A wisdom tooth is the 8th tooth in a row (figure eight) or 3rd molar, its eruption period is 17-25 years. This is a large molar, often with a complex root system. The peculiarities of its development and growth in most cases become the cause of various dental problems. Although the structure of the figure eight is characterized as an ordinary molar, its chewing function is practically absent. If a wisdom tooth hurts, it is rarely preserved. The figure eight is destroyed early, often erupts with a carious lesion, grows at an angle or in a horizontal position.
How can you tell if your wisdom tooth hurts?
Eights erupt much later than all the other teeth in the row, when the dentofacial apparatus is fully formed, and there is simply not enough space for a beginner. Due to the density of the gums and bone tissue, eruption is quite painful, accompanied by inflammation of the gums and damage to neighboring units. Pain during wisdom tooth growth is quite specific:
- Spreads along the jaw, extends to the temple, neck, head, ear, throat;
- around the figure eight there is swelling and redness of the gum tissue;
- due to pain and sore throat, swallowing is difficult;
- numbness of the jaw and severe pain indicate that the 3rd molar is growing crookedly, injuring the jaw nerve;
- it is difficult to open your mouth, especially if the wisdom tooth grows in the opposite direction from the jaw.
Each similar symptom indicates the presence of problems with the 3rd molar. You can temporarily relieve pain when wisdom teeth erupt with an analgesic. If the figure eights grow crookedly, the bite is disturbed, the cheek or gums are injured, they form in the bone tissue without erupting to the surface or appear only partially - they must be removed.
Difficulties that arise during the appearance of eights
| Pericoronitis. This is an inflammation of the gum tissue surrounding the visible part of the tooth. If you delay a visit to the dentist, purulent inflammation (abscess or phlegmon) may appear. Manifestation of pericoronitis: severe pain when opening the mouth or while eating, bad breath. In most cases, this disease occurs in 80% of people when the lower eights erupt. |
| Dystopia of the tooth. This is an incorrect position of the tooth in the jaw, that is, the eights can be located horizontally or at an angle. Over time, they begin to push against neighboring ones, leading to their destruction. Most often, dystopia is inherited. To avoid complications, it is recommended to remove dystopic wisdom teeth. |
| Retention. This is when the tooth has partially erupted or not erupted at all. If the tooth does not hurt and does not interfere with its neighbors, then it can be left. Conversely, if a tooth causes unbearable pain and destroys the roots of an adjacent tooth, then it should be removed. |
| Hidden caries . An affected wisdom tooth can cause caries to spread to other teeth; in this case, it is better to remove the tooth. |
Why can a wisdom tooth hurt?
- Non-standard eruption
- impacted teeth formed in the jawbone, not erupted completely or partially, can be positioned horizontally or vertically. When the figure eight is placed on the side, it puts strong pressure on neighboring units, causing acute pain. - Gum hood
– dense gums can prevent teething; a “hood” of mucous tissue forms over the wisdom tooth. Bacteria and food particles begin to accumulate under it, which cannot be removed when brushing your teeth. This area is constantly injured, inflamed, and painful. An acute inflammatory process often develops into a purulent one. - The molar is rotated
around its axis - the more pronounced the rotation, the stronger the impact on the dental nerve, which causes pain in the molar itself, the adjacent unit or the entire jaw. - The cheek hurts
due to a wisdom tooth if it grows in its direction. The pain intensifies when chewing, the mucous membrane of the cheek is constantly injured and inflamed. - Caries
- the localization of the 3rd molar makes it difficult to care for it; often it is cut already with carious lesions of hard tissues, which causes pain. The sensitivity of the tooth increases, it reacts painfully to temperature and chemical stimuli. - Cyst
- due to systematic injury to the gum tissue, the molar itself, a cystic formation may form at the neck. A wisdom tooth cyst is often accompanied by serious complications - inflammation of the periodontal tissues, pericoronitis, abscess, and destruction of bone tissue.
Also, the reason that the wisdom tooth began to hurt are various dental pathologies - pulpitis, periodontitis (acute, chronic), periodontal disease. Removing the figure eight is not always justified; the doctor decides this issue individually, depending on the clinical picture. First, a comprehensive diagnosis is carried out, the doctor determines the location of the roots, assesses the condition of the jaw bone, gums around the figure eight, and the entire dentofacial apparatus.
Indications for removal
- Pathological eruption of the figure eight (partial or complete retention, dystopia), accompanied by pain, chronic inflammation of the gums, destruction of adjacent molars, malocclusion, damage to the jaw joint and other problems;
- 3 molar has erupted outside the dentition, leading to crowding;
- inability to carry out treatment or prosthetics due to limited access to the dental unit;
- the presence of complications - cysts, granulomas, periostitis, periodontitis;
- orthodontic treatment - figure eights must be removed if they interfere with the installation of a corrective apparatus or prevent the teeth from taking the correct position when correcting the bite.
When do you need a doctor's help?
If the figure eight hurts, you should immediately consult a dentist. Consultation with a specialist is also necessary for pain of unknown etiology - squeezing, spreading over the entire jaw, occurring when chewing or opening the mouth. After examination and diagnosis, the doctor will decide what to do next with the molar. If the growth of a wisdom tooth is accompanied by swelling, redness of the gums, and acute pain, the doctor will prescribe anti-inflammatory therapy.
If eruption is difficult due to the gingival hood, an operation will be performed to excise it and drug therapy will be prescribed.
Wisdom teeth removal methods
The intervention tactics depend on the location of the 3rd molar, the degree of exposure to the gum surface, the number of roots, their confusion, and the position of adjacent teeth. Removing figure eights on the upper jaw is easier than on the lower jaw. This is due to the structure of the jaw tissue - the maxillary bone is looser, more airy, the mandibular bone is more massive and dense. Additionally, mandibular eights tend to have more tangled and developed roots.
According to the clinical picture, removal can be simple or complex. A simple extraction is performed like any other extraction - the molar is rocked with forceps and removed from the socket. Complex technology includes:
- gum incision;
- drilling a molar or sawing it into fragments;
- removing each fragment one by one;
- suturing the wound.
Stitches are removed on days 5-7
after the intervention (self-absorbable suture material can be used). The operation is performed under local anesthesia; removal under sedation (during medicinal sleep) is possible.
Treatment of wisdom teeth during pregnancy has its own nuances. Usually, the doctor limits himself to conservative therapy aimed at eliminating pain and inflammation. If possible, removal is performed after childbirth. The operation is carried out according to strict indications, if the inflammation has become purulent and threatens the health of the mother and child. For anesthesia, special drugs are used that are safe for the fetus.
At the RUTT clinic, the removal of a wisdom tooth with a complex root system and location is performed by experienced maxillofacial surgeons. This eliminates surgical complications - extensive trauma to the bone structures of the jaw, perforations, wandering root remains, postoperative fistulas, osteomyelitis, etc. Only maxillofacial surgeons have enough skills and experience to perform such interventions without complications.
In what cases is it better to remove a tooth?
Old school dentists insist that at the first discomfort of the patient, wisdom teeth should be removed without regret. Modern dentistry is more humane and is convinced of the need for strict indications for the procedure, rightly noting that in due time “eights” may become the only possible support for dentures.
Indications for removal are:
- eruption of the third molar outside the dentition;
- threat of displacement of adjacent teeth;
- abnormal position of the crown and pressure on the second molar;
- impossibility of therapeutic treatment of the tooth.
Today, at the first visit with complaints of pain caused by the “eight”, the dentist first takes an x-ray to examine the position of the roots, the shape of the tooth and its condition. And only then evaluates all the risks. With this approach, a wait-and-see tactic is increasingly being chosen: the doctor selects painkillers that will help survive the pain that is natural to the teething process. If necessary, incises the gum and cuts off the hood. And then for several months he observes how the wisdom tooth will behave.
Dentists of the Israeli school even fight for impacted wisdom teeth, pulling them out and putting them in the right place with the help of orthodontic instruments. The main thing is that there is enough space in the patient's jaw.
Is it painful to have a wisdom tooth removed?
26% of operations to remove “eights” are no different from the removal of other molars. The wisdom tooth is simply pulled out using hand forceps after local anesthesia is administered. In this case, the patient, as a rule, does not even have time to get scared, the whole procedure goes so quickly.
Another thing is difficult removal. This operation can last up to 40 minutes, during which the surgeon saws the tooth with a drill and takes it out in parts. Unfortunately, this is the only way to remove a tooth that lies horizontally, or has frozen in its development, and has not erupted, but due to its location causes constant pain.
And even in this case, modern anesthesia can completely relieve pain. The same applies to the recovery period. First, in most cases, the surgeon will stitch up the resulting wound, speeding up the healing process. Secondly, he will prescribe painkillers for the coming days. Therefore, you should not be afraid of removal - it will cause much less pain than regular exacerbations.
Recovery after surgery
The removal of the figure eight itself is painless, since it is performed under anesthesia. But due to injury to the gums and bone socket, after the anesthetic wears off, the figure eight, or rather the periodontal tissues, hurt for several days. Painful sensations after a simple removal usually go away within 2-3 days, after a complex one they can persist for about a week. On days 2-3, swelling increases, which subsides after 2 days and the pain subsides. After the intervention, the doctor gives recommendations regarding care, nutrition, lifestyle, and prescribes drug therapy - antibiotics, painkillers, anti-inflammatory drugs, antihistamines.
How to relieve pain?
At the first unpleasant sensations from a growing wisdom tooth, frequent rinsing with Chlorhexidine, Miramistin or Eludril solution helps. If you can’t run to the pharmacy, you can prepare a soda-salt solution: dissolve 1 teaspoon of soda and salt in one glass of warm boiled water.
Supporters of traditional methods can use oak bark, sage and chamomile. To do this, you need to take 3-4 tablespoons of the mixture, composed in equal proportions, and pour 500 ml of boiling water. Leave for an hour and strain before using.
Rinses are effective only if the pain is caused by the natural process of tooth eruption. All of the listed drugs, both pharmaceutical and home-made, relieve swelling well and suppress the activity of pathogenic microflora in the oral cavity.
If symptoms of an attached infection have already developed: fever, swelling, severe swelling, surgical intervention will most likely be required: removal of either the hood or the tooth itself. In order to reduce the risk of complications, the doctor will definitely prescribe antibiotics.
Please note: it is strictly forbidden to prescribe antibiotics to yourself!
But painkillers should be taken before visiting the doctor. In this case, the following are effective:
- Broad spectrum analgesics
. Analgin, Ketanov, Paracetamol relieve pain for several hours, usually from 1 to 5. It is also possible that the tablet will not work at all. You can increase the dose, the main thing is to strictly follow the instructions. - Anti-inflammatory drugs.
Nurofen, Ibuprofen, Diclofenac can not only provide a powerful analgesic effect, but also relieve fever and reduce swelling. - Ointments, gels, sprays for topical use
. Holisal, Metrogyl Denta, Kamistad, Angilex “freeze” any sensations in the sore gum for 2-3 hours.
An ordinary piece of ice relieves pain well. It needs to be wrapped in a cloth and applied to the external projection of the diseased tooth on the cheek. Hold for no more than 5-7 minutes. Do not put ice directly on the gum. Its tissues are too delicate and direct contact can lead to necrosis.
The most original folk method of getting rid of toothache when a wisdom tooth comes out: take a plantain leaf, wash it and roll it into a tube. Then you need to insert the sheet into the auricle, but always on the side on which the tooth hurts. Dentists call such methods useless. But this method does not cause any harm. So why not try?!
