In cases where the jaw bone around the tooth is very dense or the gum is very thick, or if the tooth cannot find a place to erupt due to the narrow jaw arch, teeth that have not erupted due to early loss of milk teeth or due to some diseases, and are under the gum and in the bone are called impacted teeth.
If these teeth cause an abscess, cause pain, if the size and position of the tooth causes the bone to thin enough to carry a risk of jaw fracture, if they are together with a tumor or cyst, and if they cause decay in the neighboring tooth, they should be extracted.
The most common impacted teeth are wisdom teeth. Following these, canine teeth can often remain embedded in the jaw bone. Impacted canine teeth can usually cause the roots of the incisors in the upper front region to melt or cause a disorder in the tooth alignment.
Abscesses are a common example of such insidious diseases in medical literature.
In such a case, the following treatment options can be applied
- Restoration of the gap created by the extraction of the canine tooth with a bridge or implant
- Removal of the canine tooth and placing it where it should be. This operation, called reimplantation, can be performed if the impacted tooth is removed without damaging it.
- With orthodontic treatment, a bracket is glued onto this tooth and the tooth is tried to be pulled into its own place.
Wisdom Teeth
They are our 3rd molars that tend to erupt between the ages of 15-25; they are called wisdom teeth and wisdom teeth. There are 4 in total, one on the right and one on the left in each jaw. If all of these teeth are present in our mouth, we can talk about 32 teeth, otherwise we have 28 teeth in our mouth.
When there is not enough space in our jaws for these teeth to grow, they remain impacted or semi-impacted. In addition, if they will cause misalignment in our teeth, if there is pain, if they are fused to the jawbone, if they are in a bad position, and if this is detected in the x-ray, it is decided to extract them.
For this reason, it is important to check the wisdom teeth and extract them if necessary. If they erupt in the right position without damaging our surrounding tissues, causing inflammation, and if they do not interfere with our front teeth, they can remain in the mouth.
Just as the 4th molar, which was located behind the wisdom tooth in ancient times, disappeared in parallel with evolution, the need for the 3rd molar is decreasing today.
Although fully impacted wisdom teeth seem to be problem-free, they can put pressure on the tooth in front despite being fully impacted. This pressure will cause pain in the ear and neck. It can form cysts in the soft tissue around it. X-rays are taken and the decision to extract them is made.
Semi-impacted wisdom teeth both put pressure on the tooth in front to come out and cause pain, swelling and abscess formation with the irritation of the mobile gum part (hood) on them. Wisdom teeth cannot complete their healthy eruption and also create an unhealthy environment for the formation of new cavities.
Wisdom teeth that have completely erupted may not cause any problems, but due to the location where wisdom teeth erupt, their hygiene is very difficult. Wisdom teeth, which are prone to decay due to their weak mineral structure, should still be extracted as a preventive measure in patients with poor oral care.
Reasons for Extraction
CORROSION: Due to the position of the wisdom tooth, decay may occur in that tooth or in neighboring teeth.
GUM INFECTION: In cases where the wisdom tooth has not fully erupted, food residues and bacteria enter under the gums around the wisdom tooth and cause infection. As a result, bad breath, pain, facial swelling and decreased mouth opening may be observed. The infection can spread to the cheeks and neck via the lymph nodes.
PRESSURE PAIN: Pain may occur due to the pressure exerted by the wisdom tooth trying to erupt on the neighboring teeth. In some cases, this pressure causes abrasion on the teeth.
ORTHODONTICS: Many young patients receive orthodontic treatment to correct the irregularities in their teeth. When wisdom teeth erupt, they cause increased irregularities, especially in the front region, due to the lack of space.
PROSTHESIS: In patients using a total denture, if the impacted wisdom teeth begin to erupt, they may cause problems such as incompatibility, impaction and inability to use the denture. Therefore, panoramic X-ray examination is also of great importance in patients who will have a total denture.
CYST FORMATION: A cyst may form in the soft tissue around the impacted or semi-impacted wisdom tooth. Removal of this cyst and tooth is of great importance in terms of preventing future bone and neighboring tooth damage. In rare cases, a tumor may develop inside the cyst or spontaneous fractures may occur in the jaw due to excessive growth of the cyst.
Many people feel discomfort after the procedure depending on the degree of the operation and their reaction to the pain. Taking the medications prescribed by your doctor on time will help you reduce these discomforts. Depending on the condition of the operation, there may be swelling and bruising on the face. Even in similar operations, the degree of swelling and bruising may vary between individuals. Applying an ice compress to your face in the first few days will help reduce this swelling.
Whether the wound heals and the discomfort subsides depends on your pain threshold, age, general health status, reaction to painkillers, degree of the operation and post-operative care. It is usually necessary to stay away from school or work for 1-2 days after the surgical extraction of an impacted wisdom tooth. This period may be extended depending on the patient's reaction to the operation. Simple wisdom tooth extractions usually do not require such a period.
Due to reasons such as poking the wound, food residues filling it, smoking, etc., inflammation may occur in the extraction area. This causes pain. These complaints are resolved by cleaning the area with oxygenated water and using appropriate antibiotics.
It is normal to see blood in your saliva for a few hours after the extraction. This is because a slight blood leak from the extraction site continues for the first few hours. You may also find a small amount of light-colored blood on your pillow the next morning. This is also common and normal. Serious bleeding problems are very rare after surgical wisdom tooth extractions. In such a case, you should contact your doctor immediately. It is important to know what to do to avoid bleeding.
- Do not use aspirin and its derivatives before and after the operation.
- Stay away from heat as much as possible after the operation.
- Do not suck or touch the operation area and avoid making excessive movements to see.
- Do not spit. Bleeding will continue as the blood clot that forms as you spit will break down.
- Apply pressure to the operation area with a gauze tampon for about 20 minutes. If bleeding continues later, continue this application with a spare tampon.
Another point to remember is that smoking delays wound healing and can cause inflammation (alveolitis) in the operation area. It is recommended that you do not smoke until the operation area has completely healed (this period is at least 2 weeks). If it is not possible to quit smoking completely, smoking as little as possible is very important for recovery.
