Do I need to pull out loose milk teeth. What to pay attention to

There are a lot of points "for and against" in the issue of pulling out the eight. The decision depends on the degree of destruction, the presence of inflammation, the impact on adjacent teeth, as well as on the state of human health.

Third molars have no functional value if they are not involved in chewing, but sometimes this only chance patient for fixed prosthetics. When a piece of the crown has broken off, do not rush to make an appointment with the surgeon, because with good condition canal systems, as well as the possibility of full access, the destroyed tooth is subject to restoration with a pin design.

1. With hypertension of the second or third degree without examination by a cardiologist.
2. The need for anesthesia during the removal of the figure eight does not allow you to risk the health of the unborn baby during pregnancy.
3. With the growth of the tooth in the area of ​​malignant lesions.
4. If less than three months have passed since the heart attack.

When can a wisdom tooth be saved?

IN certain situations it makes sense not to remove, but to leave the problematic molar, because it can still be useful, and also play an important role in choosing the method of orthopedic treatment. If you decide to leave the eight, ask the doctor if such teeth are treated in the clinic of your choice, and also inquire about the appropriateness of therapy in your particular case.

Wisdom teeth should be treated in some situations:

• the eight is necessary as a support - with the missing adjacent molars, the tooth remains the only one on which the bridge can be fixed. When it is removed, there is the option of implantation or removable prosthetics;
• the tooth is located correctly in a row - the figure eight is involved in chewing process and has an antagonist, does not injure soft tissues, therefore, therapy allows it to be preserved and prevent the protrusion of the contacting tooth of the opposite jaw (Popov-Godon phenomenon);
• pulpitis pain - when the diagnostic image reveals a convenient location of the pulp chamber, while the channels are not curved and are contoured to the very top of the root, endodontic treatment is possible;
• periodontitis - when a destructive focus is found in the apical zone, the tooth is sanitized for a long time period, and favorable outcome possible with good endodontic access and high-quality processing of the canal system.

In what case should the eight be removed?

In certain situations, it is necessary to think about whether it is worth leaving a problematic tooth and whether there will be any benefit from treatment, because sometimes its safety can not only be impossible, but also be harmful to health. In most patients, figure eights initially have more fragile enamel, and sometimes erupt with narrower lesions.

Basic prerequisites for the extraction of the eighth tooth:

• atypical position - when the crown is tilted to the side, there is no participation in chewing food, and when the axis of the tooth is shifted towards the cheek, this contributes to frequent biting of soft tissues;
• little room to cut - when the figure eight is cut in conditions of insufficient space, it puts pressure on the front standing teeth which causes them to become crowded. To prevent bias, it is recommended to remove the source of the problem;
• complete retention - with severe pain of an unerupted molar located in the gum, surgical intervention is required;
• negative impact on the adjacent tooth - often the figure eight grows at an angle, which is why it rests on the seven and can cause both the destruction of the crown and the resorption of its roots;
• a high percentage of destruction of the crown part - if the tooth is so affected by caries that it is not possible to put a filling that will meet the quality criteria, then it is advisable to part with it;


• pericoronitis - when inflammation of the gums surrounding the tooth cannot be removed by excision of the mucous hood, pus forms there, and bone destruction around the source of pain is determined on the x-ray, then the only way to stop the further spread of the process is extirpation;
• abscess - the development of apical periodontitis is often accompanied by the addition of a purulent infection with the formation of a cyst at the top of the tooth. Due to the impossibility of good channel processing and the release of infiltration, the figure eight must be removed.

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Wisdom teeth: keep or remove

Not everyone gets their wisdom teeth. But those whom they "make happy" with their appearance spend a lot of time in the dentist's chair. After all, third molars grow painfully, and are difficult to remove. Why are they needed at all? Is it worth trying to save them?

Why do we need wisdom teeth

Before deciding whether to remove wisdom teeth, you should find out why the body “grows” them? "Eights" are rudiments, "according to old memory" erupting in about half of the world's population. If even 10 thousand years ago these teeth were present in the mouth of every adult, then 15% modern people not even the rudiments of the third molars.

The decrease in the total number of teeth due to the "eights" is associated with an evolutionary process that has affected the structure of the jaw: over the past 100 years, it has narrowed by 10 cm - and this is not the limit. Scientists believe that this trend will continue in the future due to the increasing distribution of soft foods that do not need to be chewed for a long time.

As such, the function of chewing is almost not inherent in the third molars: the rest of the healthy teeth can easily cope with it. "Eights" can only serve as:

• supports for bridge prosthetics;
• a deterrent for loosening neighboring teeth;
• fallback - with age, a person's teeth fall out, and the third molars partially take on "responsibility" for the chewing process.

Healthy "eights" in modern people are a rarity. But if wisdom teeth have grown without complications and have taken their rightful place in the row, then there is no point in removing them: what if they come in handy?

Do wisdom teeth heal?

Like any other tooth, the "eight" is subject to treatment. The difficulties of this process are associated both with the complex structure of the third molars, and with their inconvenient location in oral cavity. Caries at an early stage is treated in the usual way.

Additional problems may arise if pulpitis or periodontitis has developed in the wisdom tooth. In these cases, it is necessary to fill the canals, which are very curved in the third molars. If the channels are difficult to pass, the dentist advises the removal of the wisdom tooth as a less risky procedure. After all, if it is not possible to seal the canals to the very top, the inflammatory process will spread further and as a result will lead to severe pain, the formation of a cyst, the formation of a fistula.

Treatment of a wisdom tooth is longer than if it were for “ordinary” teeth. As a rule, it takes 2-3 months. and requires repeated visits to the dentist.

How wisdom teeth are removed

In each case, the process of removing the "eights" can vary significantly in terms of complexity, and, accordingly, discomfort. Usually the operation goes like this:

Before the procedure, the dentist examines the patient's medical record. There are some restrictions in the treatment of teeth in patients suffering from diabetes, blood diseases, oncology, allergic reactions of a different nature.

Is it painful to remove a wisdom tooth

Many people are afraid to tremble in the knees to go to the removal of the "eight". But this operation, although rather complicated, is still widespread in dental practice. Therefore, there are many types of anesthesia that help the patient to endure the procedure without much discomfort.

In most cases, doctors recommend using local anesthesia as less harmful. Some clinics practice tooth extraction under general anesthesia, but some people have contraindications for this type of procedure. Also, move away from general anesthesia much more difficult than from a local one.

After the operation itself, when the effect of anesthesia wears off, the patient has to go through several painful days. This is due to damage to soft tissues, which need time to recover. The more difficult the removal was, the longer the healing process will be. But as a rule, every day the pain becomes less pronounced and completely disappears on the 10-14th day. And painkillers will help to brighten up the expectation of this moment a little: Analgin, Baralgin, Ketanov, etc.

Wisdom tooth: treat or remove

When deciding whether to remove wisdom teeth, you need to carefully weigh the pros and cons. The indications for such an operation primarily include:

1. Incorrect position of the tooth. A figure-of-eight tilted to either side is of zero value: it cannot be used either for bridge placement or for chewing. Moreover, such a deformation of the tooth leads to mucosal injury, a change in the position of neighboring teeth, and even their destruction.
2. Lack of space in the jaw. In this case, the tooth either remains in the gum, not finding the opportunity to get out, or stubbornly erupts, simultaneously displacing other teeth. In any case, the removal of the third molar is the only way out of the situation.


3. Braces are planned. Even if the wisdom tooth is located correctly, it must be removed: under the influence of braces, other teeth will change their position, and the “eight” may interfere with this.
4. Pericoronitis. This disease is associated with swelling of the gums and the formation of pus in them. Such a process is provoked by the special position of the "eight": its part is closed by an overhanging hood of mucous. In the gap between the tooth and the hood, a free space appears, which serves as an excellent "refuge" for food debris and a breeding ground for microbes. With absence special indications to save the third molar, it is removed.
5. Strong destruction of the "eight". If the carious process has destroyed the crown of the tooth almost to the ground, then there is nothing left to save, and all that remains is to get rid of the problematic third molar.
6. Impossibility of root canal treatment. Impassable canals that cannot be sealed put an end to possible treatment wisdom tooth.

There are also indications for maintaining the "eight", but they only work if the wisdom tooth has grown correctly and is absolutely healthy:

1. The best of the worst. It happens that the wisdom tooth is the most "promising" among its "colleagues". This happens when the "sevens" and "sixes" are very problematic and, most likely, will be removed. Then the wisdom tooth is left as a safety net.


2. The only one left. The situation is similar to the previous one, but in this case, the teeth adjacent to the third molar are already missing. "Eight" can be used for prosthetics.
3. Family bonds. As a rule, teeth grow in pairs. And although such “laws” do not always apply to third molars, it still happens that the “eight” has a “brother” - an antagonist tooth located opposite and closing with the molar in question. It is impossible to remove such teeth one by one, because this will lead to a gradual curvature of the remaining one.

The decision regarding the fate of the G8 should be made jointly with the dentist. The doctor will explain in detail the possible risks of the treatment options under consideration and advise what to do with the problem tooth.

Is it possible to treat or remove a wisdom tooth during pregnancy

• teeth can be treated only in the second trimester of pregnancy, except in cases of acute pain;
• cannot be used during the procedure. general anesthesia, and for local anesthesia drugs that are safe for the fetus should be used;
• removal of the "eight" is strictly prohibited due to the complexity of the operation and the significant risk of complications.

A wisdom tooth does not guarantee a sudden increase in intelligence, but with a high degree of probability it will “give” its owner severe pain, swelling of the gums, and purulent inflammation. Sometimes it is much easier to endure the procedure for removing the "eight" than to live with such a "difficult" tooth. In the West, for example, third molars are removed as soon as they appear, no matter how healthy the wisdom teeth are.

healthy-teeth.su

From Wikipedia: “The wisdom tooth is the 8th tooth in a row (colloquially called “eight”), the third molar (there are 12 in total), usually erupt at the age of 18-25 years (sometimes later, less often earlier, sometimes they do not erupt - they remain impacted). Teeth that have not fully erupted are called "semi-retinated". Currently, it is generally accepted that the third molar is a vestigial organ due to a change in diet (reducing the intake of solid and tough foods). In confirmation of this, Lately there is an increase in cases of the absence of the rudiment of this tooth - the primary adentia of the third molar. This is also evidenced by the abnormal position, retention and, often, the non-physiological shape of the crown and roots of this tooth. It is believed that wisdom teeth are called so because they appear much later than the rest of the teeth, at an age when the mental development of a person is considered complete.

Some facts

There is a common, but nevertheless erroneous opinion that wisdom teeth (eighth teeth, third molars - scientifically) can erupt in a person at any age. Actually it is not. The rudiments of the third molars begin to form at the age of 6-7, which is often detected during a planned x-ray examination, and the roots of the eighth teeth begin to form at the age of 15-17. Wisdom teeth complete their formation at 21-22 years (in rare cases- at 25-27 years old). In other words, it is simply pointless to hope for the teething of wisdom teeth over the age of 27. Also ignorant are the allegations that a wisdom tooth suddenly began to erupt in a 45-year-old patient: most often it turns out that “eruption” was confused with pericoronitis - inflammation of the mucosal hood over a semi-retinated wisdom tooth.

Some statistics

A complete set of third molars - one on each side and on each jaw - is detected in 92% of the adult population. At the same time, in 25% of people, wisdom teeth do not erupt at all - scientifically speaking, they remain impacted. As a rule, this is due to a lack of space in the dentition. In 78% of cases, wisdom teeth eruption is associated with various complications. This can be both pericoronitis and destruction, a change in the position of adjacent teeth, malocclusion, neoplastic processes, etc. In 0.1% of cases, not four, but more wisdom teeth develop - usually six, due to double upper third molars. In about 8% of people, third molars do not form at all, and girls often lack lower wisdom teeth, and men have upper ones.

A little about the reasons

Any disease or pathological condition there are reasons (etiology), the same can be said about retention and "difficult" eruption of wisdom teeth - pericoronitis. And the reason for their occurrence is very simple and understandable: this is a discrepancy between the size of the teeth and the size of the jaw.

Our bones keep growing up certain age, after which their growth first slows down, and then stops altogether. The growth of the jaw bones is "synchronized" with the order of teeth eruption, first milk, then permanent. And if this "synchronization" is broken, the teeth begin to run out of space - most often this manifests itself in the form of crowding. Retention occurs less often, and not necessarily wisdom teeth, any teeth can remain impacted if they do not have enough space for eruption.
Eights most often remain impacted, and this is due to the fact that the period of eruption of these teeth almost coincides with the slowdown and phasing out growth of the facial skull. Where should they grow if all the space in the dentition is already taken? Only "inside".

In general, retention and difficult eruption of wisdom teeth indirectly indicate the presence of bite problems or provoke them themselves. That is why all patients with pericoronitis that has arisen or impacted eights have been identified should at least go for a consultation with an orthodontist, a specialist in bite correction.

The influence of wisdom teeth on the dentition

By creating a non-specific lateral load on the dentition, third molars are one of the main causes of crowded teeth. And not only during the eruption period (see figure).

The dental system is a dynamic system, it remains mobile throughout life. In other words, the linear dimensions of the jaw change depending on whether the mouth is open or closed. These changes are rather minor, however, in the presence of such a block as wisdom teeth, there is a constant lateral load on the dentition, which leads to crowding of the teeth. In this case, the front teeth begin to “crowd” first, since they have a relatively small contact surface.

How wisdom teeth are cut

Very often, in almost 80% of cases, wisdom teeth eruption is associated with various purulent-inflammatory complications and poses a real danger to health and life. A hood of mucous membrane is formed over the erupting tooth, and a pocket is created around it, where plaque, food debris and bacteria actively accumulate (see figure).

This creates favorable ground for the development of purulent inflammation (pericoronitis), which, due to the proximity of the purulent focus to vital organs and structures, is a very dangerous disease. Excision of the hood of the mucous membrane (or, as the people say, cutting the gums) is only a temporary measure and not always effective: due to regeneration, the hood quickly recovers and makes further treatment difficult, since scars and adhesions form.

Let me remind you once again: pericoronitis is an indirect sign of the pathology of the bite, and if it occurs, it would be useful to consult an orthodontist.

Due to their location, wisdom teeth are very poorly cleaned on their own (in most cases they do not participate in active chewing), their hygiene is also difficult - which of you is able to thoroughly, without vomiting, clean distant teeth? And this, as mentioned above, leads to a colossal accumulation of plaque and microorganisms around the third molars, which leads to their rapid caries damage. In addition, if the wisdom teeth are misplaced (for example, if they are tilted medially), they very often affect adjacent teeth.

Often this happens during the eruption period: the layer of osteoclast cells that accompany any erupting tooth destroys everything in its path, including the teeth that they come across.

Tumors and neoplasms associated with wisdom teeth

In the area of ​​an erupting wisdom tooth, a layer of mesenchymal, immature cells almost always remains, which can cause tumor growth. A small number of these cells make up the follicle of the tooth or what remains around it after eruption. And if in other teeth we very quickly get rid of follicular residues in the process of active chewing, then wisdom teeth that are not involved in chewing can retain these cells for quite a long time, which leads to the growth of cysts, tumors and various neoplasms.

Here, as they say, comments are unnecessary. About the danger of tumors and neoplasms, I think, it is not worth explaining to anyone, as well as the fact that the treatment of tumors is a rather long, laborious and not always successful process ...

Wisdom teeth and joint diseases

Since wisdom teeth are very often located outside the dentition and, moreover, do not have an antagonist, the so-called dentoalveolar elongation occurs and traumatic knots (in other words, overload zones) are created in the bite.

Traumatic knots disrupt the work of the dentoalveolar system, dissociating physiological mechanisms receptor feedback, and thus lead to diseases of the temporomandibular joints, masticatory muscles, neurological disorders.

How to deal with all these problems

It is important to know that it is useless to hope for a correct and uncomplicated eruption of wisdom teeth if the patient has a clear lack of space in the dentition.

Here is an example. These are radiographs of the same patient three years apart. The first time he went to the clinic at the age of 15, it was a planned examination, in which the doctor identified emerging wisdom teeth. The measurements taken by the orthodontist showed a clear lack of space in the dentition, and the patient was asked to remove the eights. However, he refused to remove it, as a result, after three years, he complained of pain in the area of ​​the erupting tooth, crowding of the teeth, which would require treatment with a bracket system. Even visually, the images show that initially the tooth was easier to remove than later, since it partially reversed over the course of three years.

In general, indications for the removal of wisdom teeth can be formulated as follows: this is any disease, complication associated with wisdom teeth, as well as the risk of these diseases or complications.

About the benefits of prevention

There are a number of patients who need a reason to visit a dentist. And the reason is very weighty. And unfortunately, often such an occasion is an acute condition with a pronounced pain syndrome, creating serious danger not only for health, but also for the life of the patient.

In the prevention of acute inflammatory diseases dental check-ups are necessary and important. acute condition, pain, swelling - all these are signs of the extreme neglect of the disease, a sign that the body is gradually no longer able to cope with inflammation. And it gives the brain a signal in the form of strong pain impulses: “Hey, you are there! Upstairs! Do something!" But especially stubborn patients, instead of urgently going to the doctor, try to drown out these signals with the help of various tablets, as if they say to their own body: “Who are you? Let's goodbye!"

Trying to numb the pain with pills is like cutting the telephone line at the fire department. It seems like the phone is silent, but this does not mean at all that there is no fire.

Pericoronitis, an inflammation of the gums over an erupting tooth, always accompanies difficult teething.

Well, in what cases do wisdom teeth erupt with difficulty? Only only when they do not have enough space in the dentition. This, by the way, explains the rarity of pericoronitis of sixes and sevens, because by the time they erupt there is more than enough space in the jaw. But for ages 16 and over, growth mandible slows down, and in some cases a full set of teeth does not fit in it - hence the difficulty in eruption or simply the retention of wisdom teeth (this is when the teeth do not erupt at all and remain in the thickness of the jawbone). Pericoronitis of the wisdom teeth is the first sign that something is wrong with the bite. Therefore, all patients who are faced with this disease, I recommend that you always consult with an orthodontist.

Is it possible to foresee difficult eruption of wisdom teeth and subsequent malocclusion? Yes, it's possible.

In this case, the role of preventive examinations is great. How many of you visit the dentist regularly, even when nothing is bothering you? I am sure that those who do this have no problems with their teeth.

And all because at preventive examinations we can identify and eliminate potential problems before they turn into something more serious.

Suppose a 15-year-old patient came to preventive examination, we took pictures and noticed the beginnings of wisdom teeth. The patient was referred to an orthodontist who, after special study(TRG) and calculations, concluded that wisdom teeth would not fit in the dentition. Therefore, in the process of eruption, they will either give pericoronitis (and we will have to remove them), or they will begin to move the adjacent teeth forward and aggravate the bite situation.

In general, pericoronitis and difficulty eruption of wisdom teeth are a consequence of incipient bite problems.

Tactics: as it was before

Based on the understanding of the above, let's consider the correct tactics for the treatment of this disease.

The textbooks that I studied at the university (“it was the nineties, we studied as best we could”) and which, in turn, are reprints of even older textbooks that my teachers studied from, the main treatment for pericoronitis is called excision of the mucous hood over crown of an erupting tooth.

It seems like they cut off the hood, freed the crown of the tooth - and voila! The tooth erupted, everyone is happy. We sit and rejoice.

However, in practice, everything happens quite differently. In more than 80% of cases, sooner or later, a relapse of the disease occurs - and all because the excision of the hood does not eliminate the causes of pericoronitis, difficult eruption of the wisdom tooth (lack of space in the dentition), and the mucous membrane itself has unique property regeneration.

Why, then, about the excision of the mucosal hood was written in ancient textbooks, and some surgeons still practice this method treatment despite its apparent ineffectiveness? The fact is that in those distant gray times, no one seriously considered bite as the basis of dental health and, as a result, considered orthodontics almost a lot of cosmetology, they say, it is needed only for aesthetics. And a number of current surgeons do not see beyond the tip of their own scalpel and absolutely do not want to delve into the causes of certain problems in the oral cavity: they just need to cut-sew, cut-sew…

By the way, for the same reason, failures in the treatment of periodontal diseases are very frequent in domestic dentistry: without understanding the role of the correct ratio of teeth and the importance of orthodontic treatment, there is nothing to do in periodontics.

Another reason why some surgeons resort to excision of the hood for pericoronitis is the fear of complications or problems during/after wisdom tooth extraction. Say, there will be swelling, it will hurt ... But doesn’t this happen during excision of the mucous-tissue hood? It happens, how! And the reason is that it is not the bone tissue that swells, not the hole of the tooth, but the mucous membrane and the underlying soft tissues. It contains more nerve receptors and blood vessels - it is from it that the main pain and swelling come after surgery. In addition, the correct removal of a wisdom tooth takes as much time as the excision of the mucous hood, and the postoperative period passes with exactly the same sensations.

Well, the difference is that in the first case (with excision of the mucosa), we only delay the solution of the problem and do not eliminate the cause of pericoronitis. And in the second case (when removing the wisdom tooth), we eliminate the cause of the disease, thereby solving the problem.

Tactics: the right way

In my opinion, the only situation when we can resort to excision of the mucosal hood is the impossibility of extracting a tooth for some technical reason: lack of necessary tools and equipment, insufficient qualifications of the dentist, etc.

In all other cases, the only The right way treatment of pericoronitis is the removal of the causative wisdom tooth. Everything is very simple.

There are three minutes difference between the photos. And the problem is no more.

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Problem teeth

Statistical studies have shown that almost half of the inhabitants of the Earth have third painters. And 15% don't have them at all. Nevertheless, the "eights" still appear in some people and give them a lot of trouble.

In some countries, they get rid of this "gift of nature" as soon as they appear above the gum. In our country, the decision is made individually, but most often dentists advise removing them.

Why remove wisdom teeth if they still grew? To avoid the trouble caused by their growth. The most common problems with "eights":

• curvature and deformation of teeth in the process of growth;
• they can erupt for several years and during this time acquire initial caries;
• prolonged eruption leads to inflammation of the gums, accumulation of food in the gum pockets and bad smell from the mouth, and subsequently - inflammation of the root of the tooth (periodontitis);
• because of the uncomfortable position in the oral cavity, brushing is difficult, so caries is inevitable, even if the “eights” themselves are healthy. Due to contact with sick “eights”, the disease can move to neighboring teeth;
• the tooth may not erupt completely, plaque accumulates between the swollen gum and the tooth, which can become a source of various problems;
• due to the difficult access to the “eights”, their treatment and filling is complicated;
• the prolonged process of eruption is complicated by pain in the trigeminal nerve, radiating to the ear, throat or neck.

Why pull out wisdom teeth when they can be treated and left? In order not to suffer with the “eights”, it is easier to snatch them out than to waste time on their treatment. It's radical but the only way solving problems not only in the present, but also in the future. However, if a person is lucky and the third painters have grown even, beautiful and do not cause problems, then experts do not advise pulling them out.

If you decide that wisdom teeth are a problem, find out: Does it hurt to remove a wisdom tooth?

Benefits of wisdom teeth

So, why do we need wisdom teeth that cause so much trouble? Doctors may advise keeping "third painters" if they are not bothersome or uncomfortable.

As you know, with age, teeth are very much destroyed. In this case, the "eight" can become a support for the dental bridge. They are also a kind of buffers that do not allow the rest of the teeth to loosen. In ancient times, the presence of four "eights" was considered a favorable sign. This indicated that a person is under the protection of the guardians of his kind, higher powers. Therefore, instead of getting rid of wisdom teeth, they were spoken to.

Can't be deleted

As they say, in nature there is nothing superfluous, and where to put a comma in the phrase “delete cannot be left” everyone decides on their own. If the third painters are growing, then this is no accident. Perhaps they will be needed by a person in old age.

When the “eight” has completely come out of the gum, it must be covered with a special solution and sealant. This will prevent bacteria from getting inside. All this applies to healthy teeth. If they grow with pathologies or are affected by caries, they must be eliminated. So as soon as the third painter showed up, you should immediately contact the dentist.

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Wisdom teeth: to remove or not

Currently, 92% of the adult population has wisdom teeth, 25% of them remain unerupted, and about 8% of people do not form at all.

Wisdom teeth are large molars, the last (third) in a row of molars. They usually erupt only by the age of 18-25, but they may not appear at all during life.

The problem lies in their difficult eruption, because by this age all the other teeth have long formed a row, and there is simply no room for wisdom teeth.

The lack of space in the jaw is explained by the fact that in the process of evolution, human food became softer, chewing loads decreased, which eventually led to a decrease in the size of the jaws. So, compared to our ancestors, the jaw modern man decreased by 10-12 mm. At the same time, the number of rudiments of teeth remained the same.

Often wisdom teeth grow, significantly deviating in different directions. This misalignment is called dystopia , teeth “stuck” in the jaw that did not appear above the gum - impacted, and the delay in eruption itself - retention . It occurs in 25% of people.

Complications of teething wisdom teeth

Pericoronitis - inflammatory process in the periorbital tissues . This is the most common pathology. In the process of growth, tubercles of wisdom teeth often remain covered by the gum mucosa. The so-called "hood" is formed. Remains of food fall under the "hood", they cannot be cleaned out, they serve as a source of nutrition for microflora. Inflammation develops.
The main symptoms of this process are increasing pain, which can radiate to the temple, ear, occur when swallowing and opening the mouth, since muscles and lymph nodes are involved in the process. Often there is a reaction from the body: fever, malaise, headache.
The appearance of such symptoms requires the immediate intervention of a dental surgeon.
In no case should you apply warm compresses, put painkillers on inflamed gum.
Treatment of pericoronitis consists in excision of the mucous "hood", the appointment of anti-inflammatory therapy and painkillers.

Caries

It occurs due to the inaccessibility of the tooth itself. Often, even with successful eruption, teeth appear already with enamel lesions.

malocclusion

It often happens that a wisdom tooth, as it were, props up an adjacent tooth. It exerts pressure, which can lead to blurred, indistinct complaints of the patient: incomprehensible periodic or constant pains radiating to the temple, ear, lower jaw, a feeling of discomfort. Also, with their pressure, wisdom teeth can cause a change in bite, for example, crowding of the teeth, more often the anterior ones. To diagnose this condition, it is necessary to conduct an x-ray examination.

During growth, wisdom teeth can cause inflammation of the branches of the trigeminal nerve , which is also accompanied by severe pain with spread even to half of the head.

Teeth that have grown incorrectly, when chewing, can constantly injure the buccal mucosa . This gives rise to traumatic ulcers. It is clear that chronic injury any part of the mucosa is very dangerous. Changes in this case are not uncommon.

The decision to remove wisdom teeth is made in each case individually!

Some medical schools believe that it is necessary to remove all wisdom teeth even in adolescence, when the roots are not fully formed, and the bone is not yet so dense.

There are situations when the removal of wisdom teeth is simply necessary. For example, a tooth is impacted (not erupted), presses on the roots of the front tooth and causes its destruction. Or the tooth is severely dystopian. Well, with orthodontic treatment using a bracket system, there is direct reading to its removal.

IN postoperative period you should not eat for two hours, you should refrain from hot drinks, during the day the place of removal is not cleaned, rinsing is also not recommended so as not to “rinse” the clot from the hole. In no case do not heat the place of removal.

Material prepared: doctor-dentist-surgeon of the highest qualification category Grishanovich O.P.

Whether a wisdom tooth needs to be treated depends on its condition. Destroyed "eights" with granulomas on the roots or curved canals are practically not treated, but if the tooth is located in the dentition and is of value for subsequent orthopedic restoration, then it makes sense to leave it. Let us consider in more detail the situations when it is better to remove a wisdom tooth, and when it is still possible to treat it.

What are wisdom teeth for?

To come to a decision whether to treat a disturbing wisdom tooth or to remove it, you need to know and understand the purpose of the "eights".

Wisdom teeth are called the last, third molars, which close the dentition and are located in the very corner of the jaw. It is this location of the wisdom tooth that often raises doubts whether to remove or treat, because access to the crown is often difficult due to a curved position or limited opening of the mouth.

In their structure, the third molars are practically no different from the sixth and seventh teeth, except that the "eights" may have curved roots, which can make endodontic treatment difficult or impossible.

Previously, wisdom teeth actively participated in the process of chewing food, but over time, a person switched to softer products that did not require the participation of such powerful teeth, so in the course of evolution they lost their functional value, but remained in the body as a rudimentary organ.

Do modern dentists treat wisdom teeth or should they be removed? ? It all depends on the specific clinical situation, because both for the treatment of wisdom teeth and for their removal there must be certain indications: the doctor will have to decide whether there is any point in maintaining the G8.

Why are wisdom teeth removed?

Often, the patient cannot understand why it is necessary to remove wisdom teeth, because outwardly they look healthy.

Whether it is necessary to treat wisdom teeth or is it better to remove them - the decision is made by the doctor based on clinical picture in the oral cavity and x-ray examination.

Without reasons, no doctor will pull out the "eights", since there must be certain indications for this:

• Chronic apical periodontitis with curved canals, which makes endodontic intervention difficult.
• Periodontitis in acute stage when it is impossible to create adequate conditions for outflow purulent exudate. In such a situation, the question of whether to remove a diseased wisdom tooth is the way to solve the problem.
• The third molar is the cause acute osteomyelitis and supports inflammation in the bone. In this case, asking the doctor whether it is worth trying to save or is it better to remove the wisdom tooth does not make sense.
• Pathological processes around the “eight”, which is in a semi-retained position, such as pericoronitis or periostitis of the retromolar region.
• Is it necessary to remove a wisdom tooth if it has third-degree mobility? Of course, since such a tooth does not take part in chewing, but is a source of maintaining an infection that can penetrate into the deeper layers through the expanded periodontal gap.
• Severely destroyed supragingival part of the tooth, when orthopedic restoration is not expected. It makes no sense to keep the "eight" if it serves as a source of maintaining infection in the body. The question of why it is necessary to remove such wisdom teeth will only cause bewilderment for the dentist.
• Incorrect position of the third molar in a row, when it constantly injures the buccal mucosa.
• "Eight" with the phenomenon of Popov-Godon. Is it necessary to remove excessively protruding wisdom teeth from the dentition? Yes, as they can damage the gums on the opposite jaw, as well as prevent the fixation of the prosthesis.
• Bite correction with braces.
• When wisdom teeth are being treated, but inflammatory phenomena it is not possible to stop, or they become more pronounced.

In the process of treatment, you should trust the opinion of the dentist, but if you are not sure of it, you should consult another specialist about whether wisdom teeth should be removed.

Indications for conservation

Whether it is worth removing a wisdom tooth or is it better to treat it, you can find out only after contacting a dental clinic. The decision on whether to pull out a wisdom tooth is always taken by the doctor together with the patient.

Exist clinical situations when the third molar can not only be saved, but also used as an abutment tooth during prosthetics. Whether a wisdom tooth is treated depends on the characteristics of its location and the condition of the oral cavity.

Below is a list of situations where treatment is possible:

• A small carious cavity located in the area accessible for preparation.
• Inflammatory process in the pulp chamber with good canal patency. Whether it is necessary to pull out a wisdom tooth or whether it can be saved, the dentist decides on the basis of a diagnostic radiograph.
• "Eight" is located in the dentition and has no deviations along the axis.
• With the remote "seven" often the third molar is shifted to free place. In this case, the removal of the wisdom tooth is impractical. On the contrary, you should try to keep it, as it will take part in chewing and distribution of the load on the periodontium.
• Wide and short pulp chamber. With such channels, high-quality endodontic treatment is possible. Some dentists of the old school do not consider it necessary to treat even such “eights”. Why they do not treat wisdom teeth is difficult to explain, so try to find a doctor who adheres to more modern views on dental therapy.
• When there are defects in the dentition, in which the sixth or seventh tooth is missing, the "eight" can be the only possible option to support a bridge prosthesis.

For some reason, many patients do not even hesitate to remove wisdom teeth, but with them normal location and the absence of curvature of the roots, they can last for many more years.

Do wisdom teeth heal?

Why remove wisdom teeth if they do not bring problems? Domestic dentists advise not to rush to pull out, but to think about whether it is worth treating a wisdom tooth. Often, the "eights" are needed when it comes time to engage in prosthetics. Unreasonable removal may lead to the fact that it becomes impossible to use bridge structures, and the only way out in this situation, a removable prosthesis will be made.

The main difficulties in the treatment of third molars are their inconvenient location. Also, the “eights” often have an abnormal structure of the pulp chamber, which may cause difficulty in endodontic intervention. With curved and narrow canals, the dentist is unable to perform their full cleansing and filling, so the doctor may advise pulling out the "eight", since when the canal is not filled to the top, a recurrence of the inflammatory process often occurs.

Is it possible to treat or should a wisdom tooth be removed during pregnancy?

Pregnancy is a period when a woman special attention relates to her health, because the condition of her baby also depends on it. The question of whether it is necessary to treat a wisdom tooth when a woman is carrying a child remains relevant for many, since pregnancy is not always preceded by full preparation and sanitation of the whole organism.

Is it possible to treat a wisdom tooth and for how long it is better to do it, when it is necessary to remove wisdom teeth - this is of interest to many women. According to gynecologists, the second trimester is the most optimal period for sanitation of the oral cavity. But if inflammation suddenly occurs, accompanied by pain, then you do not need to wait for the birth of the baby - in this case, you can remove or treat the wisdom tooth.

Another important question in pregnant women is the following: should a problematic wisdom tooth be removed if it does not hurt? As dentists advise, it is better to postpone a planned extirpation for several months, if this does not potential danger for the baby and his mother.

If inflammation of the "eights" occurs, which cannot be removed therapeutically, is it necessary to remove problematic wisdom teeth? Of course, since the third molars in this case serve as a source of infection, which can spread throughout the body, especially with weakened immune defenses.

Is it possible to remove a wisdom tooth in the early stages? As a rule, doctors advise to abandon this procedure, if there is no urgent need for extirpation. The fact is that without adequate anesthesia, it is impossible to pull out the third molar, so anesthesia will be required. In the first trimester, the placenta has not yet formed, which protects the baby from negative factors, so there is high risk penetration of the drug to the baby.

How is a wisdom tooth removed?

The indications discussed above explain why it is necessary to remove wisdom teeth. The procedure often causes panic attacks in people, because many have heard horror stories about how the G8 is pulled out. Fortunately, such cases are an exception, usually the removal of a wisdom tooth is no different from the extirpation of other teeth.

After anesthesia, the dentist-surgeon performs the following manipulations:

• separation - exfoliation to the required level of the mucous membrane in the cervical zone before pulling out the tooth;
• the imposition of forceps and their strong fixation;
• implementation of dislocation movements;
• revision of the hole remotely of the tooth;
• compression of the edges of the wound and the imposition of a tampon.

During the procedure, the dental surgeon may stand to the right or slightly behind the patient, depending on whether the tooth is being extracted in the upper or lower jaw.

With complex removal, sometimes it is necessary to cut the gums, drill the root, use a chisel. If such manipulations are frightening, then ask the doctor if it is necessary to remove the wisdom tooth at the moment or you can wait a bit.

However, it should be understood that if there are indications, then the extirpation of the G8 cannot be avoided. If treatment is refused or pulled out after a while, there is a high risk of complications. That is why competent patients go to the surgeon and remove wisdom teeth according to indications.

Consequences

Doubts about whether to pull out or treat a wisdom tooth are visited by most patients. But what happens if you leave the G-8 to continue to get sick in the hope that it will go away on its own? Naturally, this will lead to the development of complications.

Namely:

• If there is a small hole in the tooth, then without timely filling, the progression of the carious process will occur, which can lead to the destruction of the dental crown and inflammation of the pulp.
• Untreated pulpitis can cause infection of the periapical tissues with the subsequent development of the inflammatory process.
• The purulent process surrounding the wisdom tooth, without adequate treatment, can spread to deeper tissues and lead to their melting.

Even if the tooth does not hurt, this does not mean that it is healthy. Whether it is necessary to remove wisdom teeth, only the dentist can answer after he examines the oral cavity and examines the dental images.

All doubts and fears about whether it is necessary to treat a wisdom tooth or better to get rid of it, a competent specialist will help to dispel. It is the dentist who will tell you about all the negative consequences that arise in the absence of timely sanitation of the oral cavity. When a sharp pain appears, you need to seek medical help, but whether you have to remove or still manage to treat a wisdom tooth will be known only after the diagnosis.

Useful video about wisdom teeth

At first glance, these teeth are no different from the rest. But in the process of life, most often they become the cause bad memories in the dental office. At the same time, not only the patient is faced with the inconveniences that accompany the removal of a wisdom tooth, the doctor also has to show maximum professionalism, since the process of removing a wisdom tooth is very difficult.

First of all, this is due to the unique anatomical features eights. Compared to other chewing incisors, they have root system prone to the most specific and abnormal development - the roots can be from 2 to 5, often they are too twisted, can intertwine and grow together.

In addition, the "eights" are problematic to erupt, prone to carious lesions due to the difficulties of normal hygiene, and may occupy an incorrect position in the jaw. Due to the combination of such factors and potential problems, the time-consuming process of removing a wisdom tooth is not always a rational choice, so the dentist decides whether to remove it or leave it standing.

Is it necessary to remove a wisdom tooth? Despite the difficulties and lengthy treatment of third molars, a competent dentist will always try to take measures to save the molar, subject to minor deviations. But in practical activities meeting a patient even with relatively healthy eights is extremely rare.

In most cases, problems begin even at the eruption stage, which by default is associated with fever, pain, swelling and other troubles.

Indications for removal:

• an impacted molar (not erupted), occupies an incorrect position in the jaw, which injures soft tissues and adjacent teeth, prevents them normal development or promotes destruction;
• extensive caries, the crown is significantly destroyed;
• the presence of an inflamed hood - pericoronitis;
• pulpitis, periodontitis;
• strangulated trigeminal nerve;
• it is planned to install a bracket system - they are sometimes (far from always) removed even in the absence of problems, since while wearing braces, the figure eight can prevent the correct movement and position of other molars;
• cysts were found.

According to dentists, it is desirable to keep the "eight" under control from the moment of eruption. Enough to do X-ray to immediately assess the development of the G8 and understand what to expect in the future.

If such an abnormal situation is detected, the doctor will say that wisdom teeth should be removed without delay. And it is better to listen to his opinion.

At least for the reason that at a young age, such operations and the rehabilitation period are much easier, and the likelihood of complications is minimal.

With the question - is it worth removing wisdom teeth, we figured it out. Now we will tell you when you need to remove a wisdom tooth and why.

Impacted tooth

If the impacted (not erupted) tooth is located vertically and does not cause discomfort to a person, then they will not pull out a wisdom tooth, since it may later be useful for the prosthetics procedure. This is the only option not to delete it. But the wrong position of the eights (horizontal, at a significant slope), the lack of sufficient space or high bone density can become a serious obstacle to eruption.

In addition, such teeth do not represent functional value. This also applies to fully erupted and semi-impacted molars that have been able to erupt partially.

Briefly about the consequences that may be if you leave the eights with deviations:

• a strong inclination of the molar often provokes injuries to the oral mucosa, which leads to the development of chronic inflammation of epithelial tissues;
• if there is not enough space in the row during the eruption of the figure eight, the pressure exerted on the neighboring molars increases, which in the future may experience crowding, displacement or deformation;
• an erupted tooth at an angle often rests against the nearby seven, and provokes its premature destruction.

Dmitry Sidorov

Dentist-orthopedist

Dentists among themselves call the eights "time bomb" and here's why: inside a visually healthy tooth very often develops carious lesion.

extensive caries

Due to the inaccessibility of the third molars, it is rather difficult to perform their full hygiene. Such circumstances create all the conditions for stagnation, the reproduction of pathogenic microflora and, as a logical conclusion, the development of caries.

Caries at the point of contact of the "eight" with the adjacent tooth.

In addition, if the molar has an inclined position, then there will definitely be gaps between it and the seven, which also causes additional carious foci.

A minor lesion can be cured and sealed by a dentist, but a person needs to be prepared for the fact that this is a temporary event that will only delay the removal.

If you think about whether it is necessary to remove a wisdom tooth, it is worth remembering that diseased molars are a source of infection, and all adverse processes are especially aggravated with a weak immune system, hormonal disorders. Therefore, doctors recommend that even pregnant women get rid of the affected ones in order to prevent abnormalities in embryonic development.

The danger of pericoronitis

In dental practice, the presence of a hood over the molar during its eruption is a very common situation. Food remains accumulate under the mucous membrane, which certainly contributes to the appearance of not only plaque, but also microorganisms. All this leads to pericoronitis - purulent inflammation mucous membranes. In addition, a person experiences pain, swelling appears, bad breath, it is difficult for him to swallow.

In order to prevent complications, it is necessary to immediately excise the overhanging hood or completely remove it in advanced situations. Otherwise, there may be not only pericoronitis, but also an abscess, phlegmon. Are you still wondering if wisdom teeth need to be pulled out?

trigeminal neuralgia

Very often, the infringement of the trigeminal nerve occurs due to the influence of incorrectly placed eights. Caries and pericoronitis are provocateurs of the inflammatory process.

The insidiousness lies in the fact that most do not even suspect that the eight can be the culprit of neuralgia and long time endure periodic pain. If the situation is chronic, an X-ray of the third molars should be taken in without fail, and if suspicions are confirmed, they must be removed without delay.

Cyst

At the roots of uncut eights, follicular cysts can form, which, as they increase in size, pose a serious danger.

Complications of the follicular cyst:

• can reach the maxillary sinuses, provoking purulent sinusitis;
• contributes to the development of perineuritis;
• constant suppuration and inflammation;
• fistulas;
• osteomyelitis.

If this formation is detected, it is unconditionally removed, since the treatment is ineffective. The question - whether it is necessary to remove the wisdom tooth, is not worth it here.

About pain during removal

Many people put off removing their wisdom teeth for fear of pain. Such fears are groundless, since the procedure takes place with the mandatory use of anesthetics. The presence of uncomfortable sensations appears after the end of the analgesic effect, but such a physiological process and after a while everything returns to normal on its own. In addition, it is not necessary to endure pain, it is permissible to alleviate the condition with appropriate medications, as prescribed by a doctor.

Removing a wisdom tooth can be painful in rare situations for the following reasons:

• the patient is addicted to drugs;
• abuse of painkillers;
• there is an extensive purulent process - the phenomenon is exceptional.

The degree of pain also directly depends on how to remove the wisdom tooth, its condition, on which jaw it is located.

Dmitry Sidorov

Dentist-orthopedist

For example, removing a wisdom tooth upper jaw is much easier, and the operation of removing the wisdom tooth in the lower jaw is more problematic. This is due to the physiological features of the structure of the jaw and lower wisdom teeth (large curved roots).

How is the operation

There are only two ways to carry out the operation:

1. Simple.
2. Difficult.

As the names suggest, one or another type is resorted to based on whether wisdom teeth need to be removed on their own, or additional measures are required. The doctor also assesses the state of the clinical picture and the degree of neglect of the diseased tooth.

We have used the word molar many times. That's what it is.

Simple removal method

The operation to remove a tooth is carried out in a simplified version, only forceps and an elevator are required. In this case, do not resort to incisions, drilling of bone tissue.

This method allows you to pull out the painter:

• removal if needed upper tooth wisdom;
• in the absence of significant deviations in the development of the molar;
• the condition is not accompanied by complications.

The procedure is as follows:

1. The doctor collects an anamnesis, asks the patient about the presence of possible allergic reactions to drugs in order to choose the right anesthesia.
2. The introduction of an anesthetic drug, waiting for its effect (about 5 minutes).
3. At this time, the dentist-surgeon prepares necessary tools. The sets are different, because it matters where the tooth is located, its condition, the presence of inflammatory processes.
4. Using an elevator or forceps, the doctor removes the tooth from the hole.
5. A fresh wound is treated with antiseptic preparations.
6. If necessary, an anti-inflammatory agent is placed in the hole.

Dmitry Sidorov

Dentist-orthopedist

Considering big sizes holes after wisdom teeth, the surgeon will suture the tissue to prevent infection and speed up the healing process. Suturing is not advisable to carry out only in the presence of inflammation and purulent processes, since an unhindered outflow of the contents should occur.

Manipulation is fast and does not take more than ten minutes. A few days after the removal of the wisdom tooth, it is necessary to come for an examination to monitor the condition.

Complex removal

To perform such an operation to remove a wisdom tooth, you will need a drill, and the surgeon will also cut soft tissues, and then suture them without fail.

When performing a complex removal:

• removal if needed lower tooth wisdom;
• impacted, dystopic molars;
• the presence of an abnormal root system;
• extensive destruction of the coronal part.

Preparatory measures are carried out according to a similar plan with the previous method, more time is allotted for the effect of anesthesia - about 10 minutes.

Depending on each specific case, the method complex removal the wisdom tooth may differ, but the following indicative steps can be outlined as a tooth is removed:

1. Local anesthesia.
2. The surgeon cuts soft tissues, peels them off the bone.
3. Next, the doctor cuts out, drills out the proper bone tissue.
4. Extracts "eight".
5. Processes a fresh hole where he stood.
6. Uses non-absorbable suture material to get stitches.
7. The dentist will remove the stitches only after the edges of the wound are perfectly healed.

The procedure can take from 30 minutes to 2 hours depending on the situation. At the end of the operation, the doctor tells the patient how to care for the wound, prescribes drugs if necessary, and informs the date of the next appointment.

Why do we need x-ray diagnostics

The procedure for the removal of wisdom teeth cannot be carried out "blindly", focusing on external indicators. It is necessary to clearly assess the state of the root system and the characteristics of the development of the figure eight in order to anticipate possible complications during the operation. An x-ray is necessary to understand whether it is possible to remove wisdom teeth in a particular case.

To obtain an informative picture, it is necessary to carry out X-ray examination allowing you to see:

• the presence of twisted roots;
• their number;
• building features.

To determine in which direction a tooth grows, they resort to such an effective type of x-ray as orthopantomography. This digital equipment takes a panoramic x-ray of the entire oral cavity, which shows all the nuances in great detail. anatomical structure all teeth. It allows the dentist to decide how to pull out the wisdom tooth.

Such opportunities allow you to plan the operation and avoid mistakes in the form of incomplete removal of bone fragments.

The surgeon after the operation gives clear instructions, the implementation of which is mandatory for the patient. In each individual case, they may differ, especially in terms of taking antibacterial drugs.

General rules that are useful to follow after the removal of a wisdom tooth:

1. At the end of the procedure, you must refrain from eating and drinking hot drinks for 3 hours.
2. It is strictly forbidden to drink alcohol.
3. It is allowed to drink ordinary water at room temperature.
4. You can not swim in a hot bath, go to the bath.
5. Refrain from smoking.
6. Avoid physical activity.
7. Laughter prolongs life, but it is worth remembering the stitches, which can disperse with a big smile.
8. Upon arrival home, you need to apply ice wrapped in cloth to the operated area from the side of the cheek. Manipulation is done in episodes according to the scheme: 5 minutes of cold - 10 minutes of rest, repeat the cycle several times during the day. This method will reduce pain, reduce swelling.
9. All kinds of heating is strictly prohibited - it is fraught with purulent inflammation.
10. For the first time, it is especially important not to confuse healing procedures: for example, you can not rinse the mouth, only do baths if they are prescribed by a doctor. Intensive rinsing will lead to loss blood clot which greatly aggravates the rehabilitation process.

If you strictly follow all the instructions of the attending surgeon and do not self-medicate, then the wound will heal quickly after removal and will no longer cause pain.

That's all. We hope that after reading this article, it became clear to you why a wisdom tooth is removed, how it is removed, and what is needed for this. good dentist. Good health!

Wisdom teeth do not carry functional load, and their removal has no aesthetic consequences. Related to this are numerous disputes among dentists about whether it is necessary to remove wisdom teeth immediately after eruption or whether it is better to treat them the same way as others - to pull them out only in case of emergency.

The safest and most rational dental approach is to monitor the condition of the third molar from the moment of eruption. The initial x-ray will allow the doctor to assess the developmental features of the eighth tooth, and scheduled visits to the dentist 2 times a year will allow you to identify the problem in time and, if necessary, remove the problematic rudiment.

Does a person need wisdom teeth, or is it better to remove them

In Western dental practice, it is customary to remove eights immediately after eruption. But third molars do not always hurt or become a source of problems, so deciding whether to remove wisdom teeth if they do not hurt or bother you can only be done by discussing all the nuances with your doctor. Domestic dentistry insists that there must be grounds for the removal of any tooth, including the figure eight. Otherwise, the pain, costs and consequences of removal may not be justified.

The argument in favor of removing the eights immediately after these teeth have erupted is the lack of functional load, as well as the potentially high risk of developing caries and infection of neighboring molars.

In the event that the molar develops normally, occupies an anatomically correct position, does not bother a person and is not affected by caries, it is not advisable to pull it out in order to avoid hypothetical problems in the future.

Why it is not necessary to remove a correctly erupted wisdom tooth:

• Due to the peculiarities of the structure of wisdom teeth, their removal is difficult. surgical operation and can lead to unpleasant consequences and complications.
• Wisdom teeth are needed for prosthetics, they are a good basis for installing a number of dentures that are attached to natural teeth. Such prosthetics are cheaper than implants, so keeping figure eights may be useful in the future.
• The figure eight restrains and slows down the loosening of adjacent teeth, and in their absence, takes over the chewing function.

When is a healthy wisdom tooth removed?

If an abnormal position of the rudiment is detected, the doctor may recommend removing the figure eight even if the tooth itself is completely healthy. Extraction is done in the presence of direct indications, which are:

• Lack of space in the dentition. If, during the eruption of eights, they do not have enough space in the jaw row, they shift neighboring molars to the center. This leads to crowding, deformation and displacement of the teeth. The consequence may be a violation of the bite.
• Incorrect anatomical position in a row. Sometimes a tooth erupts with an inclination towards the cheek, tongue, throat. In this position, the mucous membranes of the oral cavity are constantly injured, irritation occurs, and the patient cannot brush his teeth with high quality. Chronically non-healing wounds turn into ulcers.
• Destruction of an adjacent molar. An improperly positioned third molar may abut against the roots or crown of an adjacent molar, under constant pressure it is gradually destroyed and inflamed.
• Retention (eruption delay). The formed tooth is completely hidden in the gum and occupies an abnormal position inside. Pathology is fraught with infringement of the trigeminal nerve.
• Installing a bracket system to correct an overbite. Freeing up space after the eights are removed helps to return the dentition to the correct position. Whether it is necessary to remove wisdom teeth before orthodontic treatment, or this should not be done, the doctor will be able to determine only after the examination.

Indications for the removal of a problematic wisdom tooth

The bone tissue of the extreme molars is no different from the tissues of other molars, so wisdom teeth are also subject to treatment. The difficulty lies in the fact that the eights have a more complex structure, often burdened with multiple roots, larger sizes and unfavorable for dental procedures location. Diseases on initial stages in most cases, it is possible to stop, but the treatment of advanced forms of the disease is difficult.

The treatment of eights takes longer than the treatment of other teeth, in difficult cases it can last up to three months.

The greatest difficulty is the treatment of pulpitis and periodontitis, which requires root canal treatment. In diseases of an inflammatory nature, dentists more often decide to pull out a wisdom tooth than to try to cure it. The main indications for the extraction of the figure eight are:

• extensive carious lesion with significant destruction of the dental crown;
• periodontal inflammation - pericoronitis, pulpitis, periodontitis against the background of canal obstruction;
• cyst;
• development of neoplasms;
• destruction of bone tissue;
• softening of the root system;
• fracture;
• root bifurcation disorder;
• sinusitis;
• sepsis;
• osteitis of the jaw;
• horizontal position of the inflamed eight.

extensive caries

The inaccessibility of the third molars makes it difficult to complete hygiene. It is difficult to thoroughly clean them with a regular toothbrush, which results in stagnation of food particles and the development of pathogenic microflora. The insidiousness of caries in figure eights lies in the fact that it is rarely possible to diagnose it at the initial stage of the disease. It often develops from the inside, and visually the tooth looks completely healthy for a long time.

When the “wise” tooth is tilted, additional carious foci appear in the gaps between it and the adjacent molar, and the infection spreads even faster. Whether it is necessary to remove wisdom teeth affected by caries, or whether they can be cured, the doctor decides based on the degree of destruction of dental tissue, the condition of the canals and the possibility of full access.

pericoronitis

When a wisdom tooth erupts, a kind of hood of gum tissue often forms over it. As a result, it is difficult to clean the molar, since it is impossible to clean the space between the mucous membrane and the tooth with a toothbrush. To qualitatively clean the space under the hood, you need to resort to rinsing or using special devices.

Due to poor hygiene, plaque forms on the molar, which becomes nutrient medium for pathogens. This can lead to pericoronitis - purulent inflammation of the mucous membranes. Symptoms of the disease are swelling, discomfort when swallowing, the appearance bad smell from the mouth and severe pain syndrome.

To prevent the development of pericoronitis during the eruption of the figure eight, the overhanging hood is excised. If the inflammatory process has already begun, the hood must be removed surgically. After the operation, the oral cavity is sanitized and treated. If you do not clean the resulting cavity and start inflammation, phlegmon and abscess can develop - inflammatory processes that are dangerous for the whole body.

Cyst

At the roots impacted teeth wisdom, one or more follicular cysts can form, representing a serious health hazard. As they increase in size, they can cause more and more damage.

The growth of cystic formations is slow, but it is very dangerous - that's why removing wisdom teeth that are affected cystic formations needed as soon as possible.

A complication of a follicular cyst can be:

• purulent sinusitis (when a cyst grows into the maxillary sinuses);
• development of perineuritis;
• chronic inflammation and suppuration;
• fistula;
• osteomyelitis.

The development of inflammatory processes in the pulp

In itself, inflammation in the pulp is not a reason for the removal of a wisdom tooth. It can be cured, but this can only be done on the condition that the figure eight stands correctly and has even channels. In case of obstruction of the channels, it will not work to leave the wisdom teeth - they must be pulled out.

Strongly curved channels will not allow you to get to problem areas and perform a complete cleansing of the pulp from infection. If the channels are not completely cleaned, the inflammatory process will resume and spread to the adjacent tissues - this is why the condition of the channels is a paramount issue when choosing between treatment and extraction.

Why remove impacted wisdom teeth

The extreme molars are characterized by the phenomenon of retention (eruption delay), in which not only a feeling of discomfort, typical for cutting gums, but also a constant throbbing pain, which increases when chewing and during a conversation, can occur. If on the x-ray the doctor sees a formed molar, the eruption of which has not yet occurred, he will decide on the need to remove the figure eight. To do this, he will need data on the condition of the molar and gums, the health of the patient. A comprehensive examination will help identify the potential threat of complications.

When the figure eight does not bother, the gum near it is not inflamed, the molar does not negative impact on the surrounding tissues and, presumably, will stand in a normal position, it is not necessary to remove the wisdom tooth. Doctors recommend observing it in dynamics, visiting dentistry every six months.

It is necessary to urgently “remove” an impacted molar when:

• the tooth and surrounding tissues hurt;
• there are acute and chronic inflammations;
• cyst develops.

Is it always possible to remove a wisdom tooth

Treatment of third molars is difficult and not always justified, but pulling out is not a panacea. It is associated with operational risks and consequences. In order to make an informed decision about whether it is necessary to remove the eights or whether they can be cured qualitatively, the doctor must take into account:

• degree of damage;
• the anatomical position of the tooth and the condition of the canals;
• the presence of an inflammatory process;
• the influence of the figure eight on neighboring teeth;
• history and health status.

Why leave a wisdom tooth

At dental diseases wisdom teeth are not always recommended to be pulled out, in some cases it is better to choose treatment, even if it is very long and expensive. Treatment of the third molar is advisable if:

• Neighboring molars are missing or severely damaged, then the figure-eights become the only possible support for prosthetics. If they cannot be left, dentists consider the option of implantation and removable prosthetics.
• The figure eight is correctly located in the jaw row and, due to the presence of an antagonist, is involved in the chewing process. An antagonist is a tooth located symmetrically on the adjacent jaw. When one of the teeth of the antagonists is removed, the second one will gradually move forward and bend, therefore it is advisable to leave the tooth or to carry out the extraction of both molars.

Contraindications to the removal of eights

There are a number of indications in which you should not remove a wisdom tooth unless absolutely necessary - a rapidly spreading inflammatory process in an acute form that causes severe pain. This:

• Tooth growth in the zone of malignancy.
• Hypertension of the second and third degree. If surgery is unavoidable, it can be performed only after consultation with a cardiologist.
• History of infarction less than three months ago.
• Pregnancy. If there are indications for emergency extraction, before removing the wisdom tooth, the doctor must definitely take care of a suitable anesthesia that will not harm the child.

When the first unpleasant symptoms in the area of ​​\u200b\u200beights, you should contact a dentist who can determine the source and cause of the pain, choose the best treatment tactics, determine whether it is necessary to leave the problem tooth or is it better to pull it out. A qualified doctor will explain why this or that decision is made and help you choose best option for its implementation.

The wisdom tooth is an urgent problem for people aged 18 to 25, but not all. It's like a lottery here. Perhaps your third molars will erupt so imperceptibly that you will find them appearing unexpectedly. For some, on the contrary, figure eights bring quite a lot of cotton and discomfort. In any case, the question of whether it is necessary to pull out a wisdom tooth always remains relevant. First of all, due to the fact that you have to say goodbye to the third molars even when they are completely healthy and may well perform the functions assigned to them.

The beautiful and somewhat poetic name "wisdom tooth" belongs to the third molar. Dentists quite often refer to it simply as a figure eight. Such a tooth got its popular name due to the fact that it appears later than the others, as already mentioned, not earlier than 18-25 years.
The third molar is located at the very end of the dentition. It performs all the same functions as the rest of the molars, that is, grinding food for further swallowing.
For quite a long time, eights have been attributed to the so-called vestigial organs, that is, those that in the process of evolution have already become unnecessary for our body. Along with the third molars, this group includes the coccyx, second eyelid, appendix.
Our ancestors an extra couple chewing teeth was necessary for grinding especially hard food. IN modern times such food is no longer included in the human diet, and the need for a third molar has disappeared. Today, already in 5% of the population, third molars are completely absent. They are simply not born. This percentage is increasing every decade. Many scientists believe that in a few centuries, not the absence of eights, but their presence, will become something out of the ordinary.
Based on the foregoing, it is not surprising how relevant the question is whether it is necessary to pull out a wisdom tooth. The opinion of dentists is divided here. Some say that it is not necessary to keep such teeth, while others, on the contrary, are fighting for their health.

When is a wisdom tooth removed?

Extraction of any tooth can be emergency and planned. Each of the operations is carried out for specific reasons.
Causes emergency removal wisdom teeth, the same as in the case of any other molars or incisors:
1) Periostitis and osteomyelitis, that is purulent processes distributed in bone. In this case, the tooth is not the cause of the disease, but rather a factor that interferes with its speedy treatment. Since the listed diseases can bring with them a lot of extremely unpleasant consequences, at the first detection of them, especially if they are in the acute stage, an emergency tooth extraction is performed.

2) Phlegmon- another purulent disease. It develops due to infection in the soft tissues. It is one of the extreme stages of a number of diseases. At the slightest weakening of the immune system, phlegmon can harm the entire body as a whole, which is why they try to get rid of it as quickly as possible.
3) Abscess. This term refers to a process that can form in any tissue of the body. If it began to develop in the soft tissues of the oral cavity, it is necessary to get rid of it immediately. The third molar can become not only an obstacle to treatment, but also the cause of the disease, for example, when it was destroyed due to an infectious process. In any case, it is necessary to get rid of the abscess as soon as possible.
4) Sinusitis- this is an exacerbation of sinusitis, characteristic aching pain and inflammation. In combination with caries or pulpitis, the disease becomes another reason for tooth extraction.
5) Tooth fracture with pulp exposure i.e. nerve ending. This problem is common with blows to the cheek area. Any exposure of the nerve leads to severe pain. In addition, the affected soft tissues often become a breeding ground for pathogenic microflora.
When we are talking about emergency removal, the question of whether it is possible to pull out a wisdom tooth is no longer worth it. All of the previously listed diseases can harm not only the health of the oral cavity, but also the body as a whole.
Speaking about the reasons for the emergency removal, they cannot be attributed only to the operation to remove the figure eight. The same reasons apply to any other teeth. In the case of a planned extraction, many of the reasons for such an operation apply only to the third molars.
Scheduled deletion wisdom tooth is carried out in the following cases:
This is one of the few purulent diseases, upon detection of which the operation can be postponed for more auspicious time. A cyst forms near the roots and at the moment there are many ways to remove it without harming the tooth itself. In the case of third molars, it is much more efficient, practical and economical to simply extract the tooth.

2) Periodontitis affects the tissues that bind the teeth themselves and alveolar ridge. With its strong development, even loss of teeth is possible. If it was not possible to detect the problem in time, most likely, the tooth will simply be removed.
3) Damage to the crown. With various injuries in the face, teeth often suffer. IN modern dentistry a lot of methods are practiced to restore the integrity of the tooth, so that it can continue to perform all its functions and not spoil the smile. As you understand, in the case of wisdom teeth, such tricks are extremely rare.
4) Not enough space in the mouth. Wisdom teeth begin to grow later than all the others. Often, by the time they erupt, the rest of the teeth have time to occupy all the free space. In this case, the third molars are shifted to the side. They begin to grow into the bone tissue or towards the gums. Professionals call such teeth impacted. In most cases, the decision is made in favor of their removal. Especially often for this reason, wisdom teeth are removed before orthodontic treatment.
5) Fracture of the jaw. In practice, there are cases when the molars interfere with the reduction of the bones of the jaw system. As you understand, they are routinely removed. Here the question no longer arises, wisdom teeth: whether it is necessary to pull out.
6) Making a complete prosthesis. In old age, a person loses most of his teeth, but the third molars last much longer than the rest. To restore a series, many decide to do complete dentures. In this case, all remaining teeth can be removed, because under the weight of the prosthesis they will still be quickly erased, and they will need to be removed in a couple of years, and at the same time the prosthesis must be completely changed, and this is a big financial cost.

Is wisdom tooth treatment worth it?

The question of whether to pull out a wisdom tooth can be considered from the other side. Third molars, like any other teeth, can be affected by caries, tartar, pulpitis and other common diseases. If you regularly visit a specialist, then most likely this problem can be detected even before it can bring significant harm. In this case, of course, it is much better to save the tooth than to remove it ruthlessly.

In the future, a wisdom tooth may even be useful. Prosthetics have already been mentioned as one of the reasons for removal. As absurd as it may seem, the same reason can be one of the main reasons for saving a tooth. Some types of dentures are attached to natural teeth with special locks. Third molars do a good job of supporting. Such prostheses are much cheaper than those that completely replace the entire dentition. So sometimes wisdom teeth may be needed, which means they should not be removed without a good reason.