This kind of scene has happened several times around me, even to myself. Today we will talk about the so-called “wisdom tooth preservation and retention”.
Which wisdom teeth should be pulled out?
Wisdom teeth, also known as [third molar].
1. [impacted wisdom tooth]
In the process of human evolution, As food become finer and finer, Coupled with the use of fire, The softness of the food greatly reduces the intensity of chewing food. Without sufficient stimulation, the upper and lower jaws of human beings become shorter and shorter, but the number of teeth does not decrease. As a result, there is often not enough space to accommodate the third molar. As a result, wisdom teeth (third molars) often do not erupt upright normally. This is the most common cause of impacted wisdom teeth.
It is generally believed that [impacted wisdom teeth] should be extracted.
Do you have impacted wisdom teeth?
To judge whether a wisdom tooth is impacted or not, the simplest and most effective examination method is to take an X-ray of Zhang Quanjing.
From the panorama, we can see the eruption posture of wisdom teeth. If it is lying horizontally, reclining or even handstanding, then I’m sorry, it is very likely that this wisdom tooth will not erupt normally and completely, and perhaps extraction is the best choice.
3. Why should impacted wisdom teeth be extracted?
This is because incomplete eruption in the wrong posture often leads to the formation of difficult-to-clean areas between it and the front teeth, and local bacterial accumulation will lead to severe caries, pulp disease and acute pericoronal inflammation, resulting in unbearable pain! What’s more, it will lead to maxillofacial space infection, jaw osteomyelitis, etc.
4. What other wisdom teeth should be removed?
When wisdom teeth have severe caries, periapical periodontitis and advanced periodontal disease that are difficult to treat, it is not recommended to retain them. Because the treatment is very difficult and the treatment effect is also very poor.
In addition, wisdom teeth should also be removed when they are involved by cysts, tumors, or due to orthodontic treatment.
Which wisdom teeth should be preserved?
In short, healthy wisdom teeth do not need to be extracted. If a wisdom tooth erupts in the [correct posture] and does not have serious lesions, it is worth preserving.
Because, in addition to continuing to perform the function of molars, if the teeth before wisdom teeth appear are missing for various reasons in the future, it can be used as a potential [abutment] to provide a basis for the restoration of dentures (i.e. Dentures) and allow dentures to have a place to hang.
Although there will be temporary pain due to gingivitis during the eruption of wisdom teeth, correct use of toothbrushes, dental floss and mouthwash to maintain oral hygiene can generally be carried out safely until wisdom teeth erupt completely.
Contraindications for tooth extraction
Not all wisdom teeth recommended for extraction can be extracted. Before tooth extraction, some contraindications for tooth extraction should be excluded.
Severe heart disease (cardiac function III, IV), severe hypertension (systolic blood pressure > 180 mmHg or diastolic blood pressure > 100 mmHg), some blood diseases (such as anemia, hemophilia, leukemia, etc.), diabetes, etc., should be controlled first, and then tooth extraction should be carried out under the condition of monitoring. Pregnant women, tooth extraction is safer in 4, 5 and 6 months of pregnancy.
Risk of wisdom tooth extraction
No medical operation is absolutely risk-free, and tooth extraction is no exception, especially the extraction of impacted wisdom teeth.
After operation, pain, swelling and difficulty in opening may occur.
The maxillary wisdom tooth is close to the maxillary sinus. Sometimes, maxillary sinus perforation will occur, causing maxillary sinusitis.
Some of the mandibular wisdom teeth are close to the mandibular nerve canal, sometimes provoking the mandibular nerve, causing numbness of the lower lip, ranging from days to months.
Some impacted wisdom teeth, because they resist the anterior molars, will inevitably stimulate the periodontal membrane of the anterior teeth during extraction, resulting in sensitive soreness for a period of time.
In addition, there are some other postoperative adverse reactions. However, most of them can be recovered through continuous treatment. Patients do not have to be afraid to pull out the teeth for these reasons, which does more harm than good.
Precautions after tooth extraction
During tooth extraction, the patient will be more anxious. For example, a dentist like me will also have the fear of [man-made knife, I am fish] lying on the dental chair. This depends entirely on the dentist’s ability to appease emotions and the proficiency of movements to form enough comfort.
After pulling out the tooth, the dentist will also give some precautions:
1. Bite the cotton ball tightly and spit it out after half an hour without replacing more cotton balls;
2. You can eat and drink water after two hours. Try not to eat too hot and hard food on the day of tooth extraction. Try to chew with the half of the tooth that has not been extracted.
3. Do not brush your teeth and rinse your mouth 24 hours after tooth extraction;
4. It is normal to have a small amount of blood oozing from the wound or bloodshot in the saliva within 24 ~ 48 hours after tooth extraction. If there is a large amount of bright red blood, you should see a doctor in time.
5. Avoid strenuous exercise within 1 ~ 2 days after tooth extraction;
6. If there is suture, remove the suture 7 ~ 10 days after operation.
Adherence to these precautions can greatly reduce the occurrence of postoperative complications or reduce the severity of complications, which is conducive to rapid recovery.