Impactions.
Teeth are impacted when they fail to emerge
through the gums, or emerge only partially, at the expected time.
Your wisdom teeth, also called third molars,
usually begin to erupt between the ages of 17 and 21. Because they are
the last to emerge in the mouth, wisdom teeth are the most common teeth
to become impacted. This may happen because a wisdom tooth is turned
to the side, tilted or otherwise positioned incorrectly in the jaw.
Wisdom teeth also become impacted when there is not enough room in the
jaw or the mouth for them to emerge.
An impacted tooth can be painless, and you may not even realize it's
there. However, when an impacted wisdom tooth tries to erupt, the overlying
gum may swell and cause pain, which may also be felt in nearby teeth
or the ear on that side. A partially erupted tooth can collect food
and other debris, which can lead to gum swelling and an infection called
pericoronitis. If untreated, this infection can spread toward the throat
or into the neck. Impacted teeth also can cause problems if they develop
decay or if they push on the neighboring molar, which could lead to
tooth movement or decay, as well as changes in the bite (the way the
teeth come together). Impacted teeth also can cause cysts and other
benign (harmless) jaw tumors. These can lead to bone destruction. However,
this is rare.
SYMPTOMS
Symptoms include:
· Swelling of the gum in the back of the mouth or on the side
of the jaw
· Difficulty opening the jaw
· Bad breath
· An unpleasant taste in the mouth
· Pain or irritation when you open your mouth
· Pain when chewing or biting
· Pain can occur for several days and then disappear for
weeks or months before returning.
One of the main goals of modern dentistry is the prevention
of tooth loss. All possible measures should be taken to preserve and
maintain your teeth because the loss of a single tooth can have a
major impact upon your dental health and appearance. However, it is
still sometimes necessary to remove a tooth. Here are some of the
reasons a tooth may need to be extracted.
::
Severe Decay
:: Advanced periodontal disease
:: Infection or abcess
:: Orthodontic correction
:: Malpositioned teeth
:: Fractured teeth or roots
:: Impacted teeth |
Wisdom
tooth extraction or Impactions
Many
people require removal of their third molars also known as wisdom
teeth. As with any surgical procedure, there are some possible risks
and complications. The decision on third morlar removal should be
decided by a patient and their dentist.
Is it necessary to remove wisdom teeth?
Wisdom teeth are a valuable asset to the mouth when they are healthy
and properly positioned. Often, however, problems develop that require
their removal. When the jaw isn't large enough to accommodate wisdom
teeth, they can become impacted (unable to come in or misaligned)
Wisdom teeth may grow sideways, emerge only part way through the gum
or remain trapped beneath the gum and bone.
Extraction of third molars is
generally recommended:
· When wisdom teeth only partially erupt;
· When there is a chance that poorly aligned wisdom teeth will
damage adjacent teeth;
. When a cyst (fluid-filled sac) forms, destroying surrounding
structures such as bone
tooth roots.
The
most common reason people choose to remove their wisdom teeth is that
their mouth is too small for these teeth to normally erupt behind
the second molare into a good position. This can result in one of
the following situations:
1. Complete Bony Impaction
when the wisdom teeth are completely covered in bone. When the tooth
is completly covered with bone it will remain completly covered
with its "developmental sack" in which all teeth develop.
Later in life, this sack may undergo changes and enlarge and develop
ionto a cyst. This cyst will enlarge at the expense of the bone
of the jaw. These cysts should be removed and and examined by a
pathologist.
2. Partial Bony Impaction whenThe teeth begin to erupt but are not
able to erupt completely. In this situation, the upper third molars
usually are poisitoned towards the cheek while the lower third molars
usually lean forward with only part of the crown sticking through
the gum. This situation can to decay and gum disease around the
second molar directly in front of it.
The most common complication of the partial bony impaction,
is that the flap of gum tissue which partially covers the erupting
third molar, creates a pocket where bacteria that are present in
the mouth can grow and and cause an infection known as pericoronitis.
The swelling and infection can become very serious. The treatment
for pericoronitis is extraction of the third molar tooth.
Some dentists believe that wisdom teeth may push
the other teeth in the mouth forward and cause crowding and misalignment
of the lower front teeth. Not all dentists believe that this actually
happens.
The risks and complications involved in the removal of third molars
are:
PAIN
Surgical removal of the third molars can lead to some
discomfort and pain. This is usually treated with pain medication.
INFECTION
Because of the large number of bacteria present in the
mouth post surgical infection is always possible. Patients are usually
placed on prophylactic antibiotics to prevent infections from developing.
SWELLING
Following surgery patients may experience swelling and
bruising. These symptome vary between patients.
BLEEDING
Some post surgical bleeding is considered normal. This
is usually minimal and is easily controlled with the pressure of
biting on gauze.
INVESTIGATION
Examine the area and take X-rays if needed. X-rays can
show where your wisdom teeth are and if they are impacted.
TREATMENT
You can sometimes relieve minor irritation by rinsing
with warm salt water (1/2 teaspoon of salt in 8 ounces of water)
or by taking over-the-counter painkillers.
If the tooth continues to cause pain, it is infected or is interfering
with nearby teeth; the usual treatment is for the tooth to be extracted.This
can be done in our clinic with a local anesthetic, depending on
how far the tooth is under the gum. Extracting one tooth can take
5 to 30 minutes, depending on the position of the tooth.
We have an oral and maxillofacial surgeon to have an
impacted tooth removed. It is not uncommon to have all the wisdom
teeth removed to prevent problems in the future. This usually is
done in the surgeon's office with sedation and local anesthesia.
Before the extraction, our oral surgeon will talk to you about the
procedure and what type of anesthesia and sedatives he or she will
use. You will not be able to eat for six hours before surgery and
should take all your medications on schedule. Someone should drive
you to the appointment and take you home.
Follow the oral surgeon's instructions carefully to
minimize problems.
If the impacted tooth is not causing irritation or affecting nearby
teeth, you won't need immediate treatment. However, it is recommended
that the tooth be extracted to avoid problems later.
Although not all impacted teeth lead to problems, many
will. In addition to causing pain and possibly infection, impacted
wisdom teeth can decay just like teeth that have emerged through
the gum. An impacted wisdom tooth also can lead to the development
of a follicular (dentigerous) cyst, which can damage nearby teeth
and has the potential to destroy nearby bone.
Often, it is better to have wisdom teeth extracted before
age 21, sometimes as early as age 16. The surgery often is less
complicated, and the area, including the surrounding tissue and
bone, heals better than if they are removed later in life.
|
 |
