Removal of a wisdom tooth in the upper jaw

For many people, as practice shows, panic is caused by the mere fact that it is necessary to remove a wisdom tooth. This is due to the fact that patients imagine the procedure itself as painful. But the days when a dentist spent more than 2-3 hours chiseling out roots piece by piece with a hammer and chisel are long gone.

Modern clinics use new technologies and techniques, thanks to which the removal of a wisdom tooth in the upper jaw is quick, in a comfortable environment and absolutely painless.

Features and difficulties during removal

Extraction of the upper wisdom tooth is complicated by its specific anatomical features.
“Eights” erupt late, when the dentition is already formed. Therefore, very often they are incorrectly located, grow together with the roots of neighboring teeth, grow towards the cheek or even horizontally. Each of these factors complicates the extraction process placed on top of the 8th tooth. But if we compare wisdom tooth removal from above and below, then in the first case the surgical procedure is much simpler. In the upper dentition, the bone is less dense and massive, there are much fewer blood vessels in the soft tissues and the risks of damage to the trigeminal nerve are lower. Therefore, the operation to remove the G8 is easier and safer.

Useful tips

Before removing an incorrectly positioned wisdom tooth, we offer a number of tips that will help you prepare and go through the operation more comfortably:

Try to make an appointment for tooth extraction in the morning. During the night, the hormone cortisol accumulates in the body, which helps to survive stressful situations. In addition, one should take into account the fact that the inevitable bleeding from the wound at the site of the former tooth will stop by the evening, and the person will be able to sleep peacefully.
Eat well before surgery. As a result, saliva will be released in smaller volumes, and then you will need to leave your jaws alone and not eat for some time.
If possible, immediately use a cold object and periodically apply it to your cheek on the way home to prevent swelling from forming. A pack of dry ice from a motorist's first aid kit will do.
At home, rinse your mouth with clean water or medications recommended by your doctor.
Take medications in the correct dosage, do not get carried away with self-medication and self-prescription of drugs.

Recommendations for a better rehabilitation period after removal of an impacted wisdom tooth:

You will need to allow a blood clot to form at the site of the extracted tooth. His presence is mandatory. The clot protects the socket from the penetration of bacteria and prevents complete deformation of the gums. Dry socket is dangerous and provokes inflammation.
Do not touch the blood clot with your tongue, toothbrush bristles, or cutlery. It is not even recommended to use mouth rinse for 2-3 days after surgery. It is better to take the medicine into your mouth, hold it for a while and spit, avoiding the chance of dislodging the clot.
To stop bleeding, it is permissible to use sterile cotton wool or gauze swabs. It is allowed to moisten with Chlorhexidine, Miramistin. It is prohibited to use hydrogen peroxide!
For several days you will have to eat soft food and maintain an acceptable temperature of food and drinks.
You are supposed to temporarily give up physical activity and training. Baths and saunas, swimming pools, solariums are prohibited.
You cannot heat the surgical area, as this will cause a dangerous inflammatory process. You can apply ice, but under no circumstances keep it on your cheek all the time. Optimal rhythm: 5 minutes cooling, 5 minutes break. If you don’t have ice at home, bags of frozen vegetables and meat from the freezer will do.
Maintaining oral hygiene is not prohibited. The main thing is to leave the operated area alone in the first days and not try to thoroughly clean the teeth located near the wound. Disinfection can be carried out with solutions of Chlorhexidine, Furacilin, holding it in the mouth and spitting it out, without rinsing.

Medicine knows of cases when wisdom teeth are prescribed to be preserved. But if it grows, pushing neighbors, lies horizontally or rests on the roots of nearby teeth, there is no need to think twice. Such an eight is considered problematic and is deleted without regret.

If a wisdom tooth grows horizontally and puts pressure on the adjacent tooth

Removal of wisdom teeth using ultrasound in Moscow without pain and complications

Features of tooth extraction in the upper jaw

The structure of the upper and lower jaws is significantly different. They also vary in density and location. Therefore, the method of tooth extraction will differ:

on the upper jaw the operation is faster;
the recovery period is shorter;
pain relief is simpler and more effective.

Complications during tooth extraction in the upper jaw occur less frequently than in the lower jaw.

Anesthesia

The secret of high-quality pain relief is the correct delivery of the drug to the nerve. The choice of anesthesia method takes into account the patient’s age, his general condition, and the complexity of the tooth being removed.

Anesthesia of the upper jaw

The upper jaw is less dense than the lower jaw. It is covered with a cortical plate with many holes. Nerves and blood vessels pass through them. Pain relief is easier and faster than in the lower jaw

Sinus damage

Above the upper jaw is the nasal sinus, also known as the maxillary sinus. Its bottom may be close to the root of the tooth being removed. Then, during removal, sinus perforation may occur. This complication is typical for surgery on molars. This pattern is explained by the fact that the jaw in the area of the incisors is longer, and the nasal cavity is further away relative to them.

The main sign of sinus perforation is the escape of air, food and fluid through the nose. There is foam in the hole. Hospitalization in a hospital may be indicated for treatment.

Entry of part of the root into the sinus

Due to perforation of the sinus, part of the root can get inside it. This is caused by thinning of the bone plate or errors during the removal operation.

The symptoms when part of the root gets into the sinus are the same as when perforation occurs: air and contents of the oral cavity escape through the nose. But at the same time there is pain and increased body temperature. Treatment requires hospitalization.

Features of caries on figure eight

The cause of this disease is the accumulation of bacterial plaque and poor hygiene. “Eights” erupt late, on average after 18 - 20 years, and sometimes remain partially unerupted (impacted). At the same time, wisdom teeth are located far in the oral cavity, and it is almost impossible to clean them properly. If part of the crown is located under the gum, a so-called gum hood is formed, where food particles easily fall, and the tooth is destroyed even faster. These factors are the main reasons for the appearance of caries on the figure eight.

Preparing for surgery

Before removing a wisdom tooth in the upper jaw, the doctor prepares the patient for the upcoming operation. The preparatory process consists of:

X-ray examination of the problematic tooth;
clinical examination of the patient for the presence of pathologies and other concomitant diseases that may affect the course of the operation;
removal of subgingival and supragingival deposits from the tooth being removed and adjacent teeth to prevent the penetration of infected plaque into the alveolus.

The surgeon also assesses the patient’s psycho-emotional state and, if necessary, recommends taking a sedative.

Treatment of caries in Minsk

independently detect wisdom tooth caries . Typically, people go to the dentist with damaged dentin, cavities in the teeth and severe pain. As a rule, in such cases, wisdom teeth are not treated, but removed.

undergo dental treatment under anesthesia using sedation at the Minsk Family Dentistry Center “Medexpert”. The clinic’s specialists treat, remove, restore and restore teeth for both adults and children – and all this is painless and comfortable. It has been scientifically proven that sedation is completely safe for the body and allows for better and faster treatment.

Easy removal

When nothing prevents you from removing the tooth from the socket and cutting the gums with a scalpel is not required, then such removal is considered simple. The procedure is carried out in the following order:

the doctor orders an x-ray or recommends a CT scan;
the problem area is numbed with local anesthetics;
Using forceps, the surgeon first rocks the tooth and then pulls it out of the socket.

After the tooth is removed, the hole is treated with an antiseptic solution, after which a sterile swab is applied to it. If necessary, the wound is sutured. The entire procedure lasts about 10 minutes.

Why is dystopia dangerous?

Failure to see a dentist in a timely manner can lead to complications such as:

A wisdom tooth that fits tightly to the wall of a healthy neighboring tooth will destroy its enamel and a carious cavity will form.
A horizontally growing figure eight will harm the entire dentition and cause crowding and malocclusion.
The sharp edge of the crown will damage the mucous membrane and begin to cause persistent pain. The area will become inflamed and a wound will open, which can become infected.
The soft tissues of the face, cheeks and gums gradually fester. There is a high probability of trigeminal neuralgia, periodontitis, cysts and fistulas, and if left untreated, phlegmon can spread.
Chewing and opening your mouth will become difficult due to pain.
In some cases, body temperature rises.
A deep-lying figure eight touches nearby vessels. Due to their damage, constant bleeding occurs.
Malignant and benign tumors will appear due to the pressure of the molar on the cheek and the degeneration of the affected areas.

Difficult removal

Such an operation is considered difficult when the upper molar has to be extracted in parts with an incision in the gum and sawing of the crown. The procedure occurs in stages:

X-ray or CT scan;
gum pain relief. In case of a complex clinical picture, it is possible to perform the operation under general anesthesia;
dissection of the gum is performed to open access to the crown;
the surgeon pulls out the molar. It is often necessary to first remove the crown with a drill to ensure free access to the roots;
the hole is carefully checked for the presence or absence of bone fragments.

In cases of bone resection, the hole is filled with special bone chips, which subsequently form new bone tissue.

Since the operation is complex, the rehabilitation period is longer and can last for several weeks.

Can third molars be treated?

Wisdom teeth, like any other teeth, can be treated. But only if they erupt correctly, do not threaten the health and position of the rest of the dentition, and there is confidence that the treatment will be successful. If the specified conditions are met, it makes sense to preserve the “eight” for the following indications:

If the sixth and seventh teeth are sick or severely damaged and must be removed, in this case the wisdom tooth is left as “the best of the worst” in order to provide the patient with at least some conditions for chewing, and the doctor - the basis for future prosthetics.
If the six and seven have already been removed and it is necessary to preserve the abutment tooth for installation of prosthetic structures.
In the presence of an antagonist tooth, completely healthy and subject to preservation.

In case of curved roots that complicate endodontic intervention, severe tissue destruction, dystopia or retention, no competent dentist will undertake to treat the “eights” - he will definitely recommend removal.

Pain after removal of upper wisdom tooth

It should be understood that removing an upper wisdom tooth is much more difficult than removing any other unit in the dentition. The patient does not feel any pain during the operation. But when the anesthesia wears off, pain is inevitable.

To relieve pain, you should take painkillers recommended by your doctor. Cold compresses applied to the cheek relieve pain.

If within 3-5 days the pain does not disappear, but becomes more intense, then you should seek help from a dentist to find out the cause of this condition.

Symptoms and diagnosis

The main symptom indicating activation of third molar growth is pain that occurs when chewing. In the case of the formation of a cyst or “hood,” inflammation develops, which, in addition to pain, can be accompanied by an increase in body temperature, enlargement and soreness of the submandibular lymph nodes, and a headache due to the development of the inflammatory process.

A sign that wisdom teeth are growing abnormally is:

acute pain in the temporomandibular joint;
numbness of the jaw and aching pain. This may indicate improper growth inside the bone and possible trauma to the jaw nerve;
inflammation and enlargement of lymph nodes. As a rule, such a sign indicates that an infectious process has begun;
redness, swelling of the gums and pain when pressing on it;
displacement of teeth in a row.

If you have such symptoms, you should immediately visit your dentist for diagnostic measures. Only a specialist can confirm or deny the presence of problems associated with the growth of the third molar.

Diagnosis of an impacted tooth, completely or partially hidden under the gum tissue, is carried out in several ways:

Palpation and probing;
Sight radiography - to determine the direction of growth and the number of roots;
Orthopantomography;
Computed tomography.

The diagnostic method is determined directly by the doctor; sometimes an examination in the dental chair is sufficient, and sometimes an x-ray is necessary to identify existing problems and predict the risk of their development in the future.

What to do if the bleeding does not stop

Immediately after removing a molar, the surgeon places a tampon on the socket to stop capillary bleeding. The patient needs to clench his jaw and not remove the tampon for 20 minutes. During this time, the blood coagulates and a clot forms in the hole, protecting the fresh wound from the penetration of bacteria into it.

If the patient has high blood pressure or poor blood clotting, the tampon should be kept in place for 40-60 minutes.

When a person strictly adheres to medical recommendations, but the bleeding does not stop, he should contact a dentist for help.

Possible complications during the development of wisdom teeth dystopia

Third molars are extremely problematic teeth. If teething occurs with tolerable pain and the patient does not rush to the dentist, then the following complications are possible:

Pericoronitis – inflammation of the gum mucosa;
A follicular cyst is a “sac” of fluid pressing on the roots;
Periostitis is inflammation and suppuration (abscess) of the periosteum.

The appearance of these complications will lead to longer, more painful and expensive treatment, so you should not put off going to the doctor if you feel that your wisdom tooth has begun to erupt.

Safe and high-quality removal of wisdom teeth in Balashikha

The Berezka dental clinic offers qualified assistance to anyone who, for certain reasons, requires the removal of a wisdom tooth from above or below. The operations are performed by experienced surgeons using safe anesthesia and modern instruments.

Before the procedure, the dentist collects the patient’s medical history, conducts all the necessary examinations, and only if the clinical picture is present is it possible to extract the wisdom tooth.

The operation is performed in a comfortable environment for the patient. Innovative equipment and professional dentists ensure successful and safe removal of the most complex teeth.

Incorrect growth of wisdom teeth

70% of people who turn to the clinic for help with the eruption of a wisdom tooth are diagnosed with its incorrect location. Often the concept implies a horizontal tilt, excessive grinding into the seven, or the growth of the eighth tooth into the root part of the neighboring one.

The growth of a tooth under the gum harms the rest. The sooner a person shows interest and finds out exactly how even an unerupted wisdom tooth is located in the jaw, the easier it will be to eliminate the problem when it is discovered. It happens that the figure eight harms the healthy seventh tooth, while still hidden under the gum. While growing, the third molar seems to be trying to push out the neighboring one or rests against its walls, causing damage. It is better to remove such a wisdom tooth in advance, otherwise the risk of damage to a healthy molar increases. Later, you will have to get rid of both the third and second molars, which have lost functionality.
A similar situation develops when a wisdom tooth erupts at an angle. As it continues to grow, it will begin to prop up the seven. A particularly alarming picture emerges if there is a lack of space on the jaw. Then the dentition loses its alignment. More often this problem occurs in women.
The recumbent position of a wisdom tooth is also considered unfavorable , especially when the tooth is turned towards the adjacent seventh tooth. A person sometimes argues that preserving his own, albeit pathologically growing, tooth may be useful in the future, when the time comes to install a crown on the tooth. And the recumbent tooth takes up a lot of space in the row, shifting the others and causing their uneven arrangement.
The fit of the figure eight to the second molar , even with an anatomically correct location, is also not considered a good sign. Excessive crowding of teeth in the depths of the oral cavity almost always causes the development of caries.
At first glance, the direction of the wisdom tooth towards the cheek However, this is an imaginary impression. A tooth growing sideways regularly causes microdamage to the vulnerable mucous membrane of the cheek. Often leads to gum inflammation and pericoronitis. The seriousness of the situation is enhanced by the fact that the mucous membrane of the cheeks is not rich in pain receptors, so a person sometimes does not even feel the harm being caused.
As a result, the cheek is damaged from the inside, and the wounded area becomes a gateway for infection and becomes severely inflamed. Gradually, the cells of the mucosa, under the pressure of what is happening, are transformed and replaced by foreign, denser tissue. This indicates the emergence of neoplasms at the site of permanent injury - benign or carcinogenic.

Dentists recommend removing wisdom teeth that are positioned incorrectly in advance. This information is available to the patient after undergoing an X-ray examination. The picture immediately shows how the figure eight is located inside the gum; it becomes possible to predict the result when it erupts.

Ultrasonic removal of wisdom teeth using a piezotome

You don’t even need to wait for the mentioned process to begin; the modern level of development of dentistry allows the doctor to intervene while the tooth is “sleeping” and perform an operation to extract it in adolescence. In youth, such manipulation is tolerated much easier, and tissue regeneration occurs faster and more completely. And by the time you turn twenty-five, the undesirable scenario of the eruption of a crooked wisdom tooth will be a thing of the past.

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Why do eights almost always grow incorrectly?

The rudiments of wisdom teeth form in all people, but they do not always erupt completely, and may not appear above the gum at all. They begin to grow last, at about 25 years of age. The problem is that eights are rudiments that we inherited from our ancestors. In ancient times, when people had to eat raw meat, their jaw system was much larger, and the wisdom teeth in it performed the function of thoroughly crushing solid food.

Evolution has greatly changed our appearance, and the jaw arches have noticeably decreased in size over time. Therefore, there is simply not enough space left for the eights, and this is one of the main reasons why in most cases they lie horizontally and grow in the wrong position. As a result, excessive pressure is exerted on neighboring elements, which leads to deformation of the entire row.

Third molars grow very slowly and often remain half under the gum - this phenomenon is called retention. When an impacted wisdom tooth is also in a horizontal position, experts diagnose it as dystopia. All this usually leads to the development of inflammatory processes in the mucous membrane and rapid destruction of dental tissues by caries.

If you do not remove the dystopic figure eight, there is a danger of complications

If the third molar grows at an angle, it poses a threat to the health of other teeth, so this situation requires timely medical intervention. It also creates a constant traumatic effect on the mucous membrane, which can soon provoke inflammation. If you continue to ignore the symptoms, it can lead to even more serious problems:

purulent lesions - an open wound appears at the site of eruption, and if pathogenic microorganisms get into it, this can lead to inflammation and purulent processes. As a result, there will be a risk of developing periodontitis, abscesses and even osteomyelitis,
bleeding - if the tooth lies deep enough and horizontally, then during its growth the vessels will be injured, which can easily provoke serious bleeding,
curvature of the bite - figure eights displace their “neighbors”, which soon leads to deformation of the occlusion as a whole,
There are numerous abrasions and scratches on the mucous membrane - the result of constant injury to soft tissues and a direct prerequisite for infection.

Horizontal tooth growth brings many complications.
One of the most severe complications is the development of oncology. This happens very rarely, but experts still do not exclude the possibility of this sad scenario developing. The risk in this case is due to the constant traumatic effect on the cheek from the inside, which in the future can lead to dangerous structural changes in the mucosa and the appearance of malignant neoplasms.

Reasons for the formation of pus in the gums

There are several reasons for the formation of pus:

The inflammatory process causes a disease such as periodontal disease (gingivitis).
Periodontal disease.
Mechanical damage to the gums.
Chemical or thermal burn.
Unprofessional removal of tartar, which affected the gums.
Extensive caries causes pulpitis.
Failure to comply with hygiene standards when performing dental procedures.
Unsanitary oral cavity.
Types 1 and 2 diabetes mellitus.
Summing up the causes of purulent inflammation of the gums, we can highlight the main factor that causes this disease – the vital activity of pathogenic microorganisms.