When the mandibular “eight” is inconvenient, it may be necessary to remove the wisdom tooth in the lower jaw. The peculiar and often incorrect positioning of these vestigial molars is often the cause of problems during surgery.
Mandibular third molar – anatomy
The answer to the question why the removal of the lower wisdom tooth is associated with such problems is in the anatomy of the third molars. Wisdom teeth erupt after a person reaches 18 years of age, often around 30. Molar space is limited because dietary changes in modern humans have made the jaws narrower. Because of this, wisdom teeth can grow obliquely and not erupt completely. Another reason that causes difficulties during removal is that the lower figure-eight teeth have a complex root with four processes and they are stronger, more sinuous and massive than those of the upper ones.
What serious problems can cause the removal of a mandibular wisdom tooth:
- jaw fracture;
- damage to the teeth adjacent to the “eight”;
- gum injury.
Should wisdom teeth be pulled out?
If problems arise with the lower third molar, the answer to the question of whether it hurts to pull out a wisdom tooth fades into the background – you still have to remove it, otherwise serious consequences are possible, which you will have to get rid of in the department of facial surgery.
Recommendation for the removal of a wisdom tooth in the lower jaw:
- pathology during eruption, which is the cause of damage to the gums, neighboring “seven”, buccal mucosa and tongue;
- tumor formation due to permanent mucosal injury;
- pinched nerve;
- malocclusion due to wisdom teeth;
- partial retention (incomplete eruption) of the wisdom tooth – removal in this case is indicated when pain occurs;
- the formation of a follicular cyst with complete retention (non-eruption);
- an inflammatory process in the bone and gums – pericoronitis, pain, swelling, difficulty chewing, abscess, phlegmon;
- difficulty in hygiene procedures for the “seven” and “eight”;
- formation of a periodontal pocket;
- acute periodontitis;
- osteomyelitis of the jaw;
- destruction of the crown of the tooth;
- installation of braces;
- protrusion of the tooth, which causes blockage of the mandibular joint.
How is a wisdom tooth removed?
Removing a third molar is difficult, so it is important that the surgeon is qualified and experienced. The removal of a wisdom tooth in the lower jaw is carried out under severe anesthesia, in which the sensitivity of the face, throat, ear, and tongue is lost.
How to pull out a wisdom tooth – stages of simple removal:
- The doctor collects an anamnesis, finds out the presence of a pathological reaction to medications, examines an x-ray of the tooth that needs to be removed.
- Anesthesia is introduced – it is often used locally, in exceptional cases the patient is given full anesthesia.
- Direct impact – with the help of dental instruments (elevators, forceps), the tooth is removed from the alveolus.
- Extraction of fragments of the tooth and treatment of the wound with hemostatic, anti-inflammatory and antiseptic agents, in some cases the doctor sews up the wound.
- In conclusion, the doctor gives recommendations on the treatment of the wound, taking medication.
How is a wisdom tooth removed if it has crumbled?
Complicated removal of a wisdom tooth is carried out in the same steps as a simple one, but a dental surgeon uses more surgical instruments and a drill during direct removal. After removing a crumbled wisdom tooth, it may be necessary to re-take an x-ray, since pieces of the molar may go unnoticed in the wound.
Removal of an impacted wisdom tooth
Removing the bottom eight with a horizontal position is practically a surgical intervention that can last several hours.
This procedure can be performed under general anesthesia:
- To remove an impacted tooth, a dissection of the gum tissue is required, and in some cases, a reaming of the bone in the thickness of which the tooth is located.
- The hole after the removal of the wisdom tooth is carefully checked for the presence of remnants of the tooth itself and the bone, it is processed, the wound is sutured.
What to do after wisdom tooth removal?
The removal of a wisdom tooth in the lower jaw is often poorly tolerated by a person – after the dental procedure, pain appears, the temperature may rise. With improper care, a bacterial infection can enter the wound, which will cause serious complications.
If a wisdom tooth is pulled out – how to care for the wound:
- If the bleeding does not stop for a long time, a swab soaked in hydrogen peroxide can be applied to the wound.
- Ice can be periodically applied to the cheek for 5 hours for 5 minutes.
- Food (not hot, mashed, not salty) after removing the lower “eights” can be taken after at least 4 hours.
- You can only drink water at room temperature.
- In the first 24 hours after removal, do not rinse your mouth and brush your teeth.
- On the first day after medical intervention, physical activity, hot baths, alcohol and smoking are prohibited.
Complications after tooth extraction
Within a few days after the removal of a wisdom tooth, a person may experience complications associated with severe damage to the gums or bones, infection, bleeding. In rare cases, a nerve is damaged during the procedure. In such cases, for several days there is numbness of the tongue, cheeks and lips, a feeling of “running goosebumps”. Any of the complications is a reason to contact a dentist who will prescribe medication and issue a sick leave for 3-4 days.
You need to see a doctor if:
- there was a putrid smell;
- enlarged lymph nodes;
- the wound was covered with a grayish coating;
- it hurts to touch the gum or cheek;
- increased pain in the jaw;
- symptoms of intoxication are observed.
Antibiotics after the removal of a wisdom tooth are prescribed if the doctor detects signs of inflammation or bacterial infection of the wound, as well as in cases where the hole is not tightened for a long time. In such cases, drugs are prescribed with minimal side effects, the ability to penetrate not only soft, but also bone tissues. The decision to prescribe any drug is made by the doctor, based on individual indications. More often than others, modern dentists prescribe Lincomycetin and Metronidazole, sometimes they are prescribed in combination.
Pain after wisdom tooth extraction
A very common complication that patients complain about is that the gum hurts after the removal of a wisdom tooth. In such a case, the dentist advises painkillers that relieve severe pain:
Pain after the removal of the “eights” lasts up to 7 days, this is due to bone damage, which in this case cannot be avoided. You need to consult a doctor if the pain does not subside, acquires a pulsating character, and the area of u200bu200bits distribution grows.
Swelling after wisdom tooth removal
If the patient’s cheek is swollen after the removal of a wisdom tooth, this is one of the normal options – serious damage can cause swelling. If the swelling is not accompanied by other problems, there is nothing to worry about, after a couple of days the swelling will pass.
It is necessary to consult a doctor if the swelling spreads to other areas and the swelling is accompanied by:
- redness and fever of the cheeks;
- severe pain that grows;
- an increase in body temperature;
- nausea, weakness.
Temperature after wisdom tooth removal
Even if the removal of the lower “eight” went very well and no complications are observed, doctors recommend taking antipyretic drugs, since the temperature may rise. Do not worry if on the day of surgery in the evening the temperature rose to 38.0, the next day in the morning it was within 37.5, and by the evening it dropped to normal. If the temperature rises more strongly or lasts longer, this is a reason to see a doctor.
Bleeding after tooth extraction
The question of how to stop bleeding after tooth extraction can disturb the patient if the blood does not stop flowing for several hours, but doctors warn that a small discharge of blood can continue for a day. To reduce bleeding, you can apply cold to the jaw, press a hemostatic sponge to the wound, take a hemostatic drug – Dicinon or Etamzilat (only with the approval of a doctor). If the bleeding does not stop for more than a day, you need to get to the doctor.