Wisdom teeth - when is extraction necessary?

Wisdom teeth can be a concern for many, so for a dentist, wisdom tooth extraction is a fairly common procedure. However, for the patient, this situation may seem quite frightening. In addition, the question "is it really necessary to remove a wisdom tooth?" In this article, we will give a detailed overview of this topic. You will find answers to these questions:

Why do wisdom teeth problems occur so often?
When is it necessary to remove a wisdom tooth?
How is a wisdom tooth removed?
What is the difference between removing an impacted wisdom tooth?
After removal - symptoms and recommendations.
Would you like to have your wisdom teeth tested?

What is a wisdom tooth?

The wisdom teeth are the very last molars, and are the 8th in a row. As a rule, the rudiments of wisdom teeth are laid in a person at the age of 4-5 years, and they erupt at the age of 14-25 years. However, each person is different - some may have wisdom teeth earlier, some later. In some people, they do not appear at all, which is not considered a pathology.

Wisdom teeth got their name precisely because they appear much later than the rest of the teeth, that is, when a person is already mentally developed.

Why do wisdom teeth often cause pain and inflammation?

Some people rarely have problems with wisdom teeth, while others may need to have a wisdom tooth removed. For some, teething wisdom teeth can be a long, difficult and painful process.

Wisdom teeth are considered a relic of the past. Today's man no longer eats so much meat, so the jaw has shrunk slightly, and for many, wisdom teeth no longer fit in the jaw arch.

In America, for example, it is customary to remove wisdom teeth immediately after eruption, since they are considered a rudimentary organ, that is, they have lost their meaning. The practice of our doctors varies - the wishes and well-being of the patient are at the fore.

What problems can arise:

Often, a wisdom tooth simply does not fit in the jaw arch. As a result, the tooth partially erupts or does not erupt at all (impacted tooth).

With incomplete eruption, the tooth is partially covered by the gum . This creates a pocket between the gum and the tooth surface, where food debris accumulates and microbes multiply. Partially erupting wisdom teeth are often the cause of pericoronitis , i.e., inflammation of the gums hanging over the tooth, which can be accompanied by the release of pus. This condition is very painful, there may be a sharp pain that radiates to the ear. The nearby lymph nodes may also become inflamed. There is pain when chewing, since the swollen gum above the tooth interferes with the closure of the dentition.

If there is no indication for tooth extraction, for the treatment of pericoronitis, the overhanging gum is opened and the tissues are cleared of pus, sutures are applied . Your doctor may prescribe anti-inflammatory and pain relieving medications.

Pericoronitis is an inflammation of the gums hanging over the wisdom tooth.

The second common cause of problems is the growth of a wisdom tooth in the wrong direction or its incorrect and non-functional position. In the upper dentition, teeth can more often erupt towards the cheeks, thus injuring the mucous membrane. The lower wisdom teeth quite often grow towards the adjacent tooth at an angle or even horizontally.

An erupted and misplaced wisdom tooth can damage adjacent teeth . It presses on a nearby tooth, which can change the position of the teeth and the bite.

An unerupted (impacted) wisdom tooth presses on a nearby tooth.

It is also possible the formation of a gap between the wisdom tooth and the adjacent tooth , where, due to the impossibility of normal cleaning, food debris and microbes accumulate. Subsequently, this leads to the formation of calculus and plaque, caries on both teeth and the development of gingivitis .

All for the same reason, the lack of space in the dental arch, the wisdom tooth can press on the nerve , causing pain or even loss of sensitivity.

Problems with wisdom teeth are often caused by difficulty in cleaning them . With daily brushing, it is difficult to give your back teeth as much attention as your front teeth. Since wisdom teeth are deep in the mouth, some people even have a gag reflex when brushing these teeth. Insufficient hygiene of the posterior teeth can lead to a deterioration in the microbiological condition of the entire oral cavity. Wisdom teeth may need to be removed to avoid further problems.

What you need to pay attention to and see a doctor

The tooth erupts for a very long time and the symptoms persist for more than a year;
The symptoms are strong;
The tooth remains framed by the gum.
In the event of such ailments, you should definitely consult a doctor who will help you choose the optimal treatment. Undoubtedly, regular checkups with a dentist will help to identify problems with wisdom teeth in time.

When is the extraction of a wisdom tooth necessary?

As a rule, the extraction of a wisdom tooth is indicated in these cases: There is not enough room in the jaw arch for the eighth tooth.
The tooth is cut for a long time, often causing severe purulent inflammation in the back of the mouth, that is, often recurring pericoronitis.
The tooth is strongly inclined or horizontal in the jaw.
The tooth presses on the adjacent teeth, causing damage and displacement in the jaw.
The tooth has erupted towards the cheek and injures the mucous membrane. In the meantime, there is no need to worry about it. ” In each case, the need to remove a wisdom tooth is decided by a specialist.

When can a wisdom tooth not be removed?

With full vertical eruption and the correct shape, wisdom teeth usually do not cause any special problems and are best left. Thus, there is an additional tooth in the jaw arch, which can be used in prosthetics as an abutment tooth . For example, you can attach a bridge to it or fix a clasp for a removable denture on it.

Extraction of a wisdom tooth

If a large part of the crown of the tooth is preserved and it is possible to capture it with an instrument, then the technique for removing a wisdom tooth is similar to removing any other tooth, except that access to the tooth is difficult.

Tooth extraction includes the following steps:
Preparation of the oral cavity - First you need to cure tooth decay and inflammation, do a baking soda and remove tartar.
Anesthesia - local anesthesia.
Extraction of a tooth with forceps.
Applying a tampon with an antiseptic to the well.
Is it painful to pull out a wisdom tooth?

Usually, wisdom teeth are removed under local anesthesia , but very rarely and in special cases under anesthesia. Modern anesthetics are effective, so there is no need to be afraid of severe pain during the procedure, rather the patient will feel slight discomfort. In most cases, one tooth is removed at a time, but at the request of the patient, several can be removed at once. In terms of healing, the procedure is easier to tolerate when one tooth is removed.

Removal of unerupted wisdom tooth

It is not necessary to remove a completely unerupted (impacted) wisdom tooth if it does not cause problems. However, you should check the situation from time to time during dental examinations.

If there is an indication for the removal of the impacted wisdom tooth, it will be a surgical operation that differs from the usual tooth extraction . The operation implies that an incision is made in the gum, sometimes the flap is removed from the bone and, if necessary, the bone covering the tooth is drilled. The entire tooth is removed or previously sawn into several parts. After the extraction of the tooth or fragments, sutures are applied.

After removing a wisdom tooth

Removing a wisdom tooth can be quite a traumatic procedure, after which you may experience:
swelling of the cheek
temporary temperature rise
soreness when opening the mouth and when swallowing.
These symptoms usually disappear within a few days. As a rule, healing after a wisdom tooth extraction takes about a week. In some cases, if there was an inflammatory process in the gum before the operation, the recovery may take longer.

When to see a doctor to make sure that there are no complications?

If a week after the extraction of a tooth, the state of health does not improve, but the pain, on the contrary, increases and becomes pulsating.
If the swelling persists for more than 3 days and increases.
Postoperative care recommendations:
Do not eat solid or hot food;
Do not heat the gums;
You can apply cold to the wound bleed less and reduce swelling (cold should be kept for about 10 minutes at intervals of 1.5-2 hours);
On the first day, it is better not to rinse your mouth or do it very carefully so as not to injure the wound site; Do not smoke or drink alcohol;
Do not brush your teeth for several hours after surgery.

How much does a wisdom tooth extraction cost?

The price of wisdom tooth extraction can vary depending on the complexity of the case, for example, it is influenced by the location of the tooth and the features of the jaw. Each case is unique, and therefore, you first need to come for a consultation with a dentist, who will select the best option for you (how to remove a tooth and whether to remove it at all) and will advise the price.

Can a wisdom tooth be removed with the help of the Health Insurance Fund?

The cost of removing a wisdom tooth may be partially covered by compensation for dental treatment. This can be done in those clinics that are partners of the Health Insurance Fund (the partner of the Health Insurance Fund is the Periodent Dental Clinic). The compensation is 40 euros per year, and the patient pays at least 50% of the costs himself. Read more about dental treatment compensation .