wisdom teeth

WISDOM TEETH

Wisdom tooth is a third molar tooth which erupts at the age of 18 to 25 yrs.

Total 4 – wisdom teeth are present in the mouth , upper—left and right, lower –left and right.

If it doesn’t erupt properly by age of 22 yrs. Then chances that it will erupt properly are less .

When space available in the mouth is less than the size of the tooth , tooth gets impacted.

Tooth may get impacted against second molar , against bone or gums.

Third molar is consider as an extra tooth because even if it is missing, biting efficiency is not reduced.

Properly erupted wisdom tooth is difficult to maintain because of back position in the mouth.

If direction of erupted tooth is not proper then it causes cheek bite .

Brushing is difficult because of improper position . Such a tooth shows higher chances of cavity formation.

Impacted wisdom tooth creates following problems,

Pressure

Pericoronitis

Decay

PRESSURE

If space available in the mouth for proper eruption of wisdom tooth is less then it gets impacted

During active eruption age of wisdom tooth , it gives forces but it can’t erupt due to lack of space in the mouth. This results in PAIN .

This pain is radiating in all directions. Pain radiates to EAR , other TEETH , HEAD , NECK .

HEADACHE OF UNKNOWN ORIGIN MAY GET CURED AFTER REMOVAL OF IMPACTED WISDOM TOOTH

§TREATMENT

DISIMPACTION that is surgical removal .

PERICORONITIS

When tooth is partially erupted it is covered with gum flap called pericoronal flap

pocket gets created very easily in this flap since oral hygiene is difficult to maintain.

Bacteria gets shelter under the flap, they get protection under flap since it is difficult for the brush to reach under the flap.

Low oxygen tension under flap is favorable for bacterial growth.

If food particles enter and remain under flap, then bacteria grow luxuriously and show PAIN AND SWELLING .

PERICORONITIS TREATMENT

A Conservative

antibiotics , anti-inflammatory medicines , mouth rinses given by dentist

In minor cases Curettage is done .

Operculectomy is done to eliminate pericoronal flap. Chances of recurrence is high .

PERICORONITIS TREATMENT

B RADICAL

DISIMPACTION by surgery

When conservative treatment fails or to get rid of the problem for once and all without trying conservative treatment , surgical treatment is used.

DECAY

Partially erupted tooth show decay . Since it is irreversible and progressive disease , it will go on increasing and reach the pulp .

PAIN may go on increasing in duration and there will be continuous pain .

Tooth is tender to touch and hot and cold .

TREATMENT

SURGICAL REMOVAL

INSTRUCTIONS AFTER SURGERY

•Keep pressure pack tightly closed for one hour .

•Whatever saliva or blood comes in the mouth should be swallowed.

•Don’t spit out.

•After one hour remove pressure pack. Don’t put any pressure pack afterwards .

•Don’t spit out after that to see if blood is coming

•Spiting causes more bleeding and affect healing

•Taste of blood in the mouth and blood tinged saliva is common

•Apply ice [kept in a bag ] from out side , 10 mins on 10 mins off

•Take soft and cold diet .

•Cold will stop bleeding.

•Don’t take hard or hot diet . It causes bleeding.

•Don’t eat ice , it is hard . Soft ice-cream will do.

•Take prescribed medicines as per the advice .

•Warm saline rinses after 24 hrs

EXPECTED REACTIONS AFTER SURGERY

•Swelling after surgery is common . It is not a swelling due to infection but surgical oedema which is body’s repair mechanism. It may reduced with external cold application on the day of surgery. It reduces in 3-4 day’s time.

•Pain may not be really present. Usually pain is present in the area of injection prick .

•Above things cause mild discomfort for 2-3 days .

•Difficulty in opening the mouth –because of oedema and muscles of opening of mouth gets tear off during procedure.

TREATMENT exercise to open mouth wide . Warm saline rinses . Anti inflammatory medicines.

•Ulceration at the corner of mouth – because of surgical instruments TREATMENT –Apply vaseline or cold cream .Wisdom tooth is a third molar tooth which erupts at the age of 18 to 25 yrs.