Wisdom tooth removal. Removal of a wisdom tooth on the lower jaw

Lower wisdom teeth form between the ages of 25 and 45. Due to the individual characteristics of the organism, these terms may vary: 8 can germinate at 15 years old and at 60.

Important: Since the eights do not have their predecessors - milk teeth, which prepare the gums for normal eruption, the patient experiences severe pain during the growth of wisdom teeth.

It is difficult to meet a person in whom the germination of the lower eights is not accompanied by unpleasant sensations. In most cases this is:

difficulty moving the tooth outward: pericoronitis;
trauma to the mucous membrane due to the inclination of the tooth, accompanied by stomatitis, and in the most extreme cases turning into a malignant tumor;
pressure on neighboring teeth and, as a result, their displacement;
the formation of numerous cysts;
severe destruction caused by caries.

If the figure eight is not removed during an orthodontic prescription, the bite may be disrupted, as well as problems with the jaw joints, which can subsequently affect the quality of life.

Considering these negative factors, dentists recommend removing wisdom teeth.

Important! In 12% of people, wisdom teeth do not grow in at all. Women often do not develop the lower 8s, while men do not develop the upper 8s.

Consequences of removing the eight

The upper eights are removed using ordinary forceps. But the bottom eights are treated differently. Due to the irregular shape of the tooth and the density of the bone tissue, it is impossible to carry out a correct clamp if the visible part of the crown is less than 25% of the total size.

Important point: A wisdom tooth has several roots (3-4), the bends and turns of which interfere with removal.

Before performing an extraction, the surgeon must order an X-ray examination, which will help eliminate errors and minimize the risk of complications after the operation.

If it turns out that the tooth has tangled roots or its growth has deviated significantly to the side, then the doctor will not use standard forceps, but resort to additional tools, connect a drill and apply sutures.

What complications arise after the removal of the 8th tooth?

After surgery, a large hole remains in the oral cavity with torn tissue around it. An infection can penetrate into it, which leads to inflammatory processes and severe pain.

Typical problems associated with the postoperative period when removing the lower eights:

heavy bleeding from the socket;
swelling of the cheeks and swelling of the gums;
alveolitis (inflammatory process inside the socket with suppuration of the walls);
strong pain;
stomatitis;
cyst formation.

There are cases when the cause of negative consequences is the inexperience of the surgeon. Doctors, using excessive force, tear the corners of the patient’s mouth, break the jaw, and damage the gums due to the slipping of the forceps. It happened that improperly processed instruments caused stomatitis, viruses and infections.

Important to know: Wisdom teeth have a good blood supply due to their close location to large vessels. Infections entering the hole of a removed figure eight result in serious consequences, including death.

Main types of complications

Heavy bleeding

When removing the figure eight, bleeding is a common symptom. This is due to the fact that the gum tissue of the tooth is abundantly enveloped in blood vessels. In this case, the bleeding may not stop for a long time; the gauze swab in the hole quickly becomes saturated with it and the patient, spitting, notices a rich scarlet color.

Important! The socket is capable of releasing blood not immediately after tooth extraction, but after 2-3 hours, because When removing, anesthesia containing adrenaline is used, which constricts small vessels. As soon as the effect of the drug wears off, the arterioles dilate, causing secondary bleeding.

Common causes of bleeding after extraction of tooth No. 8 from below include diseases associated with poor blood clotting, consumption of anticoagulants, and hypertension.

Secondary bleeding due to the destruction of a blood clot

When a tooth is removed, the blood in the socket coagulates, forming a clot, and the socket itself eventually becomes covered with a white coating. You shouldn’t be afraid of this, because such formations serve as a protective barrier against infections penetrating deep into the wound.

But sometimes, during inflammatory processes or mechanical interventions, the blood clot breaks. Its damage is associated with bleeding, which doctors call late secondary.

How to stop bleeding

There are several ways to stop bleeding at home:

hold a sterile piece of bandage or gauze swab over the hole with your teeth for 15-20 minutes;
if a regular tampon does not have the desired effect, soak the gauze with 3% hydrogen peroxide, which will promote blood clotting;
You can purchase a hemostatic sponge at the pharmacy, place it together with a tampon on the hole and press lightly.

If bleeding from the hole continues for a long time, then deterioration in health, low blood pressure, weakness and dizziness may occur, and sometimes the patient loses consciousness. In this situation, it is recommended to visit the doctor again or call an ambulance, since homemade herbs and lotions are ineffective.

Pain of various origins after removal

If you have a headache on the first day after extraction, this is normal. Headaches are a side effect of anesthesia.

If the operation site itself hurts, you should take painkillers, for example: Nurofen, Ketanov, Nimesil, Nise and others. Before ingesting or injecting, make sure you are not intolerant to these substances.

If the pain does not decrease within 1-2 days from the moment of removal, the body temperature rises, the mouth is difficult to open and a foul odor is felt, you should visit the dentist again.

Jaw nerve injury

It happens that during the extraction of the lower tooth No. 8, patients begin to experience paresthesia - loss of sensitivity in the part of the face on which the operation was performed. This complication means that the mandibular nerve is most likely affected. Although this happens only once in 1000 operations, the consequences of this pathology are quite serious.

The main symptom of nerve injury is that the patient does not feel touch to the affected area. This condition can drag on for weeks or even months. To speed up nerve recovery, physiotherapeutic treatment and drug therapy are required.

Interesting fact: There have been cases in medicine where paresthesia remained with a person for life.

Due to rupture of blood vessels, weak capillary resistance to damage, and increased pressure, a hematoma (bruise) may form in the affected areas. There is no need to panic at all, because the problem will go away in 3-4 days. Applying ice to the cheek helps reduce hematoma and severe swelling.

Alveolitis

Alveolitis is suppuration of the socket. Pus at the location of the figure eight is formed mainly as a result of an infection introduced by the dentist or in cases where a blood clot failed to form or was damaged by the patient. Sometimes alveolitis occurs when postoperative hygiene is not observed, even despite the fact that the operation was performed successfully.

Symptoms of socket inflammation:

painful sensations;
difficulty chewing food;
increase in local temperature;
gray or yellow plaque accumulated in the hole;
foul breath.

Treatment of alveolitis

If you start the progression of alveolitis, you will have to resort to repeated intervention in the socket. Then the dentist scrapes the cavity under local anesthesia and an antibacterial swab is placed inside. After the operation, it is important that a blood clot forms on the wound, which cannot be removed.

The following drugs are prescribed: antiseptics for washing the socket (furacilin, hexoral, stomatidine, miramistin and others), anti-inflammatory and analgesic drugs (nurofen, diclofenac, voltaren, ibuprofen, etc.), macrolide antibiotics, lincosamides, fluoroquinolones, etc. .

It is important to know: If treatment for alveolitis is not started in time, there is a possibility that the disease will progress to osteomyelitis, characterized by problems with opening the mouth, swelling of the cheeks and gums.

How to reduce pain and prevent complications after removal

To minimize pain after tooth extraction, doctors recommend:

if swelling appears at the site where the figure eight was removed, apply a wet tea bag (until it dries completely);
systematic rinsing with salt solution;
for throbbing pain, apply ice to the cheek;
if the pain intensifies in the evening, so you need to have painkillers on hand;
choose a high pillow for sleeping, which will reduce the likelihood of swelling;
do not eat hard or hot foods;
During the recovery period, avoid smoking and alcohol; it is better to swallow liquid through a straw.

It should be noted that possible complications after removing eights should not scare you. In most cases, surgical intervention is simply necessary. It will avoid tooth pressure on neighboring ones, relieve pain and possible mechanical damage to the cheek. In addition, any complications with proper treatment and good immunity will pass over time.

Video: Complications after tooth extraction

From this article you will learn:

how wisdom teeth are removed: photos and videos,
what are the complications?
wisdom tooth removal: price Moscow (for 2019).

The article was written by a dental surgeon with more than 19 years of experience.

At the end of this article, you can read reviews of wisdom tooth removal from a large number of patients left in the comments to the article. After reading about what the patients had to endure, it will become clear to you that the removal process itself is more scary than painful. But there is also pain, only it begins after the removal of the wisdom tooth.

Is it painful to remove a wisdom tooth?

The most common question you hear is whether it hurts to remove a wisdom tooth. The fact is that if you get to a good doctor who administers anesthesia correctly, pain is excluded. But there are times when patients still say that they were in pain. And as a rule, these patients had their lower wisdom tooth removed. And this is due to poor quality anesthesia.

For example, when a wisdom tooth is removed from the upper jaw, infiltration anesthesia is administered (into the gum in the projection of the roots of the tooth itself). But when removing lower wisdom teeth, anesthesia is not applied next to the tooth, but on the inside of the lower jaw branch. Such anesthesia is technically complex, and not all doctors know how to do it well.

How to remove a wisdom tooth -

Typically, removing an upper wisdom tooth is easier than removing a lower wisdom tooth. This is due to the fact that the lower eighth teeth often have massive curved roots or lie horizontally. In addition, the bone tissue of the lower jaw is much harder (than the upper), and therefore the roots of the lower wisdom teeth break off more often.

In cases where a wisdom tooth that has not yet erupted (i.e. impacted) is removed, an x-ray is required. In all other cases, the question of whether an image is necessary remains at the discretion of the dental surgeon. The removal process itself can be simple or complex, which will depend on –

how far the tooth has erupted
does it have a strong slope towards the 7th tooth or a horizontal position,
on the shape and number of roots,
from the skill of a dental surgeon.

Important : The last point is the most important if you want the removal to go smoothly. Of course, the shape and position of the tooth are important, but the extraction strategy the surgeon chooses is even more important. An inexperienced doctor may first pick your tooth for 2 hours before making the right decision to saw it and pull out each root individually. An experienced doctor will cut it right away, and the entire removal will take not 2.5 hours, but 15-20 minutes.

1. Simple wisdom tooth removal –

In the video below you can see how a wisdom tooth is removed in the lower jaw. If the removal is simple, then the entire removal process usually takes from 2 to 10 minutes (including suturing the wound). Before this, it will take another 5-7 minutes to wait for numbness to appear.

Important points that will allow you to avoid complications...

During the history taking –
the most important thing you should tell your doctor about is: allergies to medications, diabetes, bronchial asthma, problems with blood pressure, bleeding disorders, whether you are taking anticoagulants. If you took Aspirin within 1 week before, then this should also be mentioned, because it thins the blood and thereby contributes to the development of bleeding and the formation of hematomas.
It is very important for women to inform the doctor about their critical days. The fact is that during menstruation, the number of platelets in the blood decreases by 30-50%, and stopping bleeding depends on them. If this is not taken into account (and the doctor does not suture the wound), you can get severe bleeding, and not necessarily right away in the doctor’s chair, but later at home.

Carrying out anesthesia –
after injecting an anesthetic on the upper jaw, it is enough to wait 4 minutes for adequate pain relief, and for the lower jaw it takes 6-8 minutes. In our opinion, the best anesthetic for pain relief today is. It is practically irreplaceable for allergy sufferers, asthmatics, patients with blood pressure, as well as pregnant and lactating women.

Removal process –
simple removal does not involve making incisions in the gums or drilling out the tooth from the bone tissue. The tooth is rocked with forceps and removed. After extraction, a good doctor will always put the drug “Alvogel” into the socket of the extracted tooth, which will reduce the risk of development (inflammation of the socket of the extracted tooth). This common drug is available in every clinic.

Stitching –
After simple removal, doctors rarely close the wound. But a good doctor will always put stitches to bring the edges of the wound (mucous membrane) closer together, even after a simple removal. Studies have shown that thanks to this step, the risk of bleeding or clot loss from the wound is almost completely eliminated, in addition, the wound after removal will hurt significantly less, but most importantly, the risk of developing alveolitis is reduced by 70-90%.
Therefore, I advise you - even before removal, ask the doctor to put 1-2 stitches on you, even if you have to pay extra for it. Believe me, in the end, thanks to this, you will save yourself a lot of nerves and money on medications and repeated visits to the doctor (if bleeding or inflammation of the hole develops). For assignments after deletion, see the end of the article.

Simple wisdom tooth removal: video

Another cool video where the doctor shows excellent skills. Despite the fact that the doctor eats away the bone around the tooth with a drill, the removal takes less than 10 minutes and, in fact, is also simple (although in some private clinics you may be asked to pay for it as complicated). This is to the question that a good doctor is able to make a complex removal simple for the patient, but a bad doctor can easily turn a simple removal into a complex one...

2. Complex wisdom tooth removal –

In cases where the tooth has not yet erupted, or it has numerous branched and curved roots, or when the crown of the tooth is destroyed and there is nothing to grab with forceps, or the tooth has a strong slope or is in a horizontal position - all this suggests that removal may be complex. Before such removal, an x-ray must be taken.

After anesthesia, the doctor’s actions depend on the specific clinical situation, but usually complex wisdom tooth removal is accompanied by making an incision in the gum, drilling out the bone tissue with a drill and/or sawing the tooth into several parts (which are then removed separately), as well as mandatory suturing of the wound. The duration of complex removal can vary and range from 20 minutes to, in rare cases, up to 2 hours.

Complex removal of an impacted wisdom tooth (Fig. 4-8) –
(impacted teeth are teeth that have not yet fully erupted)

Operation description –
After anesthesia, an incision is made in the mucous membrane of the gum, and the edges of the mucous membrane are moved apart to expose the bone tissue around the tooth. Then, if necessary, the doctor uses a drill, which is needed to facilitate tooth extraction. When removing a wisdom tooth, it is often necessary to either drill out the bone tissue around it, or saw the tooth itself into several parts and pull them out separately.

Next, the wound is washed with antiseptics and the anti-inflammatory medicine Alvogel is placed in the hole. The fact that it was placed in your hole is always indicated by a specific iodine smell and taste. This medicine dissolves on its own after 7 days, i.e. you don’t have to remove it from the hole. After this, the wound is sutured. The suture material may be self-absorbing (within 7-10 days), or you will have to return to the clinic to remove the sutures.

Complex removal of wisdom teeth on the upper jaw (video 1) and on the lower jaw (video 2) –

Please note that in these videos, doctors use a drill or sonic handpiece to first saw through the crown of the wisdom tooth and only then remove the tooth piece by piece. As a specialist, I am pleased to watch the confident and high-quality work of my colleagues...

Important : It should be noted that after the removal of wisdom teeth, 25-30% develop (alveolitis) in the sockets of the extracted teeth. After tooth extraction from any other location, such inflammation develops only in 2-5% of cases. Read and see the article about how teeth sockets should normally look after extraction: →

How much does it cost to remove a wisdom tooth: price in Moscow

How much does it cost to remove a wisdom tooth: the price in Moscow will depend on the complexity of the removal, as well as on the pricing policy of the dental clinic. For example, the cost of wisdom tooth removal can differ significantly in public clinics and private economy class clinics - from the price in clinics of medium and high price categories.

In addition, in some clinics there may be a gradation of wisdom tooth removal only into simple and complex, while in others - into simple, medium complexity and complex. After analyzing the prices, we divided them into economy class clinics and clinics in the middle and high price segment.

Wisdom tooth removal: price in economy class clinics in Moscow

Simple wisdom tooth removal – 1500 rubles,
the cost already includes anesthesia, but if you need to apply 1-2 stitches, you will have to pay an additional + 500 rubles.

Removal of medium complexity – 3000 rubles,
This price includes anesthesia and suturing.

Complex wisdom tooth removal – 5,000 rubles,
This includes the removal of impacted and dystopic wisdom teeth. The price is already “all inclusive”.

The price of wisdom tooth removal in clinics of the middle and upper price segment is –

Simple removal - about 3500 rubles,
The price is already “all inclusive”, usually including even repeat inspections.

Complex removal - about 9,500 rubles,
This includes the removal of impacted and dystopic wisdom teeth. This price is also all-inclusive, including follow-up inspections.

Important : It is quite difficult for the patient to plan in advance how much it will cost to remove the 8th tooth. This will depend on many factors that are determined during examination, radiography, and sometimes even during the removal itself.

After a simple extraction, it is enough to perform after the tooth extraction. But what to do after the removal of a wisdom tooth, if the removal was difficult or was carried out against the background of purulent inflammation. To the standard recommendations in the link above, we recommend adding the following -

Antihistamines –
they are also called antiallergic. We recommend taking it (preferably Suprastin) once a day before bedtime in the first 3 days after a complex removal. The advantage of these products is that they help reduce the swelling of soft tissues, which will certainly develop after a complex removal.

Antibiotics –
Antibiotics after wisdom tooth removal should only be prescribed by a dental surgeon and not taken independently. Most often, dental surgeons are accustomed to prescribing (2 capsules 3 times a day, for 5 days). This is an inexpensive Russian drug, quite effective, but it has a strong effect on the intestinal microflora, killing all living things.
Another popular antibiotic in dentistry is Amoxiclav. For adults, it is necessary to use Amoxiclav tablets containing 500 mg of amoxicillin and 125 mg of clavulanic acid - 2 times a day. However, if you have had stomach upsets (diarrhea) after taking antibiotics, then it is better to opt for the antibiotic Unidox-solutab 100 mg 2 times a day for 5-6 days.
We recommend the latter option. And try never to take Russian antibiotics in your life if possible, if you do not want to develop pseudomembranous colitis. It would be better then to give preference to inexpensive Indian antibiotics.

Wisdom tooth removal: complications

As we have already said: there are much fewer complications if, even after a simple removal, the doctor always sutures the wound. Below we will also list all the main complications after wisdom tooth removal, which (we must admit) in most cases are the cause of the following doctor errors -

Wrong strategy –
inexperienced or lazy doctors try, if possible, to remove a wisdom tooth only with forceps and an elevator, sometimes torturing the patient for 1-2 hours, instead of immediately making an incision and sawing out a small amount of bone, or sawing the crown of the tooth into several parts, removing each root separately.

Poor instrumentation –
If you see that the doctor is using a chisel, then it is almost natural that you will then have complications (inflammation of the socket, pain in the temporomandibular joint, numbness of the lower lip due to nerve injury). Hollowing out is simply not acceptable.
Sawing of roots and bone should only be done with a water-cooled drill. However, many doctors use non-water-cooled handpieces for this purpose. This in 100% of cases leads to overheating of the bone and causes the development of inflammation of the socket, called alveolitis.

Incorrect assignments after deletion –
after any complex extraction, especially one involving sawing out the bone, sawing the crown of a tooth, and even after a simple extraction, but if the tooth was removed against the background of inflammation, it is necessary to prescribe antibiotics. Some doctors do not do this, resulting in inflammation of the extracted tooth socket after 1-2 days.

Complications after wisdom tooth removal –

Bleeding after removal –
sometimes bleeding does not develop in the doctor’s chair, but several hours after removal or even at night. There are special ones at home that help most patients.
If there is numbness in the lower lip –
this indicates injury to the mandibular nerve, which passes near the apexes of the roots of the lower teeth. In this case, you need to urgently contact a dentist and neurologist.

Inflammation of the socket of an extracted tooth –
this is the most common complication, which is usually called. Symptoms are aching pain, which can be moderate or moderate in severity. If after removal your pain/swelling does not decrease, but only increases, if you experience pain when cold or hot water gets on the wound, if there is an unpleasant odor from the socket, if there is no clot in the socket and food gets stuffed there - all this is typical for alveolitis .
What to do when there is severe pain after wisdom tooth removal - read the article.

Any patient may face the need to have a wisdom tooth removed. The reasons for this are improper eruption, insufficient space for its growth or complications in the jaw. A correctly performed removal procedure by a qualified dentist should not have serious consequences of an unpleasant plan.

Is it painful to remove a wisdom tooth from above?

Experienced dentists claim that removing the upper eights does not cause pain to the patient, unless this is associated with the development of a purulent process. Removal surgery is always difficult, so local anesthesia is used. If its action is not enough to complete the process, then the patient is given a pill to eliminate severe pain. During the process, pain may be felt, but it depends on the characteristics of the client himself: if he has been taking painkillers for a long time, then the anesthesia may not work.

How to remove eights

It is always easier to carry out competent removal of the 8th tooth from above than in the bottom row, because the upper roots are less strong and tortuous. The lower jaw has a denser bone structure, which makes the specialist’s work difficult. To carry out the process correctly, the doctor takes an x-ray, especially if an unerupted tooth, which may be positioned incorrectly, has to be removed.

After the image, the doctor examines the patient, determines whether he has allergic reactions, contraindications and concomitant diseases. This is done to select anesthesia, which begins to take effect after 4 minutes. The tooth is removed from the socket using special tools; there is no incision of the gum or drilling of tissue during a simple operation. The extraction time is 10 minutes. If there is inflammation, the doctor washes the wound with an antiseptic, treats it with an anti-inflammatory agent, and sutures the wound. The cost of removal is 2-3 thousand rubles.

Local anesthesia

Removal of the upper eighth teeth always takes place with local anesthesia injected into the gums directly next to the problem site. Dentists use the drugs Ultracain, Ubistezin, Septanest - they are modern, act faster and last longer than their Novocaine-based analogues. For purulent inflammation, these anesthetics are indispensable because they contain vasoconstrictor components that prevent infection from entering the blood during tooth extraction.

Tools

Special tools – forceps and elevators – help to extract the upper eighth teeth. First, forceps are used, applied to the tooth above the bone tissue of the alveolar process. The forceps have handles, by squeezing which the doctor will loosen the molar, removing it and destroying the ligamentous apparatus with which it is attached to the bone. It is difficult to get to a wisdom tooth, so bayonet-shaped forceps with a significant bend are used. To remove impacted molars and roots, elevators of straight, angular or bayonet types are used, which help to pull them out without problems.

Difficult removal of eights

To carry out a difficult extraction of the eighth tooth, which lasts several hours, complicated by strong roots, a damaged crown or the presence of a hood, the following steps must be followed:

examination, photograph;
injection with anesthesia;
an incision in the gum at the site of the problem - you need to cut the tissue with a scalpel;
drilling of bone tissue;
dislocation with an elevator or separation into parts with a bur or cutter;
inspection for the presence of fragments;
laying down medicine;
suturing.

What to do after wisdom tooth removal

change the bandage as recommended, but do not keep it on for more than 15 minutes;
Taking a hot bath, drinking alcohol, and smoking are prohibited;
you must not touch the wound, yawn, or open your mouth wide so that the stitches do not come apart;
on the first day, it is forbidden to rinse the mucous membranes with water, herbal decoctions or soda, unless the doctor prescribes otherwise;
You can apply ice to relieve pain and swelling;
it is forbidden to heat the area of the operation to avoid the development of a purulent abscess;
Take painkillers and prescribed antibiotics.

What can you eat

You cannot eat for the next 2-3 hours. During this time, you are allowed to drink warm drinks, but not hot ones. When the stitches are removed in a week, you can carefully eat any food, but avoid the surgical site. You can preserve the integrity of the wound by avoiding hard, spicy foods, those with small grains, those that get stuck in the dental spaces.

When can you brush your teeth?

If removal is difficult, you should not clean the enamel for the first day; it is also forbidden to use floss, mouthwash and toothpaste. All of these remedies can lead to healing complications. If you injure the surgical area, a blood clot may fall out, the stitches may come apart, and the wound will take a very long time to heal. For 3 days, it is better not to touch the extraction site at all, but to brush the rest of the teeth carefully with a soft paste, without spitting it, but replacing it with rinses with saline solution.

Complications

Serious complications can occur if your hygiene is poor, your doctor's recommendations are not followed, or the circumstances are difficult. In 20% of cases, alveolar osteomyelitis develops after removal; less complex cases include gum swelling, pain, and fever. If the remnants of the roots are not completely extracted, a fistula, gumboil, or cyst may develop with the formation of pus, and if the wrong instruments were used, neuralgia of the facial nerve may form.

How long does it take for gums to heal?

Patients may be interested in how long it takes for the gums to heal after the removal of the figure eight. The healing time is individual, but if the molar is large with crooked roots, the healing will be long. While waiting for the wound to heal, swelling, redness, and bleeding may appear, but if they do not subside for more than 5 days, it is worth visiting a doctor to eliminate it.

Healing may take longer because the anesthesia was incorrectly selected, the gums were damaged during the operation, or the technique was not ideal. The duration of wound healing is influenced by the individual characteristics of the person and the success of the process. The average healing time is from a week to a month, and the sutures are removed after 7-8 days. Bone healing at the removal site occurs after 4-5 months.

How much does your gum hurt?

After the anesthesia wears off, pain in the gums appears after 3 hours; it can be constant or intermittent, gradually subsiding on the 4th day. Painkillers will help make treatment easier. If the figure eight was difficult to remove, then the tissues around it take longer to recover, which increases the duration of pain to 10 days.

Alveolitis

The unpleasant consequences of removing the top eight include alveolitis. The reasons for its occurrence are:

chronic tissue inflammation;
periodontitis;
dry socket due to improper hygiene;
remains of shrapnel in the wound.

The hole becomes infected, inflamed, and painful. Indicators of the course of the disease include a special odor from the mouth, the appearance of a grayish coating, and very severe pain, leading to the inability to eat. If this disease is detected, you cannot try to cure it yourself - this can lead to inflammation of the periosteum, abscess, and phlegmon.

Video: removal of the 8th tooth from above

A beautiful, undamaged dentition is an indicator of the health of the body and has a positive effect on its appearance.

Unlike other bones, they are formed throughout life, which gives a person a lot of trouble.

Wisdom teeth or so-called “eights” are especially successful in this.

The material will discuss why wisdom teeth should be removed and what will happen if this is not done.

What is the problem with the "eights"?

For our ancestors, third molars were of great importance because they added capabilities and strengthened the structure of the masticatory apparatus.

Modern people no longer need this and, due to extra wisdom teeth, face a number of problems:

remote location makes preventive cleaning, including with a toothbrush, difficult;
Often, when cutting, pain and inflammation, headache or ear pain, and general weakness of the body appear;
“eights” can provoke displacement of other teeth;
neighboring “sevens” can become infected with caries;
During an examination, it can be difficult for dentists to identify problem areas and, accordingly, provide the necessary treatment in a timely manner.

Indications for preservation

Modern man has no functional need for third molars, but given the difficulties and troubles that they can cause, a logical question arises: “Why not get rid of the unnecessary “eight”?”

Unfortunately, not everything is as simple and harmless as it seems. Don't waste nature's gifts.

Reasons why wisdom teeth should not be removed may be as follows:

they can serve as an excellent support if suddenly the need arises to install a bridge;
in the absence of units that perform chewing functions, the “eight” can become the basis for a splint and partially take over this role;
molars serve as a kind of barrier and prevent the loosening of the dentition.

Need for removal

Why pull out wisdom teeth? You should get rid of it if the harm outweighs the benefit. For example, pain, numbness, inflammation, itching indicate problems in the masticatory apparatus, so it is better to consult a doctor immediately.

Only a specialist can correctly determine how much the root of a tooth is curved, how much its position deviates from the norm, and what the threat is to neighboring teeth and the entire body. As a rule, for such a diagnosis, a referral is made for an x-ray (panoramic image of the jaw).

It is the “eights” that, due to their inconvenient location, are more susceptible to caries and cyst formation. To prevent adjacent teeth from becoming infected, it is important to carry out regular and thorough cleaning of the oral cavity. However, brushing your teeth 10 times a day is not possible due to a busy person, and the enamel can also suffer from excessive friction.

Significant reasons why wisdom teeth need to be removed are the following problems observed in the patient:

the tooth has an incorrectly inclined position;
gums often become inflamed or bleed;
purulent gum abscesses are observed;
the tooth injures the tongue or cheek.

If the situation is advanced and the incisors and canines have already shifted, then removal alone is no longer enough; in addition, you will have to resort to the help of an orthodontist and correct the bite. In this case, difficulties with therapeutic treatment may arise. All specialists must coordinate their actions with each other.

The only thing worth considering is that it is better to remove the “eight” before the age of 20, when the bone is not yet hard enough. Then healing will proceed without serious complications after removing the “eight”, and recovery will be faster.

Incorrect position

Typically, all of a person’s teeth, except the “wise” ones, are cut in a vertical position.

That is why, in most cases, they begin to form incorrectly even in the gums in such a way that during germination they deviate from the given vertical.

Usually there are three positions: buccal-angular, horizontal and lingual-angular.

With proper vertical growth, the tooth does not cause any inconvenience, since it does not affect either the gums or the tongue.

If done incorrectly, a number of problems arise. The most unpleasant thing is horizontal cutting: the tooth cannot germinate, but increases in size, grows into the roots of its “neighbor”, causing not only pain, but also destroying the healthy neighboring tooth.

Dental displacement

Everyone wants to have a beautiful smile, however, if the incorrect eruption of the third molar is not noticed in time, then the formed main row will simply become deformed.

The teeth will press against each other, this is especially dangerous if you have a narrow jaw.

Due to cramped conditions and lack of space, the "eight" will look for free space for germination. The consequences are pain, abnormal growth process and a damaged smile.

Decay of an adjacent tooth

Third molars are dangerous neighbors. Quite often it is because of them that the patient has to say goodbye to the healthy person.

As already mentioned, there are two main reasons: incorrect position and caries.

With a horizontal deviation, the “eight” simply changes the trajectory of its growth and injures the root of its neighbor, completely destroying it.

With caries, the “seven” is also at risk, since due to the close proximity it involuntarily becomes infected, and in advanced cases is destroyed.

Pericoronitis

Another problem is pericoronitis - inflammation of the gum tissue when the third molar has not erupted or has not grown in completely. This happens due to the fact that food debris gets into a kind of “hood” on the gum.

It is difficult to clean them out, so the food begins to rot, causing swelling, pain, bad breath, and discomfort while eating. Sometimes the patient experiences an increase in temperature.

In advanced cases, the jaw bone is injured and the periosteum becomes inflamed. Pericoronitis damages not only the molars, but also the gums, where pus begins to accumulate. If upon examination a similar purulent capsule is found, then it is recommended to remove the “eight”.

When the third molar has not fully erupted, a void is formed between the crown and the gum, and this is where bacterial plaque accumulates. The consequences are the same: unpleasant odor, pain and swelling of the gums.

Carious process

Those who abuse simple carbohydrates quickly become familiar with caries.

The causes of the disease of “eights” are exactly the same as for everyone else – insufficient oral hygiene and accumulation of plaque.

Sometimes bad heredity also affects it, and if in the first case everything depends on the patient himself, then it is already difficult to prevent anything, you will only have to correct it. Fortunately, medicine, including dentistry, has stepped far forward.

So, when the “eight” is not completely cut, a “hood” is formed.

The caries process itself can occur without any special symptoms, especially in the early stages.

It can only be noticed by an unexpected reaction to cold, hot, or sweet food.

However, the unpleasant sensations pass as quickly as they arise.

A violation of integrity occurs, dentin (hard tissue) becomes light brown. The reaction to the stimulus will be felt precisely at the boundaries of destruction.

Video on the topic

And finally, a wonderful video about why it is necessary to remove a wisdom tooth:

Do you want to remove a wisdom tooth (figure eight): find out the consequences

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

Eights are shown in green.

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

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

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

In what cases should it be deleted?

Indications for wisdom tooth removal are:

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

Wisdom tooth with crooked roots

Reasons to keep wisdom teeth

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

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

Removal technique

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

The complexity of the operation often depends on where exactly the eighth tooth is located. The upper jaw is less dense, it contains numerous channels for the entry of nerve endings, and “eights” often have fewer roots. For these reasons, removal of a wisdom tooth in the upper jaw takes less time, and preoperative anesthesia is also easier. Removing a lower wisdom tooth is often painful, and its more curved roots create an obstacle during extraction.

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

The operation consists of several stages:

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

The duration of a simple extraction option is up to 40 minutes, while a complex one takes several hours.

Possible complications

Surgery is an injury that is often accompanied by inflammation, pain, swelling and fever.

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

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

Removal of the 8th tooth from above and below is often accompanied by alveolitis - inflammation in the socket. The reasons for its appearance: individual characteristics of the body, weak immunity, a fragment that was not noticed by the doctor, infectious diseases of the oral cavity, etc. Alveolitis poses a serious threat to health, so immediately consult a doctor if you identify its symptoms:

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

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

Removal of the eighth tooth from below

Article checked by doctor

The rudiments of most teeth in humans are formed in the prenatal period, and the last four, third molars, are most often formed after 20-25 years, but can erupt at the age of 17 and 40. According to medical statistics, 80% of wisdom teeth are born into the world with complications.

It is curious that 10% of people do not have such teeth at all: in women the lower eights do not form, in men the upper eights do not form. Sometimes (in about 0.1% of cases) another anomaly occurs: 6 third molars - 2 below and 4 on the upper jaw.

A person inherited this rudiment from his ancestors. With a refined diet, his jaw size is smaller today, so the developing eights often do not have enough space. You can prevent the sad consequences of improperly erupting “wise” teeth if you consult a dentist in a timely manner.

Removal of the eighth tooth from below

Difficulty removing the bottom eight

The structure of the lower jaw has its own characteristics; this creates many obstacles when removing third molars. If on the upper jaw they can always be loosened and removed with forceps, then on the lower dentition in 90% of cases this method does not work.

The bones of the lower jaw are so massive and dense that it is impossible to normally grab and swing a wisdom tooth. Moreover, if only part of it is above the surface of the gum, this is a standard situation with difficult eruption.

Even if the coronal part is developed and well preserved, it is problematic to loosen a tooth in a massive bone mass, because it, as a rule, has a branched root system with an unpredictable location in the jaw.

Curved 2-3 roots prevent the extraction of even a loose tooth. Therefore, a dental surgeon makes a diagnosis based on an x-ray.

Crooked tooth roots

Realizing the degree of complexity of the operation, he will plan it as accurately as possible in order to prevent all possible complications after the intervention. In addition to the usual forceps, the doctor has dozens of special tools at his disposal: he can saw the eight with a drill to remove it in parts or gouge out the roots with a chisel, extracting them with an elevator.

Indications and contraindications for the removal of lower third molars

In the lower jaw, figure eights require removal for the following reasons:

caries complicated by periodontitis, periostitis, osteomyelitis;
malocclusion with displacement of adjacent dental units (torsion is formed);
the figure eight interferes with the seventh tooth;
difficulties with teething (pericoronitis);
neoplasms at the roots (cysts, cellulitis, tumors);
changes in the structure and functionality of the lower jaw;
trauma to the mucous membrane due to the figure eight growing at an angle, causing the appearance of ulcers and oncological problems.

When is wisdom tooth removal necessary?

Extraction of the third molar will help avoid destruction of the dentition and jaw and prevent inflammation. In case of acute toothache, the figure eight is definitely removed.

In some cases, teeth can be treated and removal can be avoided

The operation is postponed for the following reasons:

progressive periodontitis;
inflammation of the oral cavity of an infectious nature;
heart pathologies;
acute respiratory diseases;
first and last trimester of pregnancy;
mental disorders.

If the inflammatory processes are eliminated, the figure eights can be removed. Sometimes the surgeon will recommend treatment if there is no adjacent seventh tooth and the third molar needs to support a bridge. If the tooth grows correctly, the patient intends to cover it with a crown; there is also no point in removing it.

Bottom Eight Extraction

By analyzing the image, the surgeon determines the number of roots of the molar, their location and linearity. He will also analyze the state of the neighboring seven. If the decision is made to undergo surgery, the doctor selects anesthesia based on the patient's response. Some medications may interfere with the recovery process, so you should tell your doctor about all medications you are taking.

Surgery on lower molars differs in complexity from removal of their antagonists. First, the area around the tooth is treated with an antiseptic. Local anesthesia is most often used. If the patient does not abuse alcohol or drugs, such pain relief is sufficient. For very complex operations, general anesthesia is also used.

If the figure eight has straight roots, they will try to remove it with forceps.

An impacted tooth, covered by soft and bone tissue, requires a different approach.

To gain access to the tooth, a flap of gum is cut off.
The soft tissue is separated from the bone.
Part of the bone covering the problem tooth is cut out.
Now you can grab the “wise” tooth with forceps and remove it.
The flap is returned to its place and stitches are applied.

A recumbent or partially impacted molar is removed in the same way.

The 8th tooth or wisdom tooth erupts at the age of 18-25 years. It received its name in connection with popular beliefs. It was believed that as a person approached 30 years of age, he became wiser. A total of 4 wisdom teeth appear: 2 on top and 2 on the bottom. In 8% of people they do not grow. The ancestors believed that this was due to the fact that a person had not accumulated enough life experience: wisdom never came to him. Modern dentists talk about evolution. The food people eat has changed. It became softer and more processed. The size of the jaw has decreased, and there is simply not enough space for wisdom teeth. This is a rudiment that was inherited from our ancestors.

Features of the G8

Wisdom tooth or 3rd molar ends the line of dentition. Its root is complex and can have up to 4 branches. This is one of the features of the 3rd molar.

Possible pathologies during teething

The extreme molars do not always erupt correctly and begin to grow upright. Dentists often encounter oblique tooth growth:

Pathology will be considered not only the incorrect inclination of the last molars, but also their insufficient appearance. Dentists determine full or partial retention wisdom teeth With complete retention, the molars do not erupt. They remain inside the jaw.

This may not be perceptible to a person. If he does not experience pain, no changes occur on the gums and other teeth, then the “eight” is not touched. Dentists recommend doing an orthopantomogram, a panoramic photo of the jaw, once a year. A complication of complete impaction of 3 molars can be the formation of a follicular cyst, which forms around the bones.

Partial retention of a wisdom tooth, when it has not fully erupted, is considered more dangerous. Wherein The following complications may develop:

inflammatory process in the gums and bones - pericoronitis: swelling of the gums, severe pain, fever, difficulty chewing and swallowing food; an abscess or purulent inflammation of the intercellular space of the face and neck, phlegmon may develop;
hygienic procedures around the “seven” are difficult: caries begins at the base, which is difficult to notice; it affects the root, although the crown may appear white; The 7th tooth has to be removed;
resorption of the hard tissue of the adjacent molar, resorption: leads to the loss of the “seven”;
formation of a periodontal pocket: inflammation of the jaw bone occurs;
injury to the mucous membrane of the gum or cheek: the injury becomes chronic and leads to the formation of a tumor;
protrusion of a paired tooth: it lengthens and disrupts the process of chewing food; the mandibular joint is blocked: the patient feels crunching, clicking and pain in the joint;

In some cases, wisdom teeth are removed, but dentists do not always make this decision. There are indications for treatment of the “eight” and contraindications for extraction.

Indications for removal

Despite all the prejudices associated with the wisdom tooth, it is recommended to remove it in the following cases:

Removing a wisdom tooth will prevent the development of unwanted inflammatory processes in the oral cavity, destruction of adjacent teeth and jaw bone. If a patient goes to the dentist with acute pain, then removal of a molar is inevitable.

Contraindications for surgery

Sometimes the doctor postpones the operation to remove the “eight”. In some cases, tooth extraction is contraindicated. The cause may be diseases:

periodontitis, if gum inflammation progresses; prescribe antibiotics, painkillers, reduce the inflammatory process; wisdom teeth are removed after gum treatment; gingivitis is not a contraindication;
heart disease;
inflammatory process in the oral cavity caused by a fungus or infection;
acute respiratory infections, influenza, ARVI;
1st and 3rd trimesters of pregnancy: tooth extraction only in extreme cases;
patient refusal to undergo surgery;
psychological imbalance or mental illness;

The dentist may decide to begin treatment of the wisdom tooth, if necessary. certain reasons:

absence of the “seven”: the “eight” can, over time, move the dentition and move to a free space; the linearity of the teeth will be preserved;
the patient wants to make a bridge in the absence of a “seven”: the 3rd molar can serve as a support for the “bridge”;
correct location of the wisdom tooth on the gum, simple structure of the roots;
caries develops on the upper surface of the crown, which is easy to reach with instruments;
the tooth grows without pathologies, the patient wants to install a crown on it;

Treatment or removal of a wisdom tooth without diagnosis is impossible. The dentist will definitely prescribe an x-ray or orthopantomogram: the image is digital and more accurate, the process does not affect the human body. Diagnostics allows you to determine number of eight roots, their linearity, location. From the image, the doctor will see whether there are any abnormalities in the adjacent tooth. After analyzing the orthopantomogram or x-ray, the dentist decides to remove the 3rd molar or begin treatment.

Removal of the 8th tooth

The operation to remove a molar is performed by a dental surgeon. He studies the patient’s condition, X-ray images, and selects an anesthetic to avoid the development of allergic reactions and anaphylactic shock. Upper molars are most often simply removed. The surgeon uses special forceps to grab the tooth, loosen it and pull it out of the gums.

The procedure for removing the 8th tooth

The lower jaw is more massive than the upper, the bone is denser, the roots of the teeth are stronger, which complicates the operation.

The area of the oral cavity where it is planned to remove the figure eight is treated with an antiseptic solution.
The patient is injected with an anesthetic using a syringe: wait 5-7 minutes for the painkiller to take effect: the cheek and tongue become numb, the patient does not feel anything. The anesthetic will have a bad effect if a person uses drugs, alcohol, or constantly uses painkillers in large doses. In some cases, the tooth is removed under general anesthesia.
If the tooth grows straight, the roots are not curved, then the surgeon grabs it with forceps, loosens it, and removes it from the oral cavity.

An impacted tooth requires some manipulation: it hidden under a layer of bone and soft gum tissue. After treating the patient’s oral cavity and injecting him with anesthesia, the surgeon must open access to the tooth. To do this he needs:

Removal of a recumbent or partially impacted wisdom tooth is performed in a similar way. To grab it with forceps or an elevator, it is necessary to open access for tools. The operation involves making incisions in the gums and drilling out the bone.

The duration of the procedure is about 30 minutes. During the removal of the figure eight, the patient will not feel pain. In place of the molar a big bloody hole. The surgeon will close it with a gauze swab, which is soaked in hemostatic and antiseptic agents. The doctor will definitely warn you about the consequences of the operation and give certain recommendations. The dentist can issue the patient a sick leave for 3-4 days for rehabilitation.

Consequences after removing the “eight”

The body will definitely react to a violation of the integrity of the tissue in the oral cavity. After removal of a wisdom tooth in the lower jaw consequences are inevitable.

3 days after tooth extraction, the patient visits the dentist for inspection and probing of wounds. If the gum tissue is restored without pathologies, then the sutures are removed on the 5th day.

To reduce complications

You can eat food 4 hours after the procedure: food should be fresh, soft, semi-liquid consistency; You can drink plain water right away: it should be at room temperature;
drinking alcohol and smoking is allowed the next day;
the patient will have to refrain from taking a hot bath;
physical activity must be avoided;
For the first 4 hours, ice should be applied to the cheek to reduce swelling and avoid hematomas: keep the ice for 5 minutes, break for 10 minutes;
Do not rinse your mouth or brush your teeth for a day;
You can take painkillers and other medications only on the recommendation of a dentist;

Wisdom tooth removal will take place without consequences if you follow all the doctor’s recommendations during and after the procedure. Cost of a simple operation - from 1500 rub. A complex procedure for removing the lower 3rd molar - from 3000 rubles.

Expert opinion

Removing a wisdom tooth in the lower jaw is one of the most difficult operations in dental surgery. European dentists have developed a technique that allows one to avoid complications during wisdom tooth removal and make the healing period more comfortable. This method is called ultrasound wisdom tooth removal using the PIEZOSURGERY system. Using this technique, the dental surgeon carefully separates the wisdom tooth without causing thermal injury to the bone tissue, which speeds up healing by 2 times and reduces pain in the postoperative period by 70%! Our specialists completed an internship in Germany in 2015 and since that time, more than 2000 lower wisdom tooth extractions using ultrasound have been performed at the Bionic Dentis clinic. This modern method is not yet widespread in Russia, but has received worldwide recognition as gentle and prevents complications.

Ozerov Petr Vladimirovich, chief physician of the Bionic Dentis clinic in Moscow, expert in the field of wisdom teeth removal.

Read on our website, an expert on wisdom teeth removal, in which you will learn about modern methods of teeth removal.