sponges, the drug Alveogyl, in some cases - a rubber drainage, which is removed the next day. Next, the edges of the wound are brought together and sutures are applied.

The patient must be warned about possible complications:

Pain in the area extracted tooth.
The appearance of swelling of the buccal area.
Limited mouth opening.
Painful swallowing.
Fever, weakness, headache.
Traumatic neuritis of the lower branch trigeminal nerve which is manifested by the appearance of areas of numbness of the skin or mucous membrane lower lip, cheeks, tongue.

The socket after the removal of the lower wisdom teeth heals completely in a month, during which the patient may have different sensations in the area of the postoperative wound.

The stitches are removed no earlier than after 10-14 days.

I haven't eaten for two hours.
Do not heat the wound site (do not drink or take hot food, do not sleep on the side of removal, do not hold your cheek with your hand, do not go to the bathhouse).
Immediately after the intervention, apply cold to the cheek area intermittently. It would also be a good idea to hold something cold on the wound topically (like ice cream). The more cold, the less postoperative swelling.
Maintain oral hygiene, especially carefully brush the seventh tooth, which is now the last on this side. Plaque contains microorganisms that will provoke inflammatory phenomena, and healing will take longer. If you cannot brush your teeth due to poor mouth opening, you should at least rinse your mouth with an antiseptic after each meal.

Taking antibiotics is mandatory. The drug, its dose and schedule of administration are determined by the doctor. Also prescribed antihistamines(loratadine, tavegil, suprastin, cetrin) to reduce swelling. If you have pain, be sure to take painkillers as needed.
Limit physical exercise for the next few days.

Removal of horizontal (“lying down”) lower eighth teeth

The surgical technique for removing horizontal wisdom teeth is the most traumatic. There are two options for the location of such teeth:

When the tooth is completely covered bone tissue.
When part of the crown is above the bone.

In any option, an incision is first made in the area of the lower wisdom tooth, a mucoperiosteal flap is cut out, and the location of the tooth is visually assessed. Next, the surrounding bone tissue is removed using a straight tip. In this case, there is no need to cut out the bone along the entire length of the root; as a rule, they stop at the level of the neck of the tooth. Next, long diamond burs using a turbine tip are used to saw the tooth into two parts - the crown and the root. After complete detachment, the crown is removed with an elevator quite easily, after which the root is dislocated.

The hole is processed, special material or hemostatic sponges are placed in it, after which the wound is sutured.

According to the observations of dentists, the very prospect of removing the eighth upper tooth often causes people to panic. Patients with Soviet experience Dental treatment imagines a hammer, a chisel and a surgeon in a dental office who will hammer 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. This is accompanied by a delay in eruption painful sensations, swollen cheek, and similar 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 anamnesis, clarifying everything accompanying illnesses, examines the tooth, prepares a set of instruments necessary for a particular case, removes plaque from the unit being removed and treats 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 mature age, with diabetes or simply low immunity, such wounds do not heal for a long time. Forming ulcers may be the beginning oncological problems, that’s why it’s so important to remove it in time problem tooth. 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, such a tooth needs to be removed urgently. During the examination, the doctor will analyze the x-ray to determine the limits maxillary sinus: the closer it is to the roots, the easier it is to break or perforate it.

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.
cut flap soft fabric put it in place and stitch it.

Stop bleeding by inserting gauze swabs, impregnated with hemostatic drugs.

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 consult on proper care behind 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 training, high price, unpleasant consequences. IN clinical practice Cases have been described where 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”.

In eights on the upper jaw, if we compare them with the lower ones, grown into the array powerful jaw, there is 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 drug components, mental disorders, panic fear depending on the type of instruments and blood, high level of trauma, duration of intervention), then the operation is performed under anesthesia.

Possible complications after removal of the top eight

In general, the upper eighth tooth big problems does not deliver when deleted, but in some cases undesirable consequences there are. This is due to the negligence and inexperience of the dentist. Brute force in such manipulations is unacceptable, so the graceful young lady surgeon copes with her duties without worse than a man sports type. 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, strengthen it physical impact stupid, 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 break through the bottom at excessive loads on the root and 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 patients who visited there. This will help you find a professional without pathos and inflated prices.

Video - Atraumatic removal of the upper eight

A wisdom tooth often causes trouble: it does not erupt completely, grows sideways inside the gum, or does not appear above the surface at all. In many people, third molars have a weak structure, often crumble and rot.

Patients often ask the doctor to remove the capricious unit: in certain moment in the figure eight area, pain, swelling appears, and inflammation of the gums develops. Extraction of third molars often occurs with complications. What to do after wisdom tooth removal? Doctors' recommendations will help you understand how to avoid mistakes and complications.

When is a wisdom tooth removed?

It’s up to the specialist to decide whether to leave the capricious unit or get rid of the “eight” as quickly as possible. The dentist-surgeon will order an x-ray, look at the location of the tooth, examine the quality of the dental tissue when visual inspection. Only on the basis of a comprehensive examination of the problem unit will the doctor decide whether to remove or save the third molar.

There are cases when G8 extraction is vital:

semi-impacted wisdom tooth. A severe defect is an indication for removal of a partially erupted unit. The “figure eight” is positioned horizontally or vertically, the crown is often half hidden under a “hood” of gum tissue. Food particles get packed into the folds and often develop inflammatory process;
displacement of the figure eight away from the dental arch, tilt towards the tongue or towards the cheek. Injuries to the mucous membrane, tongue, inner surface cheeks Sometimes a malignant tumor develops in the affected areas;
the oblique position of the third molar compared to other teeth. Incorrect position provokes displacement of the units in front, caries of neighboring molars. Pain in the jaw often occurs, the dental nerve experiences excessive pressure, and headache;
the third molar is severely destroyed, filling is difficult/ineffective. Low efficiency therapeutic treatment, after which the dilapidated unit will still have to be removed.

What to do after a complex wisdom tooth extraction? Any mini-surgery on third molars carries a risk of complications. Even after a relatively simple extraction of a “wise tooth”, careful care of the wound is required, compliance hygiene measures. Competent actions and accurate implementation of recommendations will prevent complications.

Note! Less commonly, after extraction of the figure eight, a cyst (a bubble filled with liquid) is formed, and the bottom of the maxillary sinus ruptures. When the oral cavity becomes infected, stomatitis is sometimes diagnosed. In severe cases, purulent masses form and an abscess develops. When exudate spreads in tissues and penetrates into the deep layers, phlegmon is formed, which is life-threatening.

How to proceed:

when dangerous symptoms Contact the dentist who removed the tooth. The doctor will clean the wound and put antiseptic drug, will tell you how to relieve pain, remove swelling, redness;
for antiseptic baths, Chlorhexidine 0.05%, furatsilin solution, Miramistin are recommended; (Instructions for use of Chlogexidine; Miramistin -; Furacilin solution - page);
at severe inflammation the doctor will prescribe an antibiotic after wisdom tooth removal that suppresses the activity of bacteria in oral cavity. The drug is selected by the dentist individually after conducting a special test;
for swelling, redness of the gums, use a decoction of chamomile, calendula, or soda solution to relieve inflammation;
decoction oak bark with active astringent action will speed up wound healing;
if allergic reactions are the cause of swelling, take antihistamine. Effective action showed proven remedies: Cetrin, Erius, Suprastin, Tavegil. Choose third generation drugs, not drowsy with a minimum of side effects, long-lasting action;
for severe pain, take anesthetics: Ketorol, Ketanov, Nise, Paracetamol. Some medications have side effects: do not exceed the dosage;
for improvement general condition for inflammatory processes, take restorative medications and multivitamins. Healthy body cope with the infection more quickly;
for paresthesia (nerve damage), painkillers and physiotherapy will help. The dentist will prescribe the manipulations, taking into account contraindications and the patient’s condition.

Take note:

never self-medicate. If pain increases, swelling, and redness increase, immediately visit a dental surgeon;
throbbing pain radiating to the ear, swelling lymph nodes, soreness salivary glands indicates an extensive inflammatory process. If the case is severe, resection of the gum or mucous membrane and drainage of purulent masses are required;
Before visiting the dentist, take baths with chamomile infusion and take anesthetics;
Do not touch the wound in the gum with your hands, a spoon or a cotton swab;
It is forbidden to remove a festered clot: the manipulation will be carried out by a doctor while maintaining sterility.

Every person should know how to act after the removal of a wisdom tooth and other less problematic units. Wrong actions, for example, warming up instead of cold compresses, attempts to clean the hole at home often turn out to be serious problems. Remember: osteomyelitis, gumboil, cyst, swelling of facial tissues often develop when trying to self-medicate.

The process of wisdom tooth removal in the following video:

The wisdom tooth (eight, third molar) erupts in the period from 17 to 25 years, but it does not take part in the process of chewing and speaking, and is classified as vestigial organs. When affected by caries and other diseases, attempts are made to preserve it, because in the future it can become a support for a prosthesis. In addition, dentists are guided by the organ-preserving principle, and if it is possible to cure, removal is not performed. But there are a number of conditions in which molar extraction will be a mandatory measure. The procedure has both its advantages and disadvantages in the form possible complications. More often, the 8th tooth is removed from above, and the consequences of this operation can affect neighboring crowns and tissues of the dental system. Extraction of figure eight on lower jaw ends with complications less often.

How is the eighth tooth removed?

The planned removal of the 8th tooth from above takes place in 4 stages. The first stage involves an examination of the oral cavity by a dentist and identification of indications for extraction. On the second, anesthesia is performed: local anesthesia or general anesthesia. When the operating area loses sensitivity, the dentist removes the tooth from the socket with special forceps. On last stage The wound is treated, debris is removed, tissue is disinfected and sutured.

The upper eighth tooth can be subject to simple or complex removal. In the first case, the operation lasts several minutes, maximum half an hour. For complex removals, the dentist requires up to 2 hours. Lower and top eights are difficult to extract, as they have up to 5 wide roots and volumetric crowns.

The course of surgery on the upper and lower jaw is different. Removing the lower eight requires more time, which is due to the characteristics of the lower jaw. It's about about the higher chewing load experienced by the lower teeth. In this regard, their roots are massive and strong. Removing a lower molar can be a test for a dentist, which is why doctors with good experience often undertake this manipulation. physical training And great experience. During the operation, you will need to use more than one instrument, and it is necessary to know all the structural features of the lower jaw, therefore, before prescribing an extraction, the dentist always requires an x-ray.

During tooth extraction in the upper jaw, the doctor spends less effort and time, but complications are not excluded. Careless movement, strong pressure, or slipping of the instrument can lead to perforation maxillary sinus, fracture of the jaw, injury to the palate and gums, damage to the adjacent crown.

What is simple and complex tooth extraction?

Removing any tooth is a surgical procedure that requires special tools and knowledge. In some cases, the dentist has to use additional devices and skills, and then the operation is classified as complex.

Simple removal involves removing the tooth from its socket using forceps. Difficult - removal with the need to saw out part of the bone, cut the gums and saw through the partition between the roots.

Easy removal

For simple tooth extraction, the dentist uses forceps and an elevator. There is no need to make incisions in the gums or saw through the bone. To perform an operation, the doctor needs to collect a history of the patient’s disease and life. This is necessary to make sure there are no allergies to anesthetics or other contraindications. After checking for allergic reaction, the patient must also show the dentist a certificate of absence of serious illnesses.

As soon as the doctor is sure that there are no obstacles to tooth extraction, the operation begins. Before the procedure itself, you need to take an X-ray of the tooth so that the dentist can see the features of the root part.

Difficult removal and types of anesthesia

For complex removals, the dentist uses drills, makes an incision in the gum, saws through the bone tissue, and then sutures the wound. More often, figure eights with eruption problems (impacted) are subject to this operation, when the gums interfere with them, or their crown rests on an adjacent tooth. The consequence of such disorders will be frequent inflammatory processes, displacement of the dentition, and suppuration of the gums. These are indications for removing the figure eight on the upper and lower jaws.

The course of the operation to remove the figure eight using the example of an impacted tooth:

The soft tissue is cut and peeled away from the bone.
The part of the bone located above the tooth is cut out.
The tooth is removed.
The wound is sutured.

Difficult removal tooth is performed under conditions surgical room with strict adherence to the rules of asepsis and antiseptics. After the operation, the doctor prescribes a follow-up appointment in a few days.

For pain relief during complex removal, non-injection, injection anesthesia and general anesthesia are used.

The non-injection version of anesthesia involves applying an anesthetic drug to the mucous membrane. The injection method is the introduction of a product into the projection area of the root apex or into the gums using an injection.

What painkillers are used during wisdom teeth removal:

Articaine and analogues(Ultracaine, Ubistezin, Septonest) - lasts up to 3 hours, side effects include dizziness, headache, tremor;
Lidocaine- used for infiltration anesthesia in the treatment of adults, adverse reactions may include decreased blood pressure, fatigue, momentary loss tongue sensitivity, headache;
Ubistezin- contains adrenaline, which prolongs the action of the anesthetic, pain relief lasts up to 45 minutes, there is a possibility of ischemia in the area of injection if the injection technique is violated.

Indications for removal

There are relative and absolute indications for the removal of wisdom teeth in the lower and upper jaw. Relative conditions include those when the figure eight can still be preserved, but the risk of relapse of the disease is high, and extraction can prevent the need frequent treatment. Absolute indications There will be disorders in which other treatment does not produce results. Remove in dentistry lower tooth wisdom (like the upper one) is possible at the request of the patient, when the figure eight causes discomfort due to biting the cheek and inflammation of the gums.

Relative indications for wisdom teeth extraction:

impossibility of root canal treatment due to their obstruction;
severe destruction of the crown part of the tooth;
inflammatory process of about eight against the background of specific diseases;
displacement of the dentition due to improper eruption of the molar;
dystopic and impacted teeth.

Absolute indications will be purulent processes, abscess, cyst, lymphadenitis, phlegmon, when the figure eight acts as the causative tooth.

The operation to extract the eighth teeth also has contraindications, which are divided into general and local.

General contraindications to figure eight extraction:

acute period of infectious diseases in the oral cavity and facial area;
first and last trimesters of pregnancy;
severe respiratory diseases;
mental disorders during exacerbation;
early period after stroke, heart attack, traumatic brain injury;
defeats nervous system, cerebrovascular accidents;
decompensated diseases of the endocrine glands;
pathologies of the cardiovascular system;
menstruation period.

Local contraindications:

herpetic lesions of the skin of the face and oral mucosa;
benign and vascular tumors in the dentofacial area;
severe stomatitis and gingivitis (ulcerative, necrotic, purulent).

At somatic diseases patient dental clinic must obtain permission from the attending physician for tooth extraction. To do this, you need to consult with a specialist and undergo some research. Additional preparation may be required.

Is it painful to remove the eighth tooth?

The sensations when removing teeth on the upper and lower jaw are different. In this case, the type of pain relief and the body’s reaction to it are important. The lower jaw bone is denser, but the wisdom tooth on it has wide roots. When removing a lower molar, it is difficult to achieve complete pain relief, and the patient may feel pressure from the dentist's hands.

In connection with this modern dentistry offers complex surgical procedures under general anesthesia, which completely deprives the patient of any discomfort. But after this type of anesthesia, pain may develop adverse reactions. When extracting a crown on the upper jaw, complete pain relief is possible.

No matter how painful the removal may seem, without treatment even more unpleasant sensations await.

Ignoring indications for removal results in complications such as:

constant pain- pus accumulates in the gum and cheek area, which presses on the surrounding tissues, trying to find a way out;
high body temperature- the result of infectious inflammation;
enlarged and painful lymph nodes- occurs during infection, when bacteria and food particles accumulate between the impacted figure eight and the gum, damage to the lymph nodes is accompanied by a sore throat during swallowing and speaking;
cheek swelling- this is a complication of pericorinitis; swelling can also occur in the throat and ear;
halitosis- durable bad smell from the mouth, which is not removed by deodorizing hygiene products;
difficulty chewing- partially erupted figure eights can injure the gums and cheek, and frequent biting will lead to inflammation and related complications.

At risk severe complications patients with weakened immune systems and diabetes mellitus. Such people should go through preventive examination see the dentist more often in order to prevent pathologies in time and treat them without consequences at an early stage.

Do not rinse for 3 days, but be sure to wash the removal area with herbal decoctions, putting them in your mouth and spitting them out after a few seconds.
Do not warm the tooth, do not consume hot foods and drinks, you need to eat liquid food for a week.
The tampon that the dentist will leave in the hole must be carefully removed after 20 minutes, but not eaten for another 2 hours.
You need to chew food on the healthy side of the jaw until the hole heals.
For a week, refrain from visiting the bathhouse, solarium, or taking hot bath, limit exposure to open sun.
Brush your teeth soft brush, bypassing the socket of the extracted tooth.
Take medications prescribed by your doctor and do not self-medicate.

Preparations before removing the figure eight include:

Taking an x-ray.
Removing solid deposits.
Exclusion of contraindications.
Elimination of acute inflammatory process in the oral cavity.
Rule out allergies to anesthetic.

When anxiety symptoms from the tooth side wisdom, you need to see a dentist immediately. If you're worried strong pain, you can ease it at home before visiting the clinic, but you need to inform your doctor about the medications you are taking.

What can be done to relieve toothache:

rinse your mouth with a decoction of chamomile or sage;
take a Ketanov tablet or drink a Nimesil solution;
apply anesthetic gel (Metrogil, Solcoseryl) to the gums;
rinse your mouth with saline solution;
Clean your teeth well, removing food debris and plaque.

For pain relief before and after tooth extraction, you can take such common medications as Ibuprofen, Ketoprofen, Aspirin, Naproxen, Nimesil, Nise, Diclofenac. Self-medication is dangerous, and a drug from this list should be prescribed by a dentist.

You can take a pill to relieve pain on your own, but if you abuse painkillers, the body will get used to it, and the anesthesia during dental treatment will be weak or completely ineffective.

Possible consequences of deletion

After removing the 8th tooth from below, the consequences relate to nerve damage and soft tissue injury. When extracting a figure eight on the upper jaw, there is a high probability of gum damage and perforation of the maxillary sinus.

Possible complications after wisdom teeth removal:

alveolitis- inflammation of the socket of an extracted tooth, signs include redness, swelling of the gums, pain, swelling of the cheek, chills, general malaise, increased body temperature, in severe cases the infection spreads to deep tissue, causing osteomyelitis (bone inflammation);
bleeding- This normal phenomenon only the first 20 minutes after tooth extraction, but if the bleeding does not stop within several hours, this indicates a lack of blood clot, and you need to go to the dentist, otherwise infection will occur;
flux- occurs in case of infection during or after surgery, symptoms include redness, severe pain, fever, swelling of the gums, swelling of the cheek;
perforation of the maxillary sinus- during the operation, the tooth penetrates into the maxillary sinus, what causes its inflammation;
hematoma- appears when blood vessels are damaged and in case of increased fragility their walls, manifested by enlarged gums, pain, and swelling of the tissues.

Rare consequences include osteomyelitis, stomatitis, paresthesia, and jaw injury.

Alveolitis

Inflammation of the socket of an extracted tooth or alveolitis is common consequence removing the eight. Infection occurs for several reasons.

Why does the socket become inflamed after the removal of the 8th tooth:

active rinsing of the mouth in the first days after treatment, which leads to washing out the blood clot;
During the removal process, hard deposits got into the socket, which led to infection, therefore preparation for the operation includes professional cleaning teeth and plaque removal with an ultrasonic scaler;
ignoring contraindications to complex dental treatment;
chewing on the sore side, food getting into the hole and rotting.

How does alveolitis manifest:

redness and swelling of the gums;
discharge of pus from the socket;
bad breath;
the appearance of gray plaque on the gum and in the socket;
temperature rise to 39 degrees;
flux (rare);
throbbing pain that intensifies with pressure on the gum;
absence of a blood clot in the socket;
enlargement of regional lymph nodes.

Alveolitis occurs in several forms: purulent, hypertrophic, serous. In the first case, severe pain, swelling, gray plaque, thickening alveolar process, halitosis. With hypertrophic alveolitis, tissue grows from the socket. This complication is especially difficult for people with diabetes. Serous form The disease has a favorable prognosis. It is accompanied by pain that worsens after eating, feeling unwell, enlarged lymph nodes.

Differential diagnosis is carried out with periostitis, phlegmon, osteomyelitis and abscess.

Treatment of alveolitis includes:

local anesthesia;
sprinkling anesthesin in powder form into the hole;
washing the wound with antiseptics;
application of a hemostatic tampon;
drying the wound with sterile cotton wool;
washing out foreign bodies from the wound in the form of food particles and plaque.

To prevent alveolitis after tooth extraction, it is important to follow all doctor’s recommendations. Under no circumstances should you touch the hole with your hands or other objects. You should completely stop for a few days. alcoholic drinks and smoking.

The wisdom tooth (popularly “eight”) erupts later than the others. Usually the eighth pair appears by the age of 17-22, but sometimes it appears only by the age of 40.

The anatomical structure of the eighth pair is such that its treatment is complex and rarely gives positive result. Curved roots often do not allow the dentist to work with root canals, and the location of the “eights” in the oral cavity causes problems in many patients. vomiting reflex during treatment.

If therapy is not possible or does not bring the desired results, there is only one solution left -. This procedure is complex surgery causing fear in patients. But mainly this fear is caused by ignorance about the procedure and rumors that indicate its pain.

Let's consider the following questions: what constitutes wisdom, in what cases it is performed, are there any contraindications to its implementation, and what complications can the patient expect after the operation.

In what cases should it be deleted?

The wisdom is:

Incorrect position in the dentition. If the “figure eight” is inclined deep into the oral cavity, then it does not take part in chewing food, and it cannot be used in the future for prosthetics. When problems arise, this “eight” is not saved. Do the same if the 8th pair is tilted towards the cheek. In this case, it constantly injures the mucous membrane of soft tissues, which can lead to chronic inflammation and may have severe consequences for human health.
At the time of eruption, the 8th pair often no longer remains in the dentition free space. In this case, during the growth process, the “figure eight” will cause crowding and displacement of the row, which in turn will cause disturbances in chewing function and other dental problems.
Also, the “eight” must be removed if it creates a danger of destruction of the pair in front of the 7. Because of anatomical features The structures of the figure eight jaws often grow at an angle and create pressure on the enamel of the adjacent tooth, which contributes to its rapid destruction.
Above the “figure eight”, the mucous membrane of the oral cavity creates a cavity in which food debris accumulates and, when favorable conditions, are developing pathogenic microorganisms- this disease is called pericoronitis. There are 2 ways to solve this problem: cutting off the “hood” or removing it.
If root canals“eights” are curved, this leaves no possibility for their full endodontic treatment, therefore, when the coronal part of 8 is destroyed, the pair is not preserved. The same decision is made if the patient develops a gag reflex during treatment.

Reasons to keep wisdom teeth

Dentists often recommend removing figure eights, since their treatment is expensive and not always effective. But in some cases you need to try to save the eighth pair. Often, figure eight teeth serve as support for installing a bridge. Therefore, if the condition of the 6th or 7th pair does not allow them to be used for prosthetics, it is better to preserve the “eights”.

It is also not recommended to remove a tooth if its antagonist remains on the other jaw. When only one of the pair is removed, the second one stops participating in chewing food and moves into the oral cavity, so over time it also needs to be removed.

Removal technique

Removing the 8th pair has its own characteristics. Before it is carried out, an X-ray examination must be carried out. Curved roots and bent ends that can easily break off - the doctor can prevent all these problems if a high-quality x-ray is available.

The complexity of the operation often depends on... Upper jaw less dense, it contains numerous channels for the entry of nerve endings, and “eights” often have fewer roots. For these reasons, it takes less time and it is also easier to administer preoperative anesthesia. Removing the lower one is often painful, and its more curved roots create an obstacle during extraction.

The operation of extracting from the hole can be simple or complex. Complex removal is carried out if the body of the figure eight is hidden behind bone tissue that needs to be sawed out.

The operation consists of several stages:

At the first stage, the dentist conducts necessary research.
The second stage is anesthesia. Depending on the characteristics of the patient and the complexity of the operation, local or general anesthesia. General anesthesia carried out only in specially equipped clinics.
The third stage is removing the tooth from the socket.
At the fourth stage, the wound is cleaned of possible debris, sutured and disinfected.

Duration simple option extraction takes up to 40 minutes, while a complex one takes several hours.

Possible complications

Surgery is an injury that is often accompanied by an inflammatory process, painful sensations, swelling and fever.

The consequences of removing the eighth tooth from above and below are different, since there are differences anatomical structure upper and lower jaws.

The main complication that occurs after surgery is pain syndrome(especially if the lower wisdom teeth were removed). immediately after surgery, but sometimes their appearance is delayed for several days. Often, immediately after the procedure, not only the gums hurt, the pain spreads to the ear, throat or the entire half of the face. The duration of postoperative pain is individual for each person and can range from several days to weeks.

Removal of the 8th tooth from above and below is often accompanied by alveolitis - inflammation in the socket. Reasons for its appearance: individual characteristics body, weak immunity, a fragment that the doctor did not notice, infectious diseases oral cavity, etc. Alveolitis carries serious threat for your health, so consult your doctor immediately if you notice any of the following symptoms:

unpleasant taste and bad breath;
the gums hurt and swell;
formation of a rough clot in the wound.

Another consequence is wisdom numbness or paresthesia. Its symptoms resemble the effects of anesthesia: the damaged area of the mouth, gums or chin lose sensitivity for a while. This condition is due to the fact that the nerve endings. Paresthesia goes away over time, but sometimes special therapy is needed to restore sensitivity.