Extraction of wisdom teeth: how is this done?
Dear friends, the last time we talked about what kind of wisdom teeth are, when they need to be removed, and when not. And today I will tell you in detail and in all details how the removal of the “sentenced” teeth goes directly. With pictures. Therefore, I recommend especially impressionable people and pregnant women to press the key combination "Ctrl +". Joke.
Where does the removal of the 8th, and, in principle, any other tooth begin?
To minimize discomfort during the injection, it is necessary to treat the injection site with a special anesthetic gel. This is the so-called application anesthesia. It is often used in pediatric dentistry, but we also use it in work with adults. As practice shows, it becomes less unpleasant sensations, and its taste is pleasant ... at least some joy.
When removing the teeth of the upper jaw, as a rule, a simple anesthetic infiltration of the area of the extracted tooth is sufficient. It is carried out using a special syringe with specially selected anesthetics and is called infiltration.
When removing teeth on the lower jaw, infiltration anesthesia is usually not enough (with the exception of the frontal group of teeth, from canine to canine). Therefore, the technique of anesthesia changes somewhat - the anesthetic is brought directly to the nerve bundle, which is responsible for the innervation of the desired areas, using a long but very thin needle. Such anesthesia allows you to "turn off" the sensitivity not only in the area of the extracted tooth, but also on the lips, chin, parts of the tongue, etc.
It should be noted that during and immediately after anesthesia a number of interesting phenomena can be noted - increased heart rate, trembling of the extremities, inexplicable feeling of anxiety. Many patients begin to panic about this. But you don’t need to panic! These are side effects of most modern anesthetics, pass on their own within 10-15 minutes.
Well then - anesthesia is done! Now you need to make sure - is it successful?
Those places that should ideally be numb are listed above. Also, using a special tool and pressing on the gum in the area of the operated tooth, we determine whether there is still pain or not. The only thing that should be felt is the feeling that “something” is touching the gums. That is, tactile sensations are still preserved, but pain is already absent.
And then our actions differ depending on what type of wisdom tooth we are dealing with.
Refined Wisdom Tooth
This is usually the most difficult to remove the eight from all the rest.
We have already anesthetized the surgical field. What's next?
He is under the gum! So - we take the scalpel in our hands, and we carry out the most delicate incision in the area of the extracted tooth. Thus, access to the removed wisdom tooth is created. It stands out from the surrounding tissues with the help of special tools, and now we can visually assess its position and choose the removal technique.
If the tooth has not erupted, then something is bothering him. This “something” will also interfere with its removal, and this “something” may be an adjacent tooth, a bone protrusion, etc. However, you will not remove the seven to get to the wisdom tooth, right?
Therefore, we divide the tooth into parts. Using a special tip with a cutter speed of 150,000 rpm - this is no longer a simple angular, but not yet turbine. The latter, by the way, is extremely undesirable to use for tooth extraction, because at 500,000 rpm it’s easy to burn everything with the hellish flame, and even blow the emphysema half the face with air from the cooling nozzle. In general, you need to choose the right tools for removal, there are no trifles and compromises here and cannot be. And it’s worth a hundred times to think before removing such problematic teeth in the dental office for one chair at the village club on the Semi-empty Zakroma collective farm.
Special surgical tip for removing wisdom teeth. It rotates at the right frequency, provides the necessary torque, does not burn tissue and does not inflate emphysema. In surgery, we use only such devices.
So, we divide the tooth into 2-3 parts in order to remove it carefully and with little trauma for the surrounding tissues. And teeth are usually removed with the help of an “elevator”. The forceps, which are all associated with removal, are in fact extremely rare.
Well, the tooth has been removed. Next, we cleanse the tooth hole from sawdust and small fragments of the tooth that could remain. Using a curette.
When removing wisdom teeth, biomaterials are not used, the hole is independently filled with a blood clot, this is quite enough for normal healing.
Moreover, “pushing” biomaterials into the well can complicate the healing process, so let the regeneration process go naturally and simply, and not bizarrely, as some doctors suggest.
Retained teeth are removed mainly by the elevator, and not by forceps, as many are used to thinking.
The clot is in place. Next, we reduce the edges of the wound and suture so that the food does not clog into the wound, does not bleed much, and rather heals. But at the same time, the seams should not be tight, because the wound in the first day can bleed significantly. And if you do not create an outflow, edema often develops.
After removal, resorbable (absorbable) sutures are superimposed on the hole, most often they do not need to be removed. But all individually.
In principle, the procedure for removing such a tooth is no different from the removal of a fully retinned tooth. But, as a rule, it goes a little easier, because the tooth is not so deep. The main stages are essentially the same: anesthesia, creating access to the tooth (and sometimes you can do without incisions), fragmentation (dividing the tooth into parts) and, in fact, removing the teeth in parts.
After the removal of the lower half-tooth, the sutures are placed on the hole, in the area of the upper wisdom teeth suturing is not always necessary.
Removing such teeth can be called a simpler case compared to others, but only if the tooth has one straight root. Then the removal can go quite quickly. But such clinical cases are extremely rare. And, looking at the picture, we see hooks, not roots, which, with proper pressure, can simply break. Usually there are 2 roots, and in this case we just need to separate one root from another with the help of the same tool - a “raising” tip. And carefully get each of the roots separately. The beginning and completion of the extraction of such teeth is the same as that of everyone else.
Completely cut tooth and standing in the dentition
As we found out from the previous article, we leave such teeth in place. They just need care and observation, as is the case with ordinary teeth.
And it also happens ...
... that wisdom teeth block neighboring sevens and prevent them from erupting normally. In such cases, patients are referred to the surgeon in the direction from the orthodontist.
Of course, the primordium of the eighth tooth needs to be removed. This is a fairly simple and relatively comfortable operation.
Look at the pictures. Between the upper and lower - a difference of three weeks. It is clearly seen from them that after the removal of the primordia of the eights and “unlocking”, the seventh teeth immediately began to grow.
Wisdom tooth removed. The patient is satisfied. But the fun is yet to come. Namely, the postoperative period.
After the removal of 8 teeth, strict recommendations must be observed:
- In no case do not rinse or warm the area of the extracted tooth. Forget and don’t listen to instructions like “you need to rinse with tincture from shark fins and mammoth tusks”. No! This cannot be done. Why? And all because the same blood clot, which, as we have already found out, must remain in the hole and protect it, can be easily rinsed out. And again, we will return to the same inflammation and, accordingly, to long healing.
- Exclude physical activity, at least for 2-3 days . For what? And for the fact that under load the pressure rises after all (yes, yes, yes, even for Arnold Schwarzenegger and Rocco Siffredi !!!), and despite the fact that the clot is still not finished, the wound can begin to heal, and it’s bad heal up.
- We also exclude the general overheating of the body . Saunas, baths, hot baths - it is impossible. All this also contributes to bleeding.
- Do not eat until the anesthesia is completely gone . Otherwise, the risk that you can bite your lip, tongue or cheek quite enough and not notice it is extremely high. It usually takes about 2-3 hours. And ideally - cold, hunger, peace for the first couple of days.
- But when you got to food , you only need to chew on the side opposite to removal in order to minimize the ingress of food into the hole.
- Do not forget about brushing your teeth! Teeth must be cleaned necessarily, best with a soft toothbrush, so as not to injure the area of the extracted tooth. And do not forget that the tooth is already gone, so we work with the brush especially carefully in this area. AND! Sure! DO NOT ATTEMPT to clean off the white plaque that may cover the gums in the area of the extracted tooth. This is NOT PUS! This is FIBRIN! A protein whose presence indicates normal healing of the hole.
- Also, after tooth extraction, ice is dispensed . It is recommended to apply it to the cheek in the area of the extracted tooth for the remaining day. About 15-20 minutes every hour. All the same, in order to minimize swelling. But you don’t need to get carried away too much so as not to freeze your throat and lymph nodes (if you keep the ice not where it should be, or where it is necessary, but for too long).
In addition to these recommendations, medications , the so-called antibacterial and anti-inflammatory therapy, are also prescribed . This is due to the fact that the area of 8 teeth is extremely easily inflamed, but we would not want to. Along with taking antibiotics, natural yogurts and other dairy products come in well - do not forget to maintain the intestinal microflora.
If the removal was carried out correctly, and the patient complied with all the recommendations and followed the doctor’s prescription, then the risks of postoperative complications are extremely small.
Sincerely, Andrey Dashkov.
What else to read about wisdom teeth and their removal?
- Teeth of wisdom: cannot be removed
- Teeth of wisdom: Pull-Pull
-Consequences of untimely removal of wisdom teeth
- Maxillofacial surgery or not? That is the question