Wisdom teeth - malocclusion and teething - should they be removed or not?

Do we need wisdom teeth?

I use the only compound word. In biology there is such a concept as RUDIMENT
- a part of the human body that has lost its function in the process of evolution. The most famous rudiment is the vermiform appendix of the intestine or appendix. So - a large number of doctors and people believe that there is nothing superfluous in the body and wisdom teeth can serve a person at an older age, when the loss of basic teeth occurs and the doctor can use figure eights to install, for example, a bridge.

Unfortunately, in most cases this is impossible and even wrong!

Most people simply do not have room in the jaw for eighth teeth, and Mother Nature begins to mock them (and, naturally, us doctors) in every possible way: painful eruption, irregular shape, incorrect size of the tooth itself, poorly developed root system - all of the above leaves no chance for the correct use of “eights”.

How wisdom teeth are formed

Unlike other teeth, the rudiments of wisdom teeth are formed not during intrauterine development, but at 3–5 years, when the child’s body is preparing to replace milk teeth with permanent dentition. At this age, you can determine the number of future eights (and there can actually be from one to four). But at this age, it is not yet possible to detect any possible developmental pathologies.

It becomes more or less clear a little later, the crown part of the wisdom teeth begins to form. The formation process starts in a child at about 12 years of age, but the development of the root part of the figure eight takes several more years and can continue even after tooth eruption. Considering that the most common age for the appearance of wisdom teeth is 18–25 years, the eruption of eights occurs already in adulthood. It’s not for nothing that I said earlier the phrase “actually from one to four,” since approximately 10–15% have no eights at all. That is why it is normal to consider the number of teeth in an adult to be from 28 to 32. Those are wisdom teeth, right? How unwise they treat us and make puzzles!

Correct your bite or dental defect with invisible aligners Find out what it is

How to cope with pain

Pain is an invariable companion to the eruption of figure eights. To facilitate the teething process, it is recommended to chew solid foods, but only if you do not have pericoronitis; if you have pericoronitis, solid foods can only increase inflammation and pain.

gentle massage of the gums with your fingers also helps

If your gums are inflamed, you should rinse your mouth with herbal decoctions:

calendula,
daisies,
sage,
or ready-made mouth rinses.

To relieve pain, you can also use local remedies - such as Metrogil , Kamistad , Anbesol . They have both analgesic and anti-inflammatory effects.

Cutting out wisdom teeth is a real headache

The “birth” of a wisdom tooth in the oral cavity is always painful. The main reasons for the painful effect are thick walls of the dental sac, thickened mucous membrane and reduced growth-forming factors. In addition to the painful process itself, teething can cause many other complications. Which ones? Let's talk about this in a little more detail.

The wisdom tooth sometimes does not erupt completely, crowding the surrounding teeth. This situation usually entails local inflammation and pain.

The time during which a wisdom tooth is cut can be quite long, and inflammation can constantly bother you, manifesting itself as an increased temperature of the whole body and sensitive pain, which sometimes makes it difficult to even just open your mouth! This condition is fraught with inflammation of the tissues surrounding the problematic tooth, right down to the bone, and therefore requires immediate intervention by a qualified dentist.

The first problem with teething eights is caries.

Often, while a wisdom tooth is growing, it is difficult to effectively clean it (due to the location of the wisdom teeth deep in the jaw). This is how caries occurs. Incorrect positioning of wisdom teeth during eruption also increases the risk of tooth decay on the adjacent tooth due to difficulty accessing the spaces between these teeth. If symptoms of caries appear, you must consult a dentist and carry out appropriate treatment. Very often in this case, it is recommended to remove the wisdom tooth, especially if all other teeth are developed normally.

In practice, it happens that a wisdom tooth erupts already... sick, that is, it becomes infected with caries while still in the gum. In such cases, the figure eight should be removed immediately so that the diseased wisdom tooth does not negatively affect the remaining teeth.

The second problem is a cyst

In rare cases, a cyst and tumor may develop in the tissues surrounding an erupting wisdom tooth, which requires immediate surgical intervention by a dental surgeon.

The third problem is malocclusion

If the position of a wisdom tooth is incorrect during eruption, there is a high probability that such a tooth will significantly affect the position of the remaining teeth, which causes a change in the bite. And aesthetic problems arise - the teeth begin to stand crooked in the mouth. And this entails orthodontic treatment, bringing the dentition in order.

The fourth problem is tongue dysfunction

In addition to aesthetic problems, this can also cause functional problems. For example, if a wisdom tooth is displaced towards the vestibule of the oral cavity, serious injury to the mucous membrane of the cheeks, lips or tongue can occur, causing the appearance of erosions and ulcers.

Fifth problem - the wisdom tooth wanted to erupt, but could not erupt

Rarely, a situation occurs when, due to a lack of space in the dentition or in the case of an incorrect inclination of the wisdom tooth itself, an anomaly develops, called a “submerged wisdom tooth.” Such “submerged” teeth are usually removed.

It is possible that the wisdom tooth does not erupt

at all. Despite its absence, such a tooth is dangerous due to its complications. It can damage the roots of neighboring teeth or provoke neuralgic pain. In this case, you need to contact a surgeon and, most likely, the figure eight will have to be removed.

The sixth problem is pericoronitis

At the moment of eruption of the lower (!) wisdom teeth, when only part of the tooth has appeared, acute inflammation and even accumulation of pus in the formed hood between the gum and tooth can occur. This causes a serious disease called pericoronitis (pericoronitis).

The main symptoms of the inflammatory process during pericoronitis are pain and swelling of the gums surrounding the wisdom tooth, bad breath and an unpleasant taste.

If these symptoms appear during the eruption of a wisdom tooth, you should urgently consult a dentist.

The seventh problem of wisdom teeth is periodontitis

When the figure eight erupts quite smoothly, due to its inconvenient location during brushing, the wisdom tooth is not properly cleaned of plaque. Removing tartar and plaque on this tooth in dentistry is also problematic. Because of this, bacteria begin to accumulate around the wisdom tooth, causing inflammation of the gums - periodontitis, which can then develop into osteoperiostitis. In this case, the tooth must be removed.

How does a figure eight cut through?

With normal growth of a wisdom tooth, the gum above it becomes loose and soft; after a few days, the lateral chewing tubercles of the crown appear above it, and behind them - its central part with grooves. After complete eruption, the crown is located on the same level as the adjacent one.

Growth anomalies of the figure eight include difficult eruption, retention and dystopia. Let's take a closer look at them.

Difficulty erupting wisdom teeth

The eruption of the third molar may be delayed for several years if there is some obstacle in its path. For example, the lower eights grow more slowly because the mucous membrane over them is thicker than over the upper teeth. In addition to the gum, the crown needs to grow through the fibers of the buccal muscle and the levator pharynx muscle. If during chewing the mucous membrane is constantly injured, scars and seals form in the gum “hood”, the “eight” will not be able to erupt on its own.

Retention of wisdom teeth

During retention, the third molar is formed, but cannot grow through the bone tissue, so it remains or is retained in the bone socket - the periodontal sac. The cause of retention is growths on the periosteum or cementomas in the alveolar sac. Because of them, the “figure eight” fuses with the socket or with the root of an adjacent tooth.

There are 2 types of retention:

In complete retention, the crown of the third molar is hidden under the bone plate of the jaw, so it cannot be seen or felt. To detect it, the dentist does a targeted x-ray or orthopantomogram.
More common is incomplete eruption - semi-retention, when part of the crown grows through the gum, and part remains under it.

“Eight” rarely appears in people over 30 years old, because by this age it becomes denser, fuses with the bone socket and cannot completely come out of it. If nothing bothers the patient, the tooth is not touched.

Wisdom tooth dystopia

With dystopia, the figure eight is located outside the dental arch. Depending on the degree of deviation, the following positions are distinguished:

Vertical, if the tooth deviates slightly from the longitudinal axis of the “seven”;
Oblique, when the figure eight crown moves towards the cheek, second molar, tongue or palate;
Horizontal location, if its axis is perpendicular to the axis of the adjacent tooth.

Both growing wisdom teeth and impacted ones can be dystopic. They are displaced if there is not enough space in the jaw or if the rudiment is located incorrectly, for example, not in the bone socket, but in the ascending ramus of the lower jaw.

You can get a quality consultation on wisdom teeth in your city

I want to check my eights!

Treat or remove eights?

Now regarding orthodontic treatment and wisdom teeth. Believe me, it is very unpleasant for us doctors, as well as for patients, to make radical decisions. But there are good reasons! These are your own stories. Stories of patients who underwent treatment with braces as teenagers, achieved excellent results and...

All the beauty of straight teeth, especially the lower incisors (you just started to enjoy a beautiful smile) - it disappears at 20 and beyond. It is when most of us fully develop these “eights”. Two, three and even four years of therapeutic “torment” to correct crooked teeth, transform them into a beautiful/sweet/courageous smile, as they say, down the drain... Yes, yes - the only option to become the owner of beautiful teeth again is repeated orthodontic treatment. It doesn’t matter whether it’s aligners or braces again, the important thing is that there is a good saying: forewarned is forearmed! No one is immune from mistakes and relapse.

Our body is beautiful and magical in that it almost always adapts and compensates for almost any pathology. Therefore, the “eights” cut through with difficulty and subsequently deform

there are very important teeth in front!

Dry socket syndrome during wisdom teeth removal

Dry socket syndrome in wisdom teeth

The wisdom tooth refers to the concept of dry socket, or more precisely, dry socket syndrome. A dry tooth socket is alveolitis. Dry socket syndrome after the removal of figure eights can occur in this area, especially in the area of the lower wisdom teeth due to the fact that as a result of swallowing, as a result of opening the mouth, muscles tense, which aggravate the occurrence of alveolitis.

What can dry socket syndrome lead to and what to do?

A dry socket after the removal of figure eights can lead to very severe pain that radiates to the temple and ear. This is a very great torment: a person cannot, even if he is not sensitive, he cannot tolerate it, he will definitely take painkillers 4-5 or 6 tablets. And as a result of this, he will still go to the dentist. A dry socket, if it has formed after removal, will not go away on its own. Alveolitis can only get worse - up to inflammation of the jaw. There may be dire consequences.

So what do we do with eights?

The moral of this story is this: trust qualified and educated doctors, not kind and humane “neighborly” advice. Be wise. Especially at such crucial moments in life, when wisdom teeth make themselves felt. And in general, I wonder who was the first to call them “wisdom teeth”?

Moreover, an interesting point from medical practice: if you (what if?) decide to remove the eights, it is not a fact that they will be removed for you. The reason is simple - wisdom teeth must be removed exactly according to indications. A normal doctor will never remove a healthy tooth just because you want it.

You have decided to remove your wisdom teeth. How traumatic is this?

If the wisdom tooth has grown normally, its roots are not intertwined, removal usually takes place without any complications. The edges of the tooth socket after extraction are often not even sutured.

What is most important after removing the figure eight is to allow the socket of the just removed wisdom tooth to heal. Quite a big wound.

What is absolutely impossible to do?

You should not rinse vigorously, even with such seemingly beneficial solutions as chamomile or calendula.

What needs to be done.

To get rid of food debris, you need to carefully take water into your mouth and do short oral baths without intensive rinsing. Instead of water, you can use a solution of chlorhexidine, miramistin or analogs specially sold in pharmacies - they disinfect the oral cavity. And so - for at least three days. If this recommendation is neglected, the hole may become inflamed. Then the dentist prescribes treatment with medications, including antibiotics.

What if the roots of an insidious wisdom tooth are intertwined or fused?

Unfortunately, in this case complications cannot be ruled out - soft tissues may be damaged. If an inflamed tooth is removed, in rare cases the neurovascular bundle (!) of the lower jaw is injured. In this case, separate treatment may be required.

Symptoms and signs of abnormal growth

It is extremely rare for eights to appear without any complications. This is due, first of all, to the fact that wisdom teeth grow in adulthood, when the jaw is already formed. Even with proper teething, discomfort may still be present for several weeks or months. If a wisdom tooth grows incorrectly or has an abnormal location, then certain symptoms indicate this.

Let's take a closer look at the types of pathologies and symptoms associated with the growth of wisdom teeth.

Retention is a pathology in which the third molar is located under the mucous or bone tissue. The main symptoms are severe pain in the gums, as well as the development of an inflammatory process in the gum pocket.
Dystopia or abnormal position of the tooth. It manifests itself as severe pain, affecting adjacent teeth, and the development of inflammation, including phlegmon or osteomyelitis.

The initial alarming symptoms that a patient may identify when a wisdom tooth grows are:

Swelling in the cheek area.
When swallowing, severe pain occurs, radiating to the throat or ear.
Purulent or bloody discharge.
Injury to the mucous membrane.

If you detect at least one of the above symptoms during the eruption of figure eights, you must seek the help of a dentist as soon as possible. The doctor will conduct an x-ray and determine whether the wisdom tooth is growing correctly.

When is it advisable not to remove wisdom teeth?

There are situations when the “seventh” or “sixth” chewing teeth must be removed. And in this situation, a wisdom tooth that has grown correctly may still be useful. It will become one of two supports for the future bridge. However, in this case, a healthy sixth (or fifth) tooth will suffer, because it will have to be treated for an abutment crown.

Now a little about sad things

. 10-15 years will pass, the bridge will “work out” its required operating time. And sometimes it will no longer be possible to insert an implant - the atrophied jaw bone under the bridge will not allow it: in the absence of teeth, any person develops edentulous bone tissue. Thus, on the horizon of life there appear removable jaw dentures and newfangled gels that make them easier to wear.

Now a little about the positive

.
In such situations, you can initially consider dental implantation in specialized
medical centers, where they will help restore bone volume and take control of the dental situation.

Duration of figure eight eruption

The process is long and painful. Since they erupt in adulthood, the bone tissue is formed, it is harder for the tooth to pass through the bone. If there is a place on the jaw, it appears painlessly. If it is not enough, the person faces difficulties. Let's look at the signs that indicate problems with wisdom teeth. When a wisdom tooth breaks through the bone, the symptoms are as follows:

Painful sensations and swelling. During chewing, unpleasant sensations arise.
When the tooth does not cut through the gum, it lifts it and forms a hood. When food and bacteria enter, inflammation develops.
Sore throat often occurs as a result of inflammation spreading to nearby tissues.
Unpleasant sensations in the ear, including otitis media or otalgia.
Along with eruption, the lymph nodes become inflamed and lymphadenitis occurs.
It happens that the figure eight, the eruption of which is just beginning on the gum, is partially located in the mandibular canal.
There is a feeling of stiffness that extends over half of the head.
If the dentition becomes crooked, there is no room left for the eighth molar. It will not fall out, but will move the formed row and make room for itself.

What do we do after removing the eights?

We evaluate the possible damage that figure eights could cause to neighboring teeth. If the adjacent teeth are deformed, then the pathology may spread like a domino effect, and here it is already necessary to carry out systemic orthodontic treatment aimed at correcting the disturbed bite.

The most gentle and aesthetic type of dental correction today is aligners. The site provides a lot of information on aligners, but I would like to mention one undeniable advantage, namely, the patient can see the result of his treatment with aligners without even starting it! How so, you ask? The answer is simple - all future treatment of the patient is calculated using modern computer technology. The example below shows a real clinical case, a patient with crowded teeth caused precisely by the pathological effect of “eights” on neighboring teeth.

What determines the symptoms of teething?

The intensity of symptoms depends on several factors:

Anatomical features of the jaw. The jaw, which is small in size, can barely accommodate the existing 28 teeth, and the eruption of the third molar causes active displacement of the entire dentition and its crowding. This may be accompanied by pain not only in the corner of the jaw, but also in the front teeth.
The presence of molars next to the figure eight. In the absence of a second molar, the “figure eight” erupts faster and less painfully, since it encounters almost no resistance.
Features of the location of third molars relative to other teeth. Dystopic “eights” are located horizontally or at an angle to the main dentition. As they begin to actively grow, they put pressure on the nerves, roots of adjacent teeth, soft tissues, and even the trigeminal nerve, causing unbearable pain.
Features of the structure of the nervous system (trigeminal nerve). Sometimes the branches of the trigeminal nerve are located close to the place where the wisdom tooth will erupt. Increased pressure on the tooth itself, as well as swelling of soft tissues due to inflammation, can provoke a sharp increase in pain.

An experienced dentist, when assessing an image of the rudiments of wisdom teeth, can predict how problematic and painful the process will be.

Let's see how wisdom teeth led to crowded teeth

And how crowded teeth are eliminated with Star Smile aligners

The video shows how the 3D setup is done. I am commenting on the video, orthodontist Alexander Spesivtsev, clinical director of Star Smile, a doctor with many years of experience in the successful use of aligners in orthodontic practice. To restore straight dentition, the wisdom teeth themselves—the eights—had to be removed. At Star Smile, or rather in the clinics of its partners (more than 70 cities in Russia), any treatment begins with diagnosis and drawing up a virtual setup. The doctor takes photographs of the patient’s face, dentition, as well as x-rays and dental casts. Using special software, the obtained data is processed and a three-dimensional model of the patient’s dental system is obtained. And this already allows you to calculate the trajectory of tooth movement, treatment time, and the required number of sets of aligners. Also, the final result of the treatment will be visualized - the patient will be able to evaluate the aesthetics of the smile after treatment. Patients really like this approach - they can see their future smile, their straight teeth. The forecast of a 3D setup when straightening teeth with aligners comes true in almost 100% of cases. You see, this is completely different from correcting a “blind” bite, as is usually the case with braces. Everything is clear here, without any guesswork or assumptions.

Gevorkyan Oscar Vladimirovich

Candidate of Medical Sciences, Oral and Maxillofacial Surgeon, Central Scientific Research Institute, Scientific Consultant Star Smile “ If you are faced with questions
:

To remove or not to remove wisdom teeth?
How dangerous is it to remove wisdom teeth?
When do wisdom teeth interfere with orthodontic treatment?
and most importantly, is it possible to avoid the removal of “eights”?

Feel free to contact the doctors at Star Smile, they will help you understand this sometimes complex, but very important life problem for many.
Do not delay the decision in order to avoid possible complications in the future.” Since the Star Smile company is represented in all federal districts, large and medium-sized cities of Russia and interacts with many clinics and orthodontists, we offer you the opportunity to undergo a free consultation with high-quality orthodontists in your city , where you can discuss the problem of wisdom teeth and determine the optimal solution for you. To do this, you need to fill out the form below, a Star Smile medical specialist will contact you and help you by scheduling a consultation at a convenient time or providing your doctor’s contact information.

Don’t put off the problem of wisdom teeth “for later”!

Removal of wisdom teeth in pregnant and lactating women

Removal of wisdom teeth in pregnant and nursing mothers

Is it possible to remove wisdom teeth during pregnancy? Pregnant and lactating women can have their wisdom teeth removed only in case of exacerbation of one of them or necessity, when it is impossible to solve this problem conservatively. In a planned manner, it is better to remove wisdom teeth after the end of the feeding period.

Are there any special features of removing wisdom teeth during pregnancy?

We try to perform tooth extraction on all our patients as carefully, comfortably, and carefully as possible. Therefore, as a rule, there are no technical features. But if any intervention in the form of wisdom tooth removal is urgently required (because there is no other alternative), we must consult with the attending physician - a gynecologist and, accordingly, coordinate all our actions.

What anesthesia is used when removing wisdom teeth in pregnant and lactating women?

In pregnant and lactating women, after consultation with a gynecologist, we, as a rule, perform anesthesia with a reduced level of adrenaline, so as not to provoke the onset of labor in the later stages, and not to provoke a miscarriage in the early stages.