Wisdom Tooth Removal - How and Why?
This term refers to the surgical removal of the third molars, also called the #8 teeth.
Wisdom tooth removal is also known as impacted tooth extraction. Wisdom teeth must be removed if they:
- Cause infections
- develop a cyst
- damage the 7th tooth through their growth
- form a weak point in the jaw
- endanger a prosthetic provision or make inserting a prosthesis impossible
- are destroyed by deep cavities
- a good treatment (filling or root canal treatment) is not possible
We will spare you explanations of individual medical terms (retained, partially retained, impacted, etc.), because the treatment consequence is always the same. Depending on the position of the wisdom tooth, the mucous membrane must sometimes be opened more (i.e., moved to the side) and more (or less) bone must be removed.
As a rule, surgery is performed under local anesthesia and is a routine operation. In the video Wisdom Tooth Removal, a minor opening is performed because the wisdom tooth is in an easily accessible position. First, the surgeon obtains an overview; he palpates the ascending branch of the lower jaw and properly places the Langenbeck. Then he makes the cut; when doing so, a so-called gum-cut is made along the ascending branch of the lower jaw and on the #7 tooth.
More on that in the video with the same title – "Gum Cut". The gums are moved to the side with a raspatory and thus the mucous membrane (including the periosteum) is lifted off the bone. A wide raspatory is placed underneath the periosteum in order to protect other soft parts such as, e.g., the lingual nerve, because bone is removed with a drill now. Although the sound of the procedure roars in your head, you don’t experience any pain.
As soon as the bone is exposed, the instrument is changed. Now the tooth is dislocated with the turning tool and removed as a whole. Any bone chips are rinsed off and the dental follicle is removed as well. Wounds in the mouth heal from the inside out, so you don’t have to worry about a hole remaining or food scraps might becoming ingrown. Finally, a saliva-tight wound closure is performed, and in most cases, an iodine strip is placed into the wound and removed the next day.
As a rule, the swelling increases until the third or fourth day and then everything subsides. A week after surgery, the threads are usually removed.
There are no alternatives to a planned surgery, unless one leaves the tooth in the jaw, which may lead to the aforementioned complications.
The risks of surgery are small with an experienced surgeon; nevertheless, complications may occur in individual cases, possibly requiring additional measures. Every additional measure may in turn lead to complications that may then become life-threatening in the course of treatment. At this point, we will only discuss the specific complications encountered in wisdom tooth removal. These are:
- bone infection (osteomyelitis)
- injuries to surrounding structures such as the tongue, the cheeks, nerves, bloods vessels, neighboring teeth, and neighboring roots with corresponding consequences
- wound infections
- jaw fracture
- opening of the maxillary sinus, subsequently leading to an infection of the maxillary sinus
- sensory disturbances in the tongue and/or the lip
Fortunately, such complications have become very rare because of the positive developments in medicine in the past decades.
This post is also available in: German