Wisdom teeth: features, problems, questions and answers

It may take one minute or an hour, using a drill and a scalpel, but there is no way to avoid it.

Tooth extraction is a surgical operation to remove a tooth from its socket. A basic dental procedure that can scare anyone. Fear of removal is due to the idea of ​​​​ancient times, when they did not think much about the patient’s comfort, much less about good anesthesia.

The fear has not gone away, but approaches to dentistry have changed dramatically. Let's look at when it is necessary to be examined by a dental surgeon, what options are available for tooth extraction, and how to quickly recover after surgery. We will also consider frequently asked questions to the dentist.

Indications for removal:

• a painful tooth provokes the development of a cyst, negatively affects the function of the trigeminal nerve, causing its inflammation;
• abnormal position of the tooth, improper eruption, which affects the bite;
• constant injury by the edges of the crown of the mucous membrane, tongue due to the abnormal size of the tooth or its shape - this factor also affects the bite;
• multi-rooted teeth that provoke inflammation of the cyst - osteomyelitis;
• chronic inflammatory processes – periodontitis, impossibility of non-surgical treatment;
• advanced caries complicated by pulpitis, periodontitis, neuritis or odontogenic osteomyelitis.

After carrying out diagnostic measures, the doctor identifies the causative tooth and prescribes its removal. This happens in one session under local anesthesia.

How does the deletion work?

There are cases when patients want to remove a wisdom tooth without clear prerequisites for the operation. Is it possible. Some dentists support this decision due to the fact that in the area where the figure eights are located, it is very difficult for a person to brush their teeth, so food debris accumulates there, forming a stone, and then caries begins, which, without treatment, can lead to tooth loss. Therefore, doctors immediately remove it. The procedure is performed by a surgeon as it is a major operation.

Does it hurt to remove?

A typical mistake made by patients before tooth extraction is the desire to start the procedure faster in order to “get over it” faster. In this case, the anesthesia does not have time to completely dissipate through the tissues and the patient will face a painful procedure. Therefore, you need to wait a certain time, which is suggested by the dentist.

Stress factors can also affect pain during surgery. During the effect of anesthesia, you need to remain as calm as possible, which will allow you to carry out the procedure quickly and with the least risk.

How much does tooth extraction cost?

How much does tooth extraction cost?

Many patients ask the question: how much does tooth extraction cost and why do the prices for removal differ so much in different clinics? To answer this, we present you with a few defining points:

• diagnostics
• tools
• doctor's experience
• time allotted for the procedure

It is these nuances that determine not only the final cost of the operation, but also the positive result itself, which, if diagnosed correctly by an experienced doctor, is guaranteed.

Removal methods

There are two main types of extirpation - a simple removal method and a complex method.

Complex removal method

It is carried out in cases where there is no access to the tooth, application of forceps is impossible and additional access must be made through an incision in the gums. During a complex operation, the tooth is not removed immediately, but in parts.

For this, a whole set of special tools is used:

• laser,
• saw,
• scalpel,
• burs.

Complex removal may be indicated in the case of a cystic formation under the causative tooth, fistula, dystopic wisdom tooth, or retention. Contraindications to the procedure are pregnancy, allergies to anesthetic drugs, mental illness, problems with the endocrine system. But if certain conditions are created, extirpation can be carried out even in the presence of these contraindications.

Simple operation

This method does not require additional preparation; it is removed by applying standard forceps, after which the bleeding stops and further measures are taken to restore the dentition.

Molar tooth extraction procedure

The procedure will be the same in every dentistry. With high-quality modern equipment, the procedure is quick and painless. If a patient is afraid to have a tooth removed, then he must understand the consequences that such a decision will entail. One of them is pain, which may be stronger than after surgery under anesthesia.

Removal steps

How to pull out a molar, 8 stages of work:

1. Examination and diagnostic procedures.
2. Anesthesia of nearby areas.
3. Ligamentotomy.
4. Moving the forceps under the gum.
5. Dislocation.
6. Extraction.
7. Inspection and treatment of the resulting hole.
8. Stitching.

If the impacted figure eight is removed, then an additional tissue incision will be required. In this case, the gums are sutured after the molar is removed, and complete healing will take more time.

Until the next visit to the dentist, how the molar heals after removal should be monitored by the patient himself. If any unusual pain occurs, the dentist who performed the procedure should be contacted.

Anesthesia

Local anesthesia is necessary to increase patient comfort. It is inserted before the molar tooth is removed. But not all drugs have the same effect on the human body. Painkillers are divided into groups:

1. Application – suitable only for simple procedures. Not used when working with adults.
2. Infiltration – suitable for simple procedures, can be used to remove mobile incisors and molars.
3. Conductive – used when complex removal is necessary or for complex work. Allows you to block the peripheral branches of the nerve to cover a large area.
4. Intraosseous – the anesthetic is injected directly into the bone tissue, leaving the surrounding soft tissue sensitive.
5. Intraligamentary – mainly used when working with children.

When selecting an anesthetic, the doctor should always find out about the presence of an allergy to any compound in order to select the correct composition for anesthesia. Thanks to these drugs, the patient does not have to wonder whether it hurts to remove a tooth.

Is it painful to remove a tooth root?

Thanks to modern anesthesia methods, the procedure is painless. Does it hurt to have a tooth pulled out? No, and discomfort appears only after the painkiller wears off.

Recovery after deletion

In the postoperative period, additional care for the socket is indicated to prevent complications. Possible complications are associated with the wrong choice of technique, an error during removal, systemic diseases, and improper care after surgery.

Bleeding very often occurs after surgery, which the dentist can treat with hydrogen peroxide and socket tamponade. If bleeding continues, the dentist uses hemostatic drugs to stop bleeding from the socket.

At home, after removal, you need to treat the hole with antiseptic drugs - this means rinsing the mouth with weak antiseptic solutions. To relieve pain, you need to take medications prescribed by your doctor. Swelling, inflammation, and itching may occur near the hole of the extracted tooth - you should contact your dentist with these complaints, as this is a sign of infection or the development of periodontal inflammation.

Hygienic procedures after removal remain unchanged, but direct contact of the toothbrush bristles with the socket should be avoided. While eating, you need to cover the hole with cotton wool and then rinse your mouth with warm water and soda.

Surgical dentistry has moved forward in many ways in terms of the technologies, drugs and techniques used. Today, the risk of inadequate surgery is practically absent, and the dentition can be restored in many ways. Surgical dentistry is directly related to orthopedics, orthodontics, and aesthetic dentistry, so the patient does not have to worry about an aesthetic defect after treatment.

Painless tooth extraction.

For painless tooth extraction, local anesthesia . Therefore, there is no need to worry about pain associated with this procedure. In this case, the main thing is to follow several rules of the postoperative period in order to minimize discomfort and pain:

• After tooth extraction, do not drink hot foods
• do not mechanically impact the removal site (tongue, food, toothbrush)
• do not rinse, do not drink alcohol, minimize physical activity

Depending on the specific situation and the task at hand, one of the methods of tooth extraction is used:

• traditional removal (mechanical removal)
• atraumatic removal (using ultrasound)

In some cases, tooth extraction involves serious surgical intervention, when not one of the above-mentioned options in its pure form is impossible due to one reason or another. Before removing a tooth, experts recommend taking an X-ray or tomography.

Kodak Carestream CS9300

Let's start implanting the upper front teeth

a highly accurate surgical template

, individually made based on the CBCT image and using the 3D Shape intraoral scanner . Under the Straumann Bone Level SLActive implantation system, as part of a complete protocol for implantation of the upper anterior incisors.

Here you can observe the result of one-stage implantation of the front teeth; Straumann implants were installed. A bed for the implants was formed, which were installed in a strictly necessary position so that we could do aesthetic work not only on implantation, but also on further prosthetics of the upper anterior incisors.

You can see Straumann implants installed in exactly the right position

, as we planned. They are presented with the template removed. Bone biomaterial was placed in the sockets, which prevents the socket from collapsing in order to preserve the outer contour of the gum. In addition, in the area of ​​the tooth that had a fistulous tract (tooth 11), in the photo it is on the right, a collagen membrane was sutured. The membrane was tunneled and secured with a single suture to allow bone to form and mature normally in the socket.

Here you see the same implants, but in front view. You can clearly see how the collagen membrane was fixed, and it should be noted that in order for the work to be aesthetic on the one hand, and minimally traumatic on the other, mucosal detachment was carried out using the tunnel method

with further installation of the membrane.

Anesthesia methods

There are three methods of anesthesia:

• local using a spray;
• local injection into the gum;
• general anesthesia or anesthesia.

Local is used if the patient can remain motionless during manipulation. General anesthesia is indicated for people with severe mental illness, children, and sometimes adults who have a strong fear of the dentist.

Most patients are recommended to have local anesthesia injected into the gums around the affected area. If the patient is afraid of surgery, it is recommended that he take a sedative first. It is important to note that alcohol is contraindicated before removal.

Local anesthesia with a spray is carried out in cases where the tooth is loose, or for therapeutic purposes. Dental spray is often used to remove baby teeth in young children.

Sources

• Operative maxillofacial surgery and dentistry. Ed. V.A. Kozlova, I.I. Kagan. Year 2022.
• Delete operation. Tutorial. Author Bazikyan E.A. and others. Dentistry. Chapter 4. Afanasyev V.V. [and etc.]; Ed. V. V. Afanasyeva. Year 2018
• Dentistry. Chapter 4. Afanasyev V.V. [and etc.]; Ed. V. V. Afanasyeva. Year 2018
• Propaedeutic dentistry. Edited by E.A. Bazikyan, chapter 12.
• Biomechanics of removal surgery. St. Petersburg State Medical University named after I. P. Pavlova, Dept. surgical dentistry, Dept. medical and biological physics; [comp. Lisenkov V.V. et al.]

Attention!

This article is posted for informational purposes only and under no circumstances constitutes scientific material or medical advice and should not serve as a substitute for an in-person consultation with a professional physician.
For diagnostics, diagnosis and treatment, contact qualified doctors! Number of reads: 6164 Date of publication: 03/11/2019
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What are wisdom teeth used for?

Before deciding to undergo treatment and removal of teeth under general anesthesia or anesthesia, you should find out why our body “grows” them? Third molars, also known as "eights", are rudiments that erupt in approximately 50% of the world's population - so to speak, for old times' sake. And if only 10 thousand years ago it was definitely present in the oral cavity of every adult, then 15% of our contemporaries do not even have their rudiments.

Nature is systematically getting rid of “ballast”: during the evolutionary process that affected the structure of the jaw, the latter narrowed by as much as 10 cm in just 1 century, and this is not the limit. Doctors and scientists believe that this trend will certainly continue in the future due to the widespread spread of soft foods that do not require long chewing.

The third molars almost do not perform the function of chewing as such, because all the other teeth can easily cope with this. Controversial options for their use are as a support for a bridge, a restraining factor when neighboring teeth become loose, and as a backup option if other chewing teeth fall out with age. Then the wisdom teeth will show themselves in all their glory, taking responsibility for the chewing process. If, of course, they survive until then.

Modern people with healthy “8s” are rare. But since these teeth have grown and taken their place in the dentition, maybe you shouldn’t immediately resort to removing the wisdom tooth under sedation, but rather treat the tooth?

How is the nerve removed?

There are several ways to remove a nerve. Which one is needed in each specific case is chosen by the doctor in accordance with the clinical picture. The choice of treatment method depends on how damaged the tooth is and how deep the inflammatory process has penetrated.

Based on the results of the examination and examination, the dentist decides what kind of removal is needed: complete or partial. If the removal is partial, then the nerve is removed only in the crown part of the tooth, and the root is not affected. Partial removal of the nerve is used quite rarely; most often the dentist is forced to perform an operation to completely remove the nerve.