Wisdom tooth growing in a tooth: climbing horizontally, remove
«A wisdom tooth growing in a tooth,» said the dentist after the examination x-ray. You are at a loss sitting in a chair. Probably nothing wrong with that, and not worried about anything, or so little SIPS nearby. And maybe nothing will happen – let themselves sitting in the bone. However, it is not so simple. Not for nothing do we have the teeth all approximately parallel to each other are and groups are divided. The question of the position of the wisdom tooth relevant, let’s examine it.
The reasons for the wrong position
Dystopia – the phenomenon is quite common at the present time, indicated by a wrong position in the tooth row or move over the edge of the alveolar process of the jaw.
- Vestibular: the inclination of the tooth in buccal direction;
- Oral: the tilt toward the tongue or palate;
- Medial: tilt forward to the adjacent tooth;
- Distal: the tilt of the back relative to the tooth;
- Saprolegnia: tooth climbs and cut through above the occlusal plane;
- Intrapolate: eruption is indicated below the plane of the closure;
- Tortuosity: around the axis of rotation;
- Transposition: the teeth change places.
Wisdom teeth, molars or eight (the eighth from the Central line, which passes through the tip of the nose, between the Central incisors and the tip of the chin) is cut in age from 18 to 25 years. Some even later or not appear at all. The change of primary teeth starts at 5_6 years, the process is continuous, the appearance of one group after another. At the same time, the growth and movement of the jaw bones (the mandible is displaced anteriorly and downward). Ends the seventh eruption closer to 15 years. Accordingly eight appear in the mouth remains only where there is free space.
If the wisdom tooth is growing horizontally, there is nothing good about it. At this point, eight may not erupt at all or referred to only in the mouth edge that is to become retiirement. If the tooth lies horizontally, it is considered dystopianism.
What can determine the appearance of this anomaly? The main point in the incorrect eruption of the eighth teeth is hereditary pathology. Genetically laid data about the model of the jaw of the baby, it can happen that not all the teeth have enough space to emerge. And, as a rule, wisdom teeth.
However, there are several other causes of lying wisdom teeth:
- Tooth climbs on the term and has no close reference point for the emergence;
- The presence of supernumerary teeth: an atavism, in which the ontogeny has occurred tab dental germs beyond the norm. At first they can limit the free space for the emergence of eight;
- Fracture of the jaw under the influence of mechanical forces, contributing to the occlusion;
- Defects in the processes of formation of dental germs;
- Loss of milk teeth prematurely change permanent: if you do not replace the formed defect, the further process of eruption of permanent will happen in a chaotic manner.
The symptoms of note the patient
Eruption of wisdom teeth occurs, usually in adulthood. The jaw bone is already in the completed stage of formation, the gum tissue is strong, adapted to the supplied loads. From time to time a person may be nothing to celebrate. To know that the wisdom tooth is, it may, after conducting panoramic photography in the x-ray Cabinet (displays the status of both jaws in expanded form with the seizure of temporo-mandibular joint). However, this is rare.
Often the following symptoms:
- Discomfort when eating;
- Pain when opening the mouth, and the touch to the field of eight from the cheeks;
- The swelling of the gums in a radius of eight and cheeks;
- Pain when swallowing;
- Violation of the articulation;
- Aching pain, radiating to the neighboring tooth;
- The violation of clamping teeth;
- Pain and an increase in regional lymph nodes;
- General signs: headache, fever, malaise, sleep disturbance and appetite.
The manifestation of each symptom is individually. Much depends on the genetic data of the jaw, of the peculiarities of the nervous and immune systems.
Eighth teeth cause the above mentioned symptoms on the background of a set of data:
- The pain is due to the fact that the eruption in this phase of the jaw is the first time (no change of milk teeth on permanent);
- In light of the fact that eight are designated at the end of the jaw, mostly on the edge, a long time is not progresivas, they have curvature of the root;
- Since there is no support behind the appearance, often the eruption occurs in different directions;
- On the background of lack of space in the dental arch, they can put pressure to the neighboring tooth, causing the appearance of inflammation;
- Tooth climbs are long and sometimes not always there.
What are the risk of complications from malposition of eights
In case of untimely treatment of the patient to the dentist growing the wrong tooth can cause a number of complications:
- Injury to mucous membrane: when the position of the wisdom teeth at the same time horizontally and vestibular may result in chronic injury of the mucosa that is manifested by the appearance of the wounds, the swelling of the mucosa, tenderness to the touch and the mouth is open. In such a situation may prompt the accession of the microbial flora and the development of infection, aggravating the clinical picture;
- If the patient after the appearance of these symptoms not asked for help, then there is deterioration. The wound that led to the formation of stomatitis (inflammation of mucous membrane), gradually increasing in size. Amid continuing act of trauma and the lack of healing there is erosion. There is a gradual suppuration of the tissues in the gums, cheeks, soft tissues of the face. For therapy will require the intervention of oral and maxillofacial surgeons, isbecause affected area and combining in the treatment the use of antibiotics;
- Against the background of severe dystopia a change in the occlusion. Over time, this is reflected in the act of chewing, is manifested by pain in the head, jaw and neck. Wrong redistribution of pressure on the tooth, which leads to increased tension in areas and their gradual destruction;
- Too much pressure in the direction of a neighbor can lead to the formation of inflammation in the periodontium. This will lead subsequently to the formation of periodontal cysts and fistulas. Over time, the process konsolidiruyutsya in an abscess with subsequent dissemination in the form of cellulitis. As well as prolonged contact may eventually form a cavity. Is not excluded the appearance and trigeminal neuralgia;
- Malignant neoplasms: if the tooth is horizontal point of reference with the vestibular direction, then the prolonged strain on the mucosa of the cheek will determine its gradual seal. Under the influence of a number of damaging factors from outside or from the outside, this tissue may grow into a malignant tumor.
Diagnosis is performed in compliance with fundamental and additional methods of examination. The main methods include: questioning (complaints, the anamnesis of life and disease), and inspection with the aid of specialized tools. Oral collection of information allows to determine genetic predisposition, symptoms of discomfort.
Inspection start spending with an assessment of the General condition of the patient, moving to the visualization of the maxillofacial region. Usually the face is symmetrical, the proportions of the saved and the skin without pathological changes. The presence of asymmetry due to the severity of inflammation and the topography of the contact gistaminovogo of the tooth. It usually happens when in contact with the cheek. Regional lymph nodes are enlarged, painful on palpation. The mouth opening is a bit complicated.
The oral exam involves the assessment of soft tissue and hard tooth structure. It is noted that the crown of the wisdom tooth is growing in the neighboring tooth. Perhaps the partial emergence of the hillocks. Sometimes marked carious defects. The sensing cavity sensitive. At a percussion on the lead hill there is pain, radiating to the right side tooth. Palpation of the gums is painful. Often marked by the presence of mucosal hood on the hills, which accumulate food remnants, exacerbate the inflammatory process. Mucous in places of injuries thinned, defects, incrustation, painful on palpation, may bleed.
The main method of diagnosis of malposition of eight is radioviziografichesky examination. Determine often when performing panorama shooting. Is the full or partial reinerova, the direction of the crown to the roots.
Usually tactics of a dentist in dystopia eight – deletion. However, this is not always performed. If it’s a teenager 15_16 years (the bone is not yet formed until the end) and pathology of hard tissues of teeth is not very pronounced, then commence orthodontic treatment. However, if the patient age is significantly higher and the pathology presents more variation, then clearly it is necessary to remove.
The doctor performs to start the production of analgesia. Prior to any manipulations, the patient fills out informed consent for intervention, including removal. It is noted the presence of chronic diseases and allergies to previously conducted injections. Running the application (anaesthetises the place of puncture), infiltration (anaesthetises the tissue in the radius of the tooth at a certain depth), Explorer (relieve from a few of the teeth to one half of the jaw).
- After the onset of the necessary for intervention of numbness the doctor nutritoin access performs the incision of the mucoperiosteal flap (with the help of scalpel or laser), throws it. It is preferable to use the laser because it is more precise execution of surgical interventions, accompanied by little loss of blood;
- Bor drills a Burr hole in the periosteum;
- Performs the removal with the forceps and elevators of eight, if necessary, sawing it with a drill and performing the erasing;
- Performs processing the wells antiseptics, waiting for the formation of a blood clot;
- Stitches: a complete or incomplete closure (if the removal process appeared pus must after careful medical treatment to put a drainage hole);
- Makes recommendations to the patient.
Using 5_7 days the patient must come again for a visit to the doctor. The doctor evaluates the degree of healing, presence of complications (alveolitis – inflammation of the hole remote eight), produces a bandage if necessary.
Often the extraction process in the correlation of reading combined with conducting pharmacological therapy: antihistamines (Diazolin, claritin), analgesics, upon accession infection broad-spectrum antibiotics (Tsiprolet).
The postoperative period
Extraction eights for a number of reasons running harder on the background of anatomical distortion of the tissues. It is therefore important to carry out appropriate wound care. After it was done the removal is necessary to create conditions to prevent the accession of the microbial flora, to speed up the healing process:
- The oral hygiene should be done carefully to avoid injury to the area of treatment;
- In order to avoid the washout of a blood clot, which plays a significant role in the healing process, it is recommended to 2_3 of the day to exclude the use of mouthwash;
- After 3 days, you can apply the mouth trays with the salt, baking soda, herbs. You can add a few drops of an alcoholic solution of iodine solution (has antibacterial properties);
- Food is recommended to use the consistency of cream and sour cream, the act of chewing to do on the opposite side;
- Within a few hours after the operation nothing to eat or smoke;
- If there is pain after the falling of anesthesia shall be allowed to use analgesics (Ketorol, Nise);
- For 2 days you need to reduce physical and emotional stress.
If the patient noted severe pain even after taking painkillers, Spokane the gums, cheeks, fever more than 37.5 degrees Celsius, you should immediately contact your doctor to prevent the development of complications.