Gomulu Cekim | DT Şenay YILMAZ

Surgery of impacted teeth;

It is the extraction process of third molars, which usually have eruption problems in the mouth. Since these teeth erupt between the ages of 17 and 25, they are also called wisdom teeth. This is present in cases where the teeth are left in the mouth. Wisdom teeth may not need to be extracted if they grow in a direction that will contact the opposing tooth properly and without causing space constraints. The teeth that experience eruption problems on the palate after wisdom teeth are canine teeth. These can also be removed from the palate or maintained with orthodontic brackets.

Why do wisdom teeth need to be extracted?

CARISE: If saliva, bacteria and food residues accumulate in the socket formed during the eruption of the tooth, it may cause decay in the tooth and threaten the adjacent tooth. It is difficult to detect these early. If decay occurs, it may cause infection and abscess in the teeth and surrounding tissues. Painful conditions may occur.
GUM ABSCESS (PERICORONITIS): In partially erupted teeth, the infection in that area spreads to the soft tissue and causes bad breath, pain and edema. In some cases, inability to fully open the mouth causes halide (trismus). If this situation progresses further, it spreads to the cheek and neck area through the lymph. also spreads. Since this area is not cleaned well, it is prone to infection.
PRESSURE PAIN: During eruption, wisdom teeth may put pressure on neighboring teeth and cause pressure pain in that area. It may even cause wear and resorption on the adjacent tooth.
FOR ORTHODONTIC PURPOSES: Many young individuals receive orthodontic treatment to correct crooked teeth. The eruption pressure of wisdom teeth exerts force on other teeth and causes them to push, resulting in crooked teeth.
REASONS FOR PROSTHESIS: We should take wisdom teeth into account when planning prosthetics, because wisdom teeth are rarely used as prosthetics. In some cases, wisdom teeth may need to be extracted for this reason.
CYST FORMATION: Cystic formations may occur due to the non-resorption of the surrounding follicle (sheath) while the impacted teeth are erupting. These formations can grow and cause resorption (wear) in the bone, creating large gaps in the bone and weakening the jaw bone. These can cause fractures in the jaw bone. In rare cases, these cysts can turn into tumors. In order to avoid this risk, wisdom teeth extraction is performed without delay.

I have no discomfort with my wisdom teeth, does it need to be removed?

Even if you do not have any problems with your teeth, you should see your doctor for a check-up, get examined and see the condition with a panoramic film. If there is no problem in its position, no infection, tightness of space, caries problem or bad breath, it can be evaluated later. But it should not be forgotten that all of these can suddenly appear at an unexpected time and cause much more distress and pain. They can also be withdrawn for protection purposes to prevent this situation from arising.

So, what is the best time for wisdom teeth extraction?

Although there is no such time, it would be better if it is taken between the ages of 20-30 in order to heal faster and without problems. Over the age of 40, operations become more difficult, the post-operative period becomes more difficult, and the recovery period becomes longer.

I can see or feel the tip of my tooth, and there is swelling, redness and pain in the surrounding gum. What should I do?

In this case, an infection that we usually call Pericoronitis has started. Make an appointment with your doctor now. If early intervention is made, this period can be overcome before pain and swelling increase.

Can a wisdom tooth be removed if it is painful or swollen?

There is usually an acute and active infection. In this case, antibiotics are used, oral hygiene is taken under control, and imaging is performed. Otherwise, the infection will spread to the environment, the numbing effect of the anesthetic will be low, and this will cause pain during the operation. The healing period of the infected area after the operation is also difficult and long.

Is it any different from normal tooth extraction?

Yes, it is different. The location of the wisdom teeth in the jawbone, their posture, their size, and whether they are covered with bone or mucosa may make extraction difficult.
Slight swelling, pain and bleeding may occur in this area after an easy extraction. Following this extraction, if blood does not collect in the extraction space in this area and the environment remains dry, a healing problem called alveolitis - dry socket - may occur. This situation resolves after a few days. If your dentist's recommendations are followed, the patient may not encounter these problems with good postoperative care, medication, and your doctor's observation and dressing.
In older patients, as the bone structure becomes denser and flexibility decreases, extraction becomes difficult and healing slows down.

Post-operative oral care

The wound area should be played with. Otherwise, pain, infection or bleeding may occur.
Chewing should not be done with that side for the first 24 hours.
You should not smoke for the first 24 hours. Because smoking increases bleeding and impairs healing.
It should not be spit on. Otherwise, the clot may dislodge and the bleeding may not stop.
Bleeding must be controlled. If no stitches have been placed, tampons are applied with sterile gauze for 15-30 minutes after the shooting. The tampon should be kept in the mouth until a clot forms. If bleeding continues after removing the tampon, a new one is placed.
To prevent swelling on the face, circulation is slowed down by applying a cold tampon to the area after the operation. The application should be as follows: 10 minutes of cold tampon - 2 minutes break - 10 minutes of cold tampon again.
It is good to gargle with salt water after the first 24 hours. The mixture is prepared by adding 1 teaspoon of salt to 1 glass of warm water.

Again, depending on the oral hygiene situation, it may be recommended to gargle with antiseptic mouthwash after brushing the teeth twice a day, morning and evening.