Update: December 2018
Some of the organs that a person has do not carry the practical
values. One of them is the wisdom tooth – the 8th in the jaw row
molar, that is, molar. In the distant past, he was needed
for chewing tough, not cooked food. So now
this function is not needed, more people, the tooth begins
erupt much later than the rest (from 15 to 25 years),
and sometimes can just stay inside the gums or completely
Due to the fact that the wisdom tooth has lost its physiological
necessity, it is extremely rarely laid and develops
normal – without interfering with other molars without damaging surrounding tissues
and without causing an infection. If he causes discomfort
man, the doctor recommends removing this molar.
When should a wisdom tooth be removed?
There are two groups of indications, when should the molar be removed from
dentition The first – urgent when the removal of the wisdom tooth
produced immediately after the discovery of pathology. To them
- Longitudinal fracture of a wisdom tooth;
- Fracture of the molar crown, if it is restored by filling
- Развитие следующих инфекций, из-за зуба:
- Osteomyelitis of the jaw;
- Perimaxillary abscess / phlegmon;
- Purulent periodontitis / periodontitis;
- Peripheral lymphadenitis.
In a planned manner, this procedure is carried out in the event that
there is no immediate threat to the patient’s health. States
in which you can somewhat delay the removal of the wisdom tooth,
- Incorrect position of the molar, resulting in damage
- Not erupted wisdom tooth that can cause
periodontitis / periodontitis;
- Increased mobility of the “eight” and the extension of the tooth.
Having determined the indications for the removal of the molar, the doctor indicates
возможные сроки проведения operations. They depend not only on
states of the dental system, but also general well-being
When can not delete?
There are a number of states when performing an extraction operation.
tooth dangerous, due to the high probability of complications. In that
should wait a certain time and improve your well-being.
the patient. This tactic should be followed if
- Acute infectious disease (influenza, pneumonia, ARVI, meningitis and
- Pathologies of the heart and blood vessels (unstable angina; recent
transferred hypertensive crisis; not controlled hypertension
drugs). It is also contraindicated to remove a wisdom tooth if
the patient suffered a heart attack six months before the operation;
- Exacerbation of mental illness (psychosis, depression, schizophrenia
- Insufficient blood supply to the brain (stroke, recent
postponed ischemic attack, vertebral artery syndrome).
Blood coagulation disorders (hemophilia, von Willebrand disease,
Verlgoff’s disease) are not a contraindication to extraction
wisdom tooth. However, to perform the operation you must comply
one condition that will help prevent uncontrolled
bleeding – remove the molar from the dentist in hematological
Department of General Hospital.
Recommendations after tooth extraction
Afterоперационный период – важнейший этап в удалении зуба
wisdom. At this time, stop bleeding from
gingival pocket, blood clot formation and gradual
overgrowing wells. Proper adherence to the recommendations of the dentist
allows you to speed up the healing of wounds and reduce the likelihood
appearance of complications.
Immediately after removal
During this period, the main thing is to stop the bleeding. Patient pain
still not worried, due to the action of the anesthetic medication, and the swelling
did not have time to form. After выполнения манипуляции, доктор
leaves a small gauze pad in the hole that speeds up
clot formation in the gum pocket. Normally, the blood should
stop dribbling in 5-10 minutes. The swab is removed no later than
чем через 20-ть минут после operations.
However, due to the complex extraction of a wisdom tooth (with deformed
roots, in a transverse position, etc.) the edges of the wound may be
too large to form a clot between them. In that случае,
the dentist places several sutures from self-absorbable sutures
(Vikryla or Ketkuta). This procedure does not affect the maintenance of the hole,
with the exception of one nuance – you should follow the seams after
operations. If they are not separated from the gums themselves,
reapply to a doctor who removes them after accretion
edges of the pocket. As a rule, this procedure is free.
In case of continued bleeding from the well, the dentist
imposes a special hemostatic (hemostatic)
sponge or compress (for example – Alvogyl). They are removed after 4-7 days,
depending on the rate of “overgrowing” wounds. Self it
should not be done as the improper extraction of these materials
may cause re-bleeding.
Edema after the removal of a wisdom tooth, especially complicated,
is formed big enough – as a rule, it is visible even to a look
non-expert To reduce it, the doctor may recommend
for 40 minutes immediately after the operation, attach a bubble with
with ice on the affected side.
In the coming hours after surgery
Patients at this time present three main complaints: pain,
появление температуры 37-37,9оС и начало формирования
swelling. Bleeding from the gum pocket may also resume.
which is not the norm. It indicates the “washing out” of the clot.
from the hole and requires a second visit to the doctor.
Recommendations after removal for the next 3-4 hours are as follows:
- Do not eat or rinse any mouth.
- Do not perform heavy physical exertion or expose
stressful effects. These conditions will increase
blood pressure, due to which the clot simply “washed”;
- Feel with your tongue, finger or hitting the hole with a toothbrush
also not worth it, because of the possibility of renewed bleeding;
- Do not drink hot liquid and take warm
procedures: bath, sauna, bath, etc .;
- If the pain is severe, you should take one of the following NSAIDs:
Nise (Nimesulide), Meloxicam, Celecoxib. These medicines have
fewer side effects than others (Ketorolac, ibuprofen,
Citramon, etc.), but provide a good effect after
Temporary fever (1-2 days) and swelling
normal body reactions that promote wound healing.
Therefore, to deal with them does not make sense.
In the coming days after surgery
At this time, the gingival pocket gradually heals after removal.
young connective tissue begins to form and vessels grow.
In order for the process to pass quickly and without complications
prevent infection of the wound. For this purpose it is recommended
make baths with solutions 0.04% Eludril or 0.12%
Chlorhexidine. For this, in a glass of water should be dissolved 2
spoons of medicine, take them in your mouth, hold for a few minutes and
spit. Rinse or swallow these solutions can not.
Most often, the pain and swelling bother the patient for about a week.
Eliminate discomfort can be using the above
NSAIDs, taking them no more than 3-4 times a day. Must be remembered
side effects of these drugs, in the form of rapid development
gastritis and ulcers of the stomach / duodenum. If you think that you
It is necessary to take long-term NSAIDs (more than 2 days),
It is recommended to drink 1 tablet of Omerpazole (or OMEZ,
Rabeprazole, Lansoprazole), until discontinuation of NSAIDs.
Complications after the removal of the diseased wisdom tooth are found
often enough, so you should be attentive to
the state of your body. We list the signs, if detected
which is recommended to consult a dentist:
- Cheek after removal continues to swell for several
days (longer than 3), indicating an increase in edema;
- Bleeding from the gum pocket is resumed;
- Температура поднимается выше 38оС, или держится в
пределах 37-39оС несколько дней;
- Numbness of the skin of the face (in the area of the cheeks, chin, nasolabial
triangles, lips) and gums.
After surgery, for several days, may persist.
small contracture – difficulty opening the mouth. It arises
reflexively and independently passes without any treatment.
To speed up the recovery of movements, you can “train”
temporomandibular joint, every day, actively opening the mouth to
the appearance of pain.
One week after surgery and later
How much does the gum pocket area after removal? After
7 days of pain should not bother the patient. Swelling to this
time is also significantly reduced in volume or completely
disappears. Since the young connective tissue is already completely
filled the hole, continue to prevent further infection
makes sense. Given these nuances, taking baths and using
NSAIDs are optional a week after tooth extraction.
Further healing and bone formation, if not
complications in the postoperative period, proceeds independently.
The first signs of bone formation can be detected after 2
of the week. Full closure of the bone through four
of the month.
In some cases, the overgrowth of the hole after tooth extraction
wisdom does not pass according to the above scheme. Due to the development
complications, tissue repair can drag on
significant period (up to six months). To prevent this from happening,
know the first signs of pathology and when they appear, refer to
to the dentist.
This complication often occurs due to the use of anesthetics.
together with narrowing vessels preparations (adrenaline). Artery spasm
prevents the formation of a blood clot, without which
Gum healing is impossible.
The treatment of a dry well is quite simple – it should be slightly
injure the gum pocket walls after termination
vasoconstrictor drugs. Perform this manipulation only
doctor, since independent actions can become the cause
Lunar postoperative pain
Pain in the gums after removal of the molar is a normal phenomenon, which
takes place in all patients. As a rule, discomfort
have a nagging / pulling character and low intensity. Average,
they persist for 3-5 days.
The appearance of a sharp, “shooting” pain in the gum pocket,
which does not diminish after using NSAIDs, a sign
adverse. Her appearance should alarm the patient, so
how often such sensations are the first signs of damage
surrounding tissues or their inflammation. States accompanied by
lung postoperative pain, and features of their clinic
|Cause of alveolar pain||Why does it occur?||Characteristics|
|Alveolite||Это воспаление стенок лунки, the cause которого могут являться:
At the initial stage, the pain is aching in nature and increases in
With the further development of alveolitis the following
|Limited osteomyelitis holes||The most common cause is the addition of an infection due to poor
treatment of the oral cavity in the first days of the postoperative period.
If osteomyelitis is not treated, the above symptoms
|Sharp edges of the alveoli||Traumatic operation||Acute pain in the area of the hole, which is intensified during
chewing food. As a rule, it occurs 1-2 days after
|Exposure of the alveoli||Trauma to the gums during surgery, due to which the plot was exposed
bones with periosteum.
|Pain occurs only when the gums are irritated by heat or
|Lunar nerve neuropathy||In some people, the roots of wisdom teeth can reach the canal,
in which the nerves of the mandible lie. As a result, after removing
tooth they become available irritation.
Patient tactics for all these conditions should be one –
contact your dentist who will determine the exact cause
postoperative pain and will conduct the necessary treatment.
Purulent postoperative complications
These are the most adverse effects of tooth extraction.
wisdom that require surgical treatment. To purulent
Complications include phlegmon and abscess. Pain in these conditions
expressed slightly, in contrast to the symptoms of intoxication:
- Температуры выше 38оС;
- Headache, dizziness;
- Loss of appetite.
Also the formation of phlegmon / abscess is often characterized
the appearance of pronounced swelling of the entire face. The presence of the above
symptoms after wisdom tooth extraction – absolute indication,
to see a doctor. If possible – to
The removal of a wisdom tooth is a serious operation, after which it is important
comply with the recommendations of the doctor. He will tell the patient how to
take care of the gum pocket than rinse after removal and
approximate terms of healing. If the extraction of the molar was performed
technically and the patient managed to avoid the development of complications
зарастание лунки костью происходит через четыре of the month. Otherwise
case – much later. To prevent this from happening,
pay attention to the appointments of the dentist and regularly
to control the state of the gum pocket.