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Wisdom tooth extraction.

TOOTH EXTRACTION

Modern dentistry in many cases allows avoiding tooth extractions, unfortunately sometimes it is necessary to extract teeth.
Tooth extraction surgery should be done only as a last resort, when all other methods to save the tooth are impossible, or when the tooth can cause other, more serious complications.

Indications for tooth extraction

•    Acute stage of chronic periodontitis, when it is impossible to eliminate the inflammatory nidus at the tooth apex.
•    The tooth that can cause cysts, inflammation, or neuritis of the trigeminal nerve.
•    The tooth that constantly hurts a tongue or buccal mucosa, and also interferes with a normal bite.
•    Multi-rooted teeth that cause odontogenic osteomyelitis.
•    The teeth that are severely damaged by decay, and remedial measures will not bring a proper result.
•    Teeth that are affected by an advanced stage of a periodontal disease ("sore gums").
•    Tooth (root) fracture.
•    Misplaced teeth (e.g., impacted, completely submerged beneath the gum, wisdom tooth) or preparation for orthodontic treatment.

Before starting tooth extraction a dentist examines a patient's oral cavity, makes an X-ray of the damaged teeth and evaluates their state. A doctor must explain the essence of a surgical intervention to a patient and get their signed consent to the operation.

Before extracting the tooth, a surgical site is irrigated by an antiseptic. A doctor gives local anesthesia to the patient. Then a dentist separates a circular bundle from the tooth, applies tongue to the tooth root, loosens the tooth and extracts it. After that a doctor inspects the alveolar socket, squeezes the edges of the socket to make the size of the postoperative wound smaller and applies a gauze ball for 15–20 minutes. After a doctor has made sure that there is no bleeding and the socket is filled with a blood clot, they release the patient, giving the recommendations on the wound postoperative care.

WISDOM TOOTH EXTRACTION

If the problem tooth is a wisdom tooth, its extraction belongs to the class of complicated or highly complicated extractions.

The abovementioned reasons for tooth extraction are also valid for a wisdom tooth extraction, however, in this case there are some peculiarities.

Patients start experiencing problems with wisdom teeth on the stage of their eruption. They start erupting at the age of 18 to 25 (sometimes even much later), when tooth alignment is already formed by 28 teeth, which causes misplacement of wisdom teeth in the tooth alignment. Dentists use a term "submerged tooth", which is a tooth, which is not able to fully erupt and take its place in the tooth alignment. This can happen either because of a lack of space for the tooth in a tooth alignment or because the tooth has the wrong angulation.

In addition, incorrect position of wisdom teeth can cause damage to the adjacent teeth, putting pressure on them and causing root damage and resorption, as well as displacement and malocclusion. There are four wisdom teeth: upper left, upper right, lower left, and lower right.

Practice shows that the earlier you get rid of wisdom teeth, the less complications you can expect from them in the future. It is better to remove wisdom teeth when their roots are not yet formed, and the bone surrounding the wisdom tooth is not very dense, i.e. in late or early adolescence.

If a wisdom tooth has taken the wrong position or hasn't erupted fully, it leads to pericoronitis (inflammation of the tissues that surround the tooth), because part of the tooth remains under the gum and food debris get accumulated in gum pockets, which creates a great nutrient medium for various microorganism reproduction. Wisdom teeth are often affected by decay because food debris gets accumulated between a wisdom tooth and the second molar thus forming plaque, as it is difficult to clean up this space with a toothbrush. In this case decay affects not only a wisdom tooth but also its adjacent second molar.

What happens when wisdom teeth are extracted?

Most of the difficulties a doctor faces when removing wisdom teeth are caused by the position of the teeth in the tooth alignment. The further a wisdom tooth has cut through the gum tissue, the easier the tooth removal and subsequent tissue healing will be. You should not necessarily expect the worst. Some wisdom teeth are removed as easily as any other tooth. When examining the tooth before removing it, a dentist should tell you what you will face during the actual removal and subsequent healing.

If a wisdom tooth is affected by an active infection (e.g. pericoronitis), a dentist will usually advise you to defer removal and prescribe a course of antibiotics, usually lasting about seven days. Antibiotics can help to reduce the level of infection, which will make the removal process and the subsequent healing easier.

In order to remove a wisdom tooth a dentist first of all should provide access to it. If the tooth is under the gum and is covered with a bone tissue, it is necessary to cut the gum first, and then remove the bone area located above this tooth. In order to remove as little bone tissue as possible when extracting a wisdom tooth, a doctor often "divides" a wisdom tooth into pieces. Due to the fact that each of these parts is less than the whole tooth only a small opening is needed to remove this part from the bone covering it. Usually a surgery to remove the atypically located tooth is performed under local anesthesia.

Post-removal healing

The general rule is: the easier the removal procedure was, the faster and easier the healing will be. Since the degree of difficulty in removing wisdom teeth can be different - from the most complicated to the most easy removals, a dentist should tell you what is to be expected in your individual case.

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