Wisdom teeth rarely bring problems to anyone. When pain occurs, the question arises: remove or treat the figure eight, and what should be done in such a situation. The eruption of the last molars occurs in adulthood, when the formation of bones and soft tissues has already been completed, which is why the advancement of eights is accompanied not only by pain, but also by inflammation.
Most people with problems with these teeth want to get rid of the discomfort as soon as possible and go to the surgeon. But this is not the only way out of the situation. The wisdom tooth is subject to treatment and restoration. But when is it better to part with him, and in what cases to engage in therapy?
Problems of eruption of eights
Difficulties in the treatment of wisdom teeth are often due to the atypical location of the root canal system, which makes it difficult or even impossible to properly process and seal them. It is for this reason that one should treat the therapy or removal of the figure eight with an understanding of the issue.
Many patients of dental clinics point to difficulties that begin at the moment of eruption of this tooth and cause trouble after that.
- Pain when the figure eight comes out of the gums.
- Difficulties with daily cleaning even of a healthy tooth.
- Food jam.
- Frequent inflammation of the mucous hood.
Wisdom teeth are cut in adulthood, which causes many problems due to various factors:
- difficult eruption - the process is often complicated by a lack of space in the corner oral cavity, so the tooth has to "push" the neighboring ones in order to provide itself with space. In addition, the figure eight grows at the age when the growth of the jaws stops, due to which the bone tissue becomes dense, which makes it difficult to move;
- dystopia - the wrong orientation of the tooth in the bone, which is quite common. The figure eight can be tilted in any direction, lie in a horizontal plane, or grow with a crown part in the direction opposite to the gum.
- caries - due to the impossibility of proper hygiene, around the last tooth there is an accumulation of deposits of food and plaque, which contributes to the growth of the activity of pathogenic microbes and leads to the destruction of hard tissues. Sometimes wisdom teeth erupt already affected by caries;
- retention - the location of the tooth in the jawbone or under the gum, which can be complete or partial. The figure eight in this position may not cause trouble, but often it presses on the neighboring seventh, which leads to the resorption of the roots and the appearance of hidden cavities. In addition, the wisdom tooth sometimes causes severe headaches that can radiate to the temple or ear. In such a situation, medical intervention is required;
- pericoronitis - inflammation of the gingival pocket covering the coronal part. It occurs due to food residues getting under the hood, and the inability to completely remove them leads to decay and inflammation of the soft tissues;
- deformation - the growing last molar is faced with a lack of space, so there is pressure on the neighboring ones, leading to crowding of the teeth;
- strong pain - main reason, forcing to seek help from a doctor. When the figure eight cannot cut through the thick layer of the mucous membrane, this causes excruciating pain, which can only be eliminated by making an incision in the gum and freeing the way for the tooth.
There are a lot of points "for and against" in the issue of pulling out the eight. The decision depends on the degree of destruction, the presence of inflammation, the impact on adjacent teeth, as well as on the state of human health.
Third molars have no functional value if they are not involved in chewing, but sometimes this is the patient's only chance for fixed prosthetics. When a piece of the crown has broken off, do not rush to make an appointment with the surgeon, because if the canal system is in good condition, as well as the possibility of full access, the destroyed tooth must be restored with a pin design.
- With hypertension of the second or third degree without examination by a cardiologist.
- The need for anesthesia during the removal of the figure eight does not allow you to risk the health of the unborn baby during pregnancy.
- With the growth of the tooth in the area of malignant lesions.
- If less than three months have passed since the heart attack.
When can a wisdom tooth be saved?
In certain situations, it makes sense not to remove, but to leave the problematic molar, because it can still be useful, and also play an important role in choosing the method of orthopedic treatment. If you decide to leave the eight, ask the doctor if such teeth are treated in the clinic of your choice, and also inquire about the appropriateness of therapy in your particular case.
Wisdom teeth should be treated in some situations:
- the eight is necessary as a support - with the missing adjacent molars, the tooth remains the only one on which the bridge can be fixed. When it is removed, there is the option of implantation or removable prosthetics;
- the tooth is located correctly in a row - the figure eight is involved in the chewing process and has an antagonist, does not injure soft tissues, therefore, therapy allows it to be preserved and prevent the protrusion of the contacting tooth of the opposite jaw (Popov-Godon phenomenon);
- pulpitis pain - when a diagnostic image reveals convenient location pulp chamber, while the channels are not curved and are contoured to the very top of the root, endodontic treatment is possible;
- periodontitis - when a destructive focus is found in the apical zone, the tooth sanitation continues for a long time period, and a favorable outcome is possible with good endodontic access and high-quality processing of the canal system.
In what case should the eight be removed?
In certain situations, it is necessary to think about whether it is worth leaving a problematic tooth and whether there will be any benefit from treatment, because sometimes its safety can not only be impossible, but also be harmful to health. In most patients, figure eights initially have more fragile enamel, and sometimes erupt with already lesions.
In addition, the extreme molars are not always available for a high-quality medical examination, which is why carious cavities remain undetected on early stages. Further, infection of the pulp and periapical tissues develops rapidly, which causes sudden severe pain.
Basic prerequisites for the extraction of the eighth tooth:
- atypical position - when the crown is tilted to the side, there is no participation in chewing food, and when the axis of the tooth is shifted towards the cheek, this contributes to frequent biting of soft tissues;
- little room to cut - when the figure eight is cut in conditions of insufficient space, it puts pressure on the front standing teeth which causes them to become crowded. To prevent bias, it is recommended to remove the source of the problem;
- full retention - with severe pain an impacted molar located in the gum is required surgical intervention;
- negative impact on the adjacent tooth - often the figure eight grows at an angle, because of which it rests on the seven and can cause both the destruction of the crown and the resorption of its roots;
- a high percentage of destruction of the crown part - if the tooth is so affected by caries that it is not possible to put a filling that will meet the quality criteria, then it is advisable to part with it;
- pericoronaritis - when inflammation of the gums surrounding the tooth cannot be removed by excision of the mucous hood, pus forms there, and bone destruction around the source of pain is determined on the x-ray, then the only way to stop the further spread of the process is extirpation;
- abscess - the development of apical periodontitis is often accompanied by the addition purulent infection with the formation of a cyst at the top of the tooth. Due to the impossibility of good channel processing and the release of infiltration, the figure eight must be removed.
Video: wisdom tooth - remove or leave?
In cases where it is impossible to save your teeth, you have to agree to the extraction of teeth and tooth roots. About how the removal occurs without pain of the upper and lower teeth and roots, in which cases it is necessary to remove a tooth under anesthesia, is it possible to install an implant at the same time, what are the prices for this in Moscow, whether prophylaxis is required after tooth extraction, you can find out in this article.
In what cases is a tooth removed?
In connection with the development of new materials and technologies for dental treatment, implantation and prosthetics, indications for the extraction of teeth and roots are constantly decreasing. However, when the degree of tooth decay and environmental bone tissue is such that there is no other way, the clinical experience of doctors systematizes the following main reasons for removal:
Tooth extraction, photo
How to remove a tooth without pain?
Few people calmly relate to the fact that it is necessary to pull out a tooth. After all, the sensations during and after removal cannot be called pleasant. The removal of a tooth and its roots in Moscow or a small regional center of Siberia causes similar negative emotions. What to do?
In our time, thanks to the development of pharmacology, powerful painkillers have been created for the painless removal of teeth and roots. Modern anesthesia and anesthesia during tooth extraction make this manipulation quite tolerable. The most widely used compounds for ambulatory dental anesthesia. These are drugs based on articaine and mepivacaine, which have a strong and long-lasting effect, for 3-5 hours. With the injection of such drugs, any tooth can be removed without pain, including the third molar or, in other words, the wisdom tooth.
For a painless puncture of the gums, application anesthesia is used in the form of a spray or gel, which is applied to the gums at the site of the intended injection. Main active substance in the medicine is a 10% solution of lidocaine.
For very fearful patients, outpatient sedation is provided, which allows you to calmly survive all the medical manipulations of a dental surgeon in a comfortable half-sleep. After removing a tooth in this way, there are no bad memories.
Extraction of teeth under anesthesia
Extraction of teeth under general anesthesia in Moscow and other large cities is becoming increasingly popular. The cost of this service is gradually decreasing. Tooth extraction and anesthesia are not necessarily related concepts. However, the most common variant of dental sedation or anesthesia is the removal of wisdom teeth under anesthesia, in a dream. It does not matter which anesthesia is better for tooth extraction, because the patient is in an anesthetic sleep and does not feel anything.
In some special cases, especially those who are allergic to local anesthesia, dentists perform tooth extraction under anesthesia or sedation. As a rule, this is not required even with multiple removal of roots or crowns, but in some cases, for example, with dental phobia or simultaneous removal and bone grafting, anesthesia is indicated.
Anesthesia means that the patient is in a drug-induced sleep, with a complete blackout of consciousness. Additional blood tests and ECG are required for induction into anesthesia. In Moscow, the cost of 1 hour of anesthesia for dental extraction starts from 8 thousand rubles.
Extraction of teeth, video
Pulled a tooth, what to do
In life, there is often a situation when you need to remove a tooth urgently. If you need to remove a tooth in Moscow, this can be done day and night, in round-the-clock dentistry. Thus, finding a clinic where you can extract a tooth without pain is not a problem. In most cases, 5-10 minutes after your tooth has been extracted, you will be able to see the extracted tooth in the surgeon's dentist's tray.
It is much more important what will remain in place of the pulled out tooth, what to do after the tooth is pulled out, what medications to take and how long the wound heals after tooth extraction. Gum treatment after traumatic tooth extraction may take several weeks.
Wound after tooth extraction requires proper care. An experienced dentist will always give recommendations after tooth extraction, following which the healing of the gums will pass quickly, without complications.
Standard procedures after tooth extraction include:
- anti-inflammatory drugs after tooth extraction (suprastin or analogues)
- antimicrobial medicine after tooth extraction (antibiotics or sulfa drugs, nimulide, amoxiclav or rulid)
- antiseptic rinse, if a purulent process has already occurred with a flux or abscess
- tamponade of the well (if necessary)
- recommendations for food intake and return for re-examination
Removal of upper teeth
When removed upper teeth there are the following features:
- Bone upper jaw looser than on the bottom, so most often when anesthesia requires less anesthesia.
- In the region of the posterior upper teeth, there are the boundaries of the maxillary cavity, near which the roots of the upper molars may lie. It is necessary to take into account such a complication during tooth extraction as pushing the roots into the sinus, with perforation of the Schneider's membrane and the development of odontogenic sinusitis.
- Removing the molars of the upper jaw requires a very careful attitude. How is a root tooth removed? The upper molars have 3 roots, so when removing them, you need to especially carefully loosen the first and second molars. The relatively simple removal of the upper incisors and canines is explained by the fact that they have only one root.
- The likelihood of edema and hematoma, ceteris paribus, is higher after the removal of the upper posterior teeth, compared with the lower ones.
Extraction of lower teeth
When removing the lower teeth, there are the following features:
- Considering that the bone mandible denser than on the top, most often it takes more time and anesthesia to completely anesthetize the surgical field. Complex removal teeth, with separation of the roots, often have to be done with the lower molars.
- After traumatic removal of the lower rotten teeth, the loss of bone tissue in the lower jaw is greater than in the upper, all other things being equal.
- When the lower molars are removed, the swelling that occurs in the area of the surgical wound leads to a limitation of mouth opening and pain when swallowing for several days.
The removal of tooth 6 from below happens most often, and this is due to the fact that it appears first in a permanent bite, therefore it is more susceptible to caries and its complications, leading to the complete destruction of the first lower molar.
Removal of the root of the teeth
Situations when a tooth was pulled out and the root remained are not uncommon. How is the root of the tooth removed, in what cases is it required?
Removal of a rotten tooth root, with a cyst or granuloma is done in the following cases:
- with root caries
- if it is impossible to unseal the root canal to install the inlay and crown
- with root mobility of 3-4 stages
- in the presence of a growing granuloma or cyst
How is a tooth removed if only the root remains? How difficult is it to remove the root of a tooth?
To implement this manipulation, certain conditions are required:
- Sufficient bone density and mineralization
- Sufficient bone volume
- Specially designed implants
- Auxiliary bone - active substances, osteogenesis stimulants
Carrying out such an operation allows reducing the number of operations from three to one, as well as speeding up dental prosthetics by half.
Tooth extraction - price in Moscow
How much does it cost to pull out (remove) a tooth?
Given the mass nature of this manipulation, it has social significance and is included in the package of services paid by the state. Therefore, in Moscow state dental clinics, the removal of roots and teeth is free of charge.
Paid tooth extraction in Moscow allows you to get some benefits:
- complete anesthesia
- sparing extraction of teeth with preservation of bone walls for subsequent implantation of teeth
- Possibility to perform multiple extractions of teeth under general anesthesia and sedation
Many patients are interested in how cheap it is to remove a tooth in Moscow? Is tooth extraction cheap? Is it safe?
You can remove a tooth for free or cheap in Moscow either in the district dental clinic, to which you are attached, or at the Department of Surgical Dentistry at the Medical University, where students will remove the tooth, under the supervision of teachers.
In commercial clinics in Moscow, turnkey prices for dental extraction (removal of roots and teeth) start from 2000 rubles per tooth or root.
All manipulations are performed under local anesthesia. Thanks to modern painkillers, manipulations do not cause any pain.
When should a tooth be removed?
When the tooth is not subject to therapeutic treatment. Only a doctor can determine whether it makes sense to treat a tooth, or whether all therapeutic measures will not lead to a cure for the tooth. First of all we are talking about those teeth that are destroyed to the level of the gums and are the focus of chronic inflammation. If the tooth cannot be treated, then it must be removed, since, leaving it in the oral cavity, the patient must understand that this is a “time bomb”. Someday the tooth will still hurt. Only over time, it will collapse even more, and its removal will be more difficult.
Teeth are also removed for orthodontic indications.
In cases where orthodontic treatment without the removal of some teeth will not lead to the desired result.
In case of periodontal disease, it is also necessary to resort to tooth extraction.
With progressive periodontitis, when periodontal operations are powerless, it is more correct to remove the tooth. Remaining in the oral cavity, such a tooth will cause suffering to the patient, and create conditions for strengthening inflammatory process in the periodontium.
Separately, I would like to talk about the "Teeth of Wisdom".
As you know, third molars appear at different ages. As a rule, this happens when the dentition is already fully formed. Very often they do not have enough space, and the teeth change their position, erupting not in the dental arch, but with some deformation. Difficulties in the hygiene of these teeth are associated with this, so they are destroyed faster, although they appear last.
Is it always necessary to remove wisdom teeth?
Our doctors will answer you - no, not always.
In the event that the teeth have erupted in the dental arch and access to them is not difficult, such teeth are subject to treatment.
If the tooth is dystopic (its position is disturbed) and impacted (for some reason it did not erupt completely) and access to it is difficult, then such a tooth should be removed.
Leaving it in the oral cavity, we create conditions for the development of a chronic inflammatory process, which can lead to the loss of not only this tooth, but also the neighboring one.
Reminder to the patient after tooth extraction.
It is necessary to refrain from eating for 2 hours after removal.
Do not rinse the hole unless your doctor has told you to.
Do not take a hot bath and do not visit the sauna and steam bath to avoid re-bleeding.
What are the possible complications after tooth extraction?
Bleeding from the hole.
If the bleeding does not stop after the extraction of teeth and continues for more than a few hours, you should consult a doctor.
Alveolitis - inflammation of the socket of the tooth.
If you are concerned bad smell from the hole, and pain appeared, be sure to see a doctor.
Even if the removal went well, further healing depends largely on the patient. Only the exact implementation of all the recommendations of the doctor will avoid complications. If you have any questions or doubts, it is better to see a doctor once again.
Tooth-preserving operations
Despite the fact that therapeutic methods of dental treatment have made a huge step forward, there are situations when they do not lead to a cure for the tooth.
As a rule, we are talking about chronic periodontitis (granulomas and cysts of the teeth).
It would seem that it is possible to apply surgical method treatment and tooth extraction. But there are techniques that combine conservative and surgical aspects. These are dental surgeries. They allow you to save part of the tooth, which can later be used in prosthetics.
Before performing a surgical operation, it is necessary to revise the root canals as much as possible. Take X-rays, and only then plan a surgical intervention.
Root apex resection.
The most commonly used operation for chronic foci of infection at the apex of the tooth root. 
Under anesthesia, the top of the tooth root is cut off along with pathologically altered tissues. This technique is used in cases where the root canal, due to its anatomical features failed to reach the top.
Resection of the apex of the tooth root is carried out both on single-rooted and multi-rooted teeth.
Hemisection and amputation of the root of the tooth.
Under anesthesia, the tooth is sawn in half between the roots and the root that caused the inflammation is removed along with a part of the crown.
It is carried out on the molars of the lower jaw.
Having in arsenal dental clinic many new materials and tools, the need for tooth-preserving operations has decreased markedly. But there are situations when this is the only way to save a tooth.
The specialists of our clinic are fluent in them.
A lot can happen in life... A sports accident or a simple fall can damage your smile. Caries or periodontitis with age can cause the loss of several teeth at once. This leads to stress. But now it is not at all necessary to go without teeth or put removable prosthesis. Your dentist has a modern solution - implants.
Small titanium pins are analogues of the roots of the tooth, which are integrated into the jaw. In terms of stability, dental implants correspond to intraosseous structures, which provides reliable support for both single crowns and for bridges and dentures. Implant-supported crowns are like your molars – they feel completely natural in your mouth.
You will no longer have problems with loose dentures. There is no need to damage, turning, neighboring healthy teeth for building a bridge. Implants offer a safe solution for patients of any age and for any situation. The implants are reliable, stable and can be customized just for you.
By choosing implants, you choose safety and quality for life. You will have a beautiful smile and enjoy your food again.
At a consultation with an implantologist, you will learn how to use implants safely and without complications to replace one tooth, several or even all teeth. You will hear answers to all your questions about treatment, implant care and many other useful information.