Usually the question of whether to remove wisdom teeth does not arise out of the blue: apparently, a destroyed or cutting molar causes anxiety. Most of the trouble associated with the growth of the eighth tooth, in the future - with factors such as caries and pulpitis.
Doctors note that any body signals emanating from a wisdom tooth require a reaction. Attempts to solve the problem with painkillers are as unwise and dangerous as turning off the fire alarm for the sake of peace and quiet.
Causes of pain can be very serious: periodontitis, cyst, root canal obstruction, inflammatory diseases. Modern dentistry successfully and painlessly, if possible, eliminates any irregularities.
Due to its anatomy, the Eight are difficult to access and unresponsive in treatment, the timing and characteristics of their growth differ from the rest of the dentition; in the process and after removal, certain difficulties may also arise. Experts believe that if the wisdom tooth is healthy and does not cause discomfort, there is no point in surgical intervention.
The role of the wisdom tooth
Like any other organ, wisdom teeth perform their functions, which you should be aware of before deciding to get rid of them.
Dentists have noted the following benefits of preserving molars:
- role in the digestive system: symmetrically positioned eights participate in chewing food along with other teeth.
- Prosthetic capabilities: in the absence of adjacent teeth, this is the only support for a fixed denture.
- the formation of the correct bite: an impressive hole, remaining after removal, can cause the curvature of the dentition and teeth loosening.
These are good reasons not to remove, but to treat a wisdom tooth for such diseases as pulpitis, caries, periodontitis. Pulpitis (inflammation of the dental nerve) is often the result of carious damage. To save the tooth, it is necessary to decontaminate and properly fill the root canals.
Periodontitis (inflammation of the tissues around the dental root) can develop both as a result of the obstructed growth of the wisdom tooth and because of the destructive processes, with time it takes the form of a cyst. The struggle for the safety of a tooth damaged by periodontitis sometimes lasts more than three months. There are complications in which it is impossible to cure a wisdom tooth.
If the jaw clicks when the mouth is opened, it can inform a person of a ripe or only imminent problem in the region of the jaw joint. Usually, after the initial intake, doctors diagnose arthrosis, but this is not always the case, and for a correct diagnosis, a full and repeated examination is necessary.
About cystic diseases of the maxillary sinus read later in our material.
See if you can rinse and disinfect your mouth with hydrogen peroxide here.
Do I need to remove wisdom teeth?
In medicine, the wisdom tooth has long been considered a rudiment, not related to the quality of digestion and creating unnecessary trouble for patients and doctors.
Today, experts discover new facts in favor of the safety of the eighth tooth and note the negative consequences of its removal.
The approximate period of the formation of wisdom teeth is 15-27 years. The growth process is conceived by nature as natural and painless. The problem may be the wrong bite, which is why a massive wisdom tooth simply does not have enough space in the dentition.
Complicating eruption and pericoronitis (inflammation of the gums). Do not rely on the fact that growing and previously grown teeth themselves share the jaw space.
Is it necessary to remove a wisdom tooth
When the growth of wisdom teeth is accompanied by pain, you should contact your dentist to identify the cause of discomfort. Even in such seemingly hopeless situations, the attending physician suggests ways to avoid removal, for example, prescribe treatment from an orthodontist. Ideally, it is desirable to begin to be interested in the state of bite in advance, without waiting for the wisdom tooth to erupt.
If the need for removal does arise, dentists warn of possible consequences:
- long painful healing of a large hole,
- feeling of numbness in the jaw or tongue: if such a condition lasts for more than a week, it is necessary to undergo a medical examination,
- alveolitis: inflammation of the gums at the place of the extracted tooth, often happens due to neglect of hygienic norms and doctor's recommendations.
Do I need to treat a wisdom tooth or remove
The decision about the need to remove a wisdom tooth is taken by the dentist based on the following factors:
- the tooth is so destroyed by caries that it cannot be treated.
- root canal obstruction.
- improper location, leading to pain and injury to the mucous.
- cyst formation.
- incurable repeat pericoronitis.
- acute inflammation, indicating a neglected form of the disease.
Lack of space for eruption can lead to deformation of the dentition, in some cases, the jaw bone. A gradual but steady disturbance of the bite in the end affects the quality of chewing food and the functions of the digestive system. Not the last role is played by the aesthetic side: the crowding of the front teeth negatively affects the image of the patient.
Among the most common causes of inflammatory processes, experts note pericoronitis, which is repeated, despite repeated medication, pulpitis of the trigeminal nerve branches, incurable periodontitis.
Wisdom tooth treatment
In comparison with the rest of the dental row, the eight have characteristic differences that must be taken into account during treatment.
Most often, dentists have to deal with the following problems:
- Mechanical damage to the enamel.
Pericoronitis is an inflammatory process that gradually forms during the period of tooth cutting.
The disease is diagnosed with the following symptoms:
- increasing pain, which often increases with the opening of the mouth,
- throbbing sore throat, ears, temples,
- persistent headache, fever,
- the appearance of edema
- redness of the mucous membrane,
- discharge of mucus into the oral cavity.
Relieve the patient's condition at home with the help of traditional painkillers and rinses with a cool solution: a teaspoon of salt and soda per cup of water. It is important to understand that these tools only partially eliminate unpleasant symptoms, but are not an alternative to qualified dental care.
Inappropriate actions in this situation include:
- The use of heating pads, compresses, hot solutions for rinsing: heating contributes to the enhanced development and spread of infection.
- The use of painkillers and anti-inflammatory pharmaceuticals for other purposes, for example, applying a pill to the site of edema: the drug effect is reduced to zero, the probability of irritation of the mucous membrane is high.
The dentist first of all reveals the abscess, disinfects the cavity, prescribe anti-inflammatory drugs, sometimes in combination with painkillers, if the patient’s condition requires it.
The abundance of pus at autopsy is an indication for prescribing a course of antibiotics.
Because of its inaccessibility for a toothbrush and hygienic rinse, a wisdom tooth is more prone to caries.
Sometimes the cause of the development of the disease is damage to the enamel during difficult eruption. Often, the eight closely pressed to the seven, which also contributes to infection.
In individual cases, treatment complicates the structure of the roots: in order to qualitatively fill in the curved root canals, a certain professional experience is required from the doctor. It creates inconvenience and tooth placement: it happens that the patient cannot open his mouth wide enough or control the gag reflex. The treatment of a wisdom tooth requires special accuracy, since the probability of complications with an error is higher than in cases with other teeth.
If you are worried about bitterness on the lips, then this can mean a number of problem factors, the roots of which most often go to diseases of the gastrointestinal tract, for example, inflammation of the small intestine or giardiasis.
On how to restore tooth enamel on the teeth, read this link.
Do I need to pull a wisdom tooth
The removal procedure is preceded by an X-ray examination - a necessary measure that allows the surgeon to get an idea of what to deal with.
The most common "underwater stone" are crooked roots. Knowing in advance their shape and location, the specialist will be able to make sure that during the operation they are extracted without residue.
Digital orthopantomographic image allows you to get the most accurate panoramic X-ray image of the entire oral cavity. The information content and clarity of the image is not the only advantage of the orthopantomogram. The patient feels quite comfortable, the technology eliminates the possibility of errors due to uncontrolled movements or bending of the film during biting.
Preliminary examination includes the study of the patient's medical card for allergic reactions to medications and the presence of concomitant diseases that may be felt during the procedure and during the rehabilitation period.
The waiting time between the time of anesthesia and the start of the operation is about five minutes. The doctor prepares the appropriate set of tools.
Modern surgical dentistry has a sufficient arsenal of anesthesia tools and techniques to minimize pain during the procedure.
There are factors that can reduce the effectiveness of painkillers:
- Regular use of drugs by the patient.
- Taking large amounts of analgesics shortly before the procedure.
- Extensive focus of inflammation: theoretically this is possible, but in practice it happens very rarely.
The simple removal procedure can take less than a minute; more complex cases take about 10 minutes.
A complex operation implies not just extracting the root, but also a number of manipulations:
- incision and detachment of soft tissues,
- drilling of bone fragments,
- suturing non-absorbable material.
After a few days, a follow-up appointment is appointed, the surgeon decides on the removal of sutures during the examination. Indications for complex removal are retention and an extensive inflammatory process. After removal of the inflamed wisdom tooth, suturing is not performed so that the contents can flow freely, antibacterial therapy is prescribed. A day after the procedure is carried out inspection.
There are physiological differences between the removal of the upper and lower teeth. The molars of the lower jaw are wider, they almost always have several roots, the shape of which makes extraction difficult. The upper teeth of wisdom are also characterized by branching of the roots, however, they are removed quite easily.
At the end of the operation, the doctor applies a tampon soaked in disinfectant solution and a means of promoting blood clotting. A tampon should be kept in the mouth for no more than 10 minutes: after soaking with blood, it becomes a breeding ground for bacteria.
Typically, the dentist makes recommendations that should be followed the first day after surgery:
- eat food no earlier than two hours
- refrain from products with pronounced taste properties: under their influence, the receptors activate blood flow,
- adhere to the temperature regime: drink only cool drinks, do not take hot baths, do not use the sauna,
- avoid physical exertion, do not strain the jaw muscles,
- a compress from ice wrapped in a towel will help reduce pain and swelling, it is applied to the cheek for 5-7 minutes,
- It is advisable for hypertensive and diabetic patients to prepare medicines in advance in case of possible exacerbation of diseases,
- follow the recommendations of the doctor exactly, do not improvise without asking.
The procedure for the removal of a wisdom tooth is never prescribed without good reason, which represents a serious threat to the health, and sometimes the life of the patient.
In the conditions of a modern dental clinic, the operation is carried out fairly quickly, with a minimum of pain, with the observance of technology and sanitary standards. Fulfillment of the dentist's prescriptions serves as a guarantee of fast healing of the hole and further well-being.
Why do we need wisdom teeth at all, and when can they come in handy?
It is believed that wisdom teeth are an example of atavism - they came to us from distant ancestors who ate roughage, which, if prepared, then without long-term heat treatment. To chew it effectively, a large chewing surface was required — large and strong molars, including wisdom teeth.
Compared with the dental rows of our ancestors, the dental arch of a modern person has become shorter on average by 10-12 mm - accordingly, there is less space for eights. The food consumed by human civilization has become softer and more digestible, and, in fact, the need for wisdom teeth, in terms of their functionality, has disappeared.
However, wisdom teeth can be very useful in the lives of most people if two basic conditions are met:
- They have a pair - that is, the upper and lower eighth teeth on one (or both) sides of the jaw are a pair of antagonists,
- They are not strongly destroyed by caries and have no mobility (for example, due to periodontitis) - that is, they can be used in the future as a support for an orthopedic construction (single crown, bridges, for a removable denture, etc.).
In the first case, everything is more or less clear: why should a wisdom tooth be removed if it functionally meets all the requirements for normal chewing of food. Naturally, in this regard, he does not occupy such leading positions as 6 and 7 molars, but he contributes his regular and full contribution.
With regard to the wisdom tooth, as hopes for perspective prosthetics in the elderly, one can say the following: if you lose a large number of teeth in the upper or lower jaw in certain clinical situations, it is the eight that can be an excellent support for the future prosthesis in the broad sense of the word.
An example of using a preserved wisdom tooth as a support for a partial denture is shown in the photo below:
From the practice of the dentist
Often, a wise tooth becomes the last hope for a bridge - then why, one wonders, without a compelling need to pull out a wisdom tooth, which, if you lose end teeth important for prosthetics (6 and 7), can become a reliable support for the bridge coming from the five (premolar).
Even in the event of some destruction, the wisdom tooth can become a support under the crown, and that, in turn, will serve as a supporting element for fixing a partial denture (byugelny, laminar, butterfly-prosthesis, etc.).
So, as you can see, wisdom teeth should be protected and if there is an opportunity to heal, and only be removed as a last resort, when there are appropriate indications for this. However, with regard to indications for the removal of eights, there are some subtleties - let's consider them further. And let us begin, perhaps, with the question of the need to remove wisdom teeth with their carious lesions ...
Is it worth treating a wisdom tooth if it is affected by caries, or is it better to remove it immediately?
As a rule, when they independently find out dental caries, patients come to dentists-therapists who are directly involved in the treatment of teeth (that is, they carry out therapy).
Let's see how a dentist therapist makes a decision about whether an eighth tooth can be treated with caries, or whether we should think about removing it, referring it to a dentist-surgeon.
Example # 1: there was no problem with the eruption of a wisdom tooth, and he fell into place without injury to the oral mucosa, however, on its surface (chewing, contact, or others), over time, foci of caries appeared. In this case, it is not necessary to remove the wisdom tooth, but it is advisable to treat it, and as early as possible so that the carious process does not go deeper to the pulp chamber (to the “nerve”).
However, even if the pulp of the tooth is affected and it is no longer a matter of caries, but of pulpitis - even in this case, the wisdom tooth does not need to be rushed to be removed, it is only necessary to treat the canals and install a filling. The tooth will be "dead", but it can serve for a very, very long time.
The picture below shows an example of significant decay of the wisdom tooth:
Now we will consider situations when it is not always advisable to treat a wisdom tooth with caries, and sometimes it is better to remove it as soon as possible.
Пример №2: значительное разрушение зуба мудрости при неполном его прорезывании. Иначе говоря, лишь отдельные бугры зуба мудрости показались над десной, а остальная его часть находится под десной, но при этом уже наблюдается серьезное кариозное разрушение.
Wait, when the wisdom tooth is all on the surface for its full treatment, or, especially, to endure periodic pain, temperature and edema when it is difficult to erupt - there is no sense, it is a vicious practice. Of course, this does not apply to superficial caries, or even medium with relative comfort (no pericoronitis symptoms). However, monitoring the situation is also important here so as not to miss the destruction of the tooth to such an extent that it will have to be removed anyway, but already against the background of serious complications (periostitis, osteomyelitis, abscess, phlegmon).
Example No. 3: incorrect position of the wisdom tooth that has erupted in the jaw in the presence of significant carious destruction (including the situation that impedes the hygiene of the 7th tooth). When a wisdom tooth has a significant deviation from the normal position in the jaw, it is difficult to ensure its adequate hygiene, as a result of which caries progresses rather quickly, and the seven can also be involved in the process. In addition, there is often a violation of the bite in general.
Be that as it may, in practice each situation is individual, and the doctor decides whether to treat a wisdom tooth or remove it, taking into account the specifics of a particular clinical case.
Even if you signed up for a wisdom tooth extraction dentist, it is not a fact that he will remove it for you. The fact is that dentists-surgeons are engaged not only in the extraction of teeth, as people commonly think, but also in their salvation by performing tooth-saving operations (and if they are removed, then only with clear indications).
If we are not talking about any indifferent doctor in a seedy clinic, then it is the dentist-surgeon who will help you to establish exactly whether you need to remove a wisdom tooth right now or you can try to save it.
A few words about the treatment of caries of the eighth teeth
So, in case of caries lesion of a normally erupted and properly functioning wisdom tooth, it is not necessary to hurry to remove such a tooth, it is enough to carry out its full treatment.
Almost always, in such cases, the classical preparation of the carious cavity using a drill is used as a preservation technique.
Modern dental units provide the frequency of rotation of boron at the level of 80-100 thousand revolutions per minute. At such a speed, the contact of boron with hard tooth tissues in the absence of forced cooling would lead to a strong heating, therefore, air-water cooling of the tip is used.
Let's consider a number of popular issues related to the treatment of wisdom teeth affected by caries.
Patient question number 1: is it painful to treat caries on the wisdom tooth?
At the stage of superficial or even average caries, a wisdom tooth can now be treated absolutely without pain, even without the use of anesthesia. The fact is that during the work of the handpiece that meets the requirements of dentistry of the 21st century, there is practically no vibration (as it happened before) and overheating of the tooth, which almost always excludes the formation of pain. However, in hypersensitive people, as well as in the treatment of deep caries, it is preferable to conduct anesthesia.
Patient Question # 2: Last time when treating caries of the lower wisdom tooth, I froze the floor of my face for 6 hours, is there a softer alternative?
The question is really relevant. Many dentists work according to the old principle: knowing that the classic infiltration “near the bottom eighth tooth” will not be very effective, they immediately make conduction (torus or mandibular) anesthesia, which determines the duration of “freezing” up to 6-8 hours. That is, the patient does not feel his cheek, lip, tongue, etc. for quite a long time.
A modern alternative is the types of infiltration anesthesia - intraralgamental (intra-cohesive) and intraseptal (intra-septal). The amount of injected anesthetic with these techniques is minimal, and if they are precisely observed, the effect is very high: within 40-60 minutes, you can completely cure the wisdom tooth caries, and at the same time, half of the face will not be frozen. However, not all doctors are perfectly fluent in this anesthesia technique.
The upper wisdom teeth, in contrast to the lower ones, are perfectly anesthetized by the classical infiltration method: leading the solution to the root, which eliminates the phenomenon of long-term loss of sensitivity of the face areas. By the way, to remove the upper wisdom teeth in most cases is also much easier than the lower ones.
Patient No. 3 question: can two wisdom teeth be cured in one visit?
Old school doctors may begin to frighten that the caries of the two lower teeth at the same time is dangerous to treat because of the same conductor anesthesia on the “half of the face”, which will cause a loss of sensation of the tongue, may lead to the development of asphyxiation, etc. Although it is a myth, it is preferable to treat the two lower teeth with an intraligamentary or intraseptal anesthesia (or without anesthesia, if possible). Those who are ready to sit in a chair for more than 2 hours should bear in mind that a professional dentist can cure all 4 wisdom teeth in one visit, so two eights are not the limit.
When treating teeth, patients often make the remark that the doctor over-drills a tooth - they say, it is too long and very hard to grind down a drill. Young doctors such complaints really baffled.
The fact is that you can “grind off” a significant piece of a tooth very quickly, in just a couple of minutes. But precisely because of the desire to achieve high quality cleaning of carious tissues, the preparation process is not so quick. Sometimes this painstaking work has to be spent from 5 to 30 minutes - in order to minimally affect healthy tissues and clean out necrotic as much as possible.
In some cases, wisdom teeth is desirable to still remove
Now consider the situation where a dentist has the right to recommend to remove a wisdom tooth, even without signs of carious destruction.
The main indications for the removal of wisdom teeth:
- A impacted or polyurethinized tooth (that is, when problems arise, when the tooth cannot erupt, or partially erupted). Naturally, each case is individual. The impacted wisdom tooth can stay under the gum for a long time and not cause concern, as well as a polyurethinized tooth can be the result of a more or less normal partial eruption of the crown part. If there are no symptoms of obstructed eruption, then there is nothing to worry about, however, with severe symptoms (swelling, severe pain, high fever, festering from the gums near the tooth), the doctor may decide in favor of removal - and almost always will be right,
- Dystopian wisdom tooth - that is, when it occupied the wrong position in the jaw. It is not always necessary to remove such teeth. If a figure-eight that is cut in the direction injures the mucous membrane of the cheek or tongue, then it is necessary to remove it (a chronic injury can lead to the development of malignant tumors). In other cases, options are possible, depending on the situation in the oral cavity as a whole,
- Significant mechanical destruction of the crown of the wisdom tooth (for example, cleavage extending far under the gum), when its restoration with the help of a tab and an artificial crown is not possible,
- The active stage of serious purulent complications in the form of exacerbation of periodontitis, periostitis, osteomyelitis, abscess, phlegmon, etc. (including can be observed after the treatment of canals in the wisdom tooth). With regard to the lower wisdom teeth, delay in such a situation is like death, so it is imperative to remove it. The lower jaw is massive, the spaces in it are wide, the risks of leaving the infection deep into them are high, even fatal. If we talk about the upper eights, in exceptional cases, you can take up the treatment of exacerbation of periodontitis or incipient periostitis, but in this case it is necessary to take into account all possible risks
- The impossibility of conservative treatment for one reason or another. It happens that a dentist, taking up a wisdom tooth treatment, may face the fact that he cannot continue this treatment - for example, complications arise (a piece of instrument in the canal with no equipment for its extraction, root perforation, over-expansion of the canal), or a doctor cannot find and (or) along the entire length process and fill the channels with high quality. In some such cases, a more qualified, experienced dentist with the necessary equipment can help, but such experiments always cost a lot of money, and not every patient can afford it.
- Orthodontic treatment. Today, the orthodontist’s tactics before removing the same bracket systems to remove wisdom teeth, especially those who, being uncapacitated, run into the adjacent sevens, as if pushing the entire dental row, have become popular. Studies have shown that this is justified, since the success of correcting bite while maintaining interfering wisdom teeth is questionable. However, it is not always necessary to remove eights when installing braces.
Is it necessary to remove a wisdom tooth in violation of the hygiene of 7 teeth?
It has already been noted above that in such cases wisdom teeth are sometimes actually removed. However, at the moment this issue is considered controversial: a number of experts believe that it is worth deleting, as in practice, the walls of the 7th tooth, often adjacent to the wisdom tooth, are often found in practice. Others believe that the seventh tooth can always be cured if it is suddenly sore, but at the same time, a figure eight, even with insufficient hygiene, can serve a person for many years before it makes itself felt.
Is it necessary to treat the complications of caries in prospective wisdom teeth?
If a tooth is not treated in time at the stage of carious destruction, then further complications of caries develop - pulpitis, and then periodontitis. Will the treatment of the canals of the wisdom tooth be promising in such cases?
Let's begin, perhaps, with pulpitis, as one of the most common diagnosis at a dentist’s appointment.
Pulpitis is an inflammation of the neurovascular bundle (“nerve”) inside a tooth, when this tissue, in spite of the inflammatory process that has begun, is still somehow but alive.
If it was not about the wisdom tooth, then any dentist-therapist would say with certainty that there is no need to remove the tooth, it is enough to treat the canals. However, the wisdom tooth, unlike the others, has an unpredictable number of channels, its roots are often bent, and access for comfortable and high-quality treatment is often difficult (especially when treating the upper eights). Under the conditions of an ordinary state polyclinic, it is not always possible to properly treat such a tooth, and complications may arise in the future.
At the same time, high-quality endodontic treatment is possible in dental clinics of the business class with pulpitis of almost any, even the most unusual in structure of the wisdom tooth - with control of the processes in the image, using a dental microscope, ultrasound equipment, apex and other auxiliary devices. However, the price of this service will be considerable.
There is an opinion that there are no "impassable" canals of the teeth - but there is a lack of good specialists and the necessary equipment. That is, if the doctor hints at the removal of the eight and says that with pulpitis, the wisdom tooth cannot be cured, because it has curved or narrow channels, then we can only say that either the clinic does not have the appropriate equipment or the doctor is not experienced .
If you have a strong desire to save the wisdom tooth from removal, it is best to consult 2-3 doctors. If 2-3 doctors tell you to remove a wisdom tooth, and the sooner the better, then this should be done.
When the inflammatory process in the pulp chamber goes far, the pulp dies off, and we are already talking about the diagnosis of periodontitis. In this case, the doctor considers the feasibility of preserving the tooth in terms of the risk to the patient's health - depending on the form and stage of the process, it is possible to begin the treatment of canals for acute forms and for chronic fibrous periodontitis.
If we are talking about granulomas, cystogranulomas, cysts, then most often the wisdom tooth is removed “away from sin”, although sometimes according to the testimony can be selected and tooth-saving techniques. Here to decide and take responsibility for the doctor.
The photo below shows the extracted tooth with cysts on the roots:
Periodontitis periodontitis - strife. In acute forms (especially in the serous stage), as well as in chronic fibrous and granulating periodontitis, the ability to preserve the wisdom tooth is significantly higher than with granulomatous periodontitis. In general, the words “granuloma”, “cystogranuloma” and “cyst” should warn you that the treatment may not be entirely successful, or the doctor will immediately suggest that you remove a wisdom tooth, and this will almost always be a justified decision.
How much can the treatment and removal of wisdom teeth
Now, when you have a general idea of when it is possible to treat and in which it is preferable to remove wisdom teeth, let's see how much the corresponding procedures can cost and whether it is possible to somehow save money.
So, if you carry out treatment in a public institution at the place of residence (hospital, clinic), you can almost always save a lot, but get far from the highest quality service. The removal of a wisdom tooth is an extreme measure, and in the same hospital it can be removed for free under the so-called “Krikain” (in the language of dental surgeons, this means that anesthesia does not work, and the patient literally screams in pain). At the same time, there is also a high risk that the roots of a tooth that are not completely removed remain in the hole - the doctor has too little time for one patient to pay due attention to all important points.
As for the wisdom tooth extraction in private dentistry - it will cost significantly more than in the public clinic. Upper wisdom teeth in 70-80% of cases fall under the statistics of "light" teeth, and after analyzing a snapshot, the issue of price is solved within the limits of 2,000 rubles for the removal of one eight.
The lower wisdom teeth, especially the impacted and polyurethinized ones, can be removed at a high price: from 3 thousand rubles to 8-10 thousand in one procedure. In some cases, anesthesia and hospital stay are included in this price.
Treatment of caries on the teeth of wisdom can come at a price of 2-3 thousand to 7-8 thousand rubles for one tooth. The price for the treatment of the canals of the wisdom tooth largely depends on the number of these canals: if the canal is one, then for its endodontic treatment usually take about 1000 rubles. With an increase in the number of channels (and there may be 4-5 of them), the cost of endodontic procedures also increases proportionally.
It should be borne in mind that anesthesia is considered separately (plus), the use of cofferdam, drugs (drugs) for drug and anti-inflammatory canal treatment, temporary and permanent fillings, etc. As a result, the complete treatment of a wisdom tooth with pulpitis can cost 5–20 thousand rubles, and the treatment of periodontitis is even higher.
In conclusion, I would like to note that for many patients wisdom teeth are as important as any other tooth, and they are extremely reluctant to part with them. Meanwhile, there are many such patients who, in the event of problems, are not willing to spend time and money on preserving their wisdom teeth, and at the first opportunity remove the eights without regret. Anyway, the dentist cannot make a decision for you: he can only put accents, weighing all the pros and cons, but the patient will always have the last word.
Features and characteristics of wisdom teeth
Wisdom teeth - extreme (third) molars in a row, two on top and bottom. They are not born in early childhood, but by the age of 18-25, for which, in fact, they received their name.
Wisdom Tooth - Channel Structure
Eights, as well as all their “brothers”, consist of roots, a neck and a crown part, but at the same time they have some anatomical differences:
- they have no dairy predecessors and only one "neighbor"
- the number of roots in the third molars can vary from 2 to 5 (for the remaining teeth, it does not exceed 3),
- the roots of wisdom teeth are curved and twisted.
The appearance of wisdom teeth is usually accompanied by a certain discomfort, and in some cases, a strong pain syndrome, inflammation and serious problems. This is due to the term of their eruption - the process begins when the dental-maxillary apparatus of a person is already formed, and the teeth have to not only “pierce” the tissue, but also to free up space by shifting the dentition.
Often, due to the lack of free space, the third molar is cut through only by half, or it starts to grow crookedly or in a horizontal direction. In addition, in half the cases, the growth of a wisdom tooth causes purulent and infectious processes that can trigger serious complications.
The wisdom tooth grows horizontally
Possible problems with teething
Третьи моляры почти не участвуют в процессе жевания, поэтому не очищаются от налета самостоятельно, как это происходит с остальными зубами. Кроме того, из-за расположения в конце зубного ряда их тяжело очистить с помощью щетки, что приводит к скоплению налета и бактерий, вызывающих воспалительные процессы разного характера.
Неправильное расположение зубов мудрости — источник проблем
Таблица. Common problems with teething wisdom.
Pressure on the seventh tooth
Pericoronitis (inflammation of the hood)
Inflammation of the trigeminal nerve
Each of the above pathologies presents a certain danger and can cause not only carious processes in the adjacent teeth, but also more serious problems. Since the third molars are located in close proximity to the tendons, muscles and nerves, the inflammation / infection can go to nearby areas. Sometimes improperly growing eights cause permanent injuries of the oral mucosa, which cause serious discomfort to a person.
Another problem that may arise from improperly growing or inflamed wisdom teeth is various tumors, in particular, cysts. Often, cysts do not give any symptoms, but tend to increase and put pressure on bone tissue, leading to its deformity, and also cause purulent inflammation. In addition, in the region of the third molars, immature cells always remain, which can cause both benign and malignant tumors.
A wisdom tooth can be removed due to various reasons.
Is it necessary to remove wisdom teeth?
Some experts advise to remove the third molars at the stage of their growth, that is, before they erupt and tightly “settle” in the hole, but in most cases this issue is solved individually, taking into account the structure of the dental apparatus and the state of the oral cavity.
Is it necessary to remove a wisdom tooth
Indications for preserving teeth
If the third molar is not affected by the carious process and is growing correctly, there is no direct indication for removal - you just need to carefully monitor its condition and hygiene. In addition, there are several cases where wisdom teeth are desirable to maintain.
- The need for prosthetic seventh teeth. If a person has the seventh tooth or the sixth and seventh teeth removed at once, the eight can be a support for the fixed prosthesis.
- The tooth has an antagonist. If the third molar does not have an antagonist (that is, a tooth on the other jaw, with which it closes), it is released from the tissues due to the absence of a natural load, which, in turn, causes the curvature of the bite. For the wisdom tooth on the upper jaw the lower third molar will be the antagonist, and vice versa. That is, if a person has two pairs of eights or at least a pair on one side (top and bottom), it is undesirable to delete one of them.
The treatment of wisdom teeth is quite possible.
Indications for the removal of wisdom teeth
Together with the indications for the treatment and preservation of third molars, there are a number of cases when they must be removed, and the sooner the operation is performed, the better.
- Incorrect position in the row. If the tooth has a strong inclination in one direction or the other, and also grows in the horizontal direction, it should be removed. The functionality of such a molar tends to zero when chewing, and in the future it can cause a lot of problems.
Wisdom teeth. Indications for removal
Wisdom tooth heavily destroyed
How is the removal procedure?
The complexity of the operation and the patient's feelings depend on the anatomical features of the tooth and the skill of the surgeon. The lower eights are more difficult to remove than the upper ones, since they have massive roots (sometimes 4-5 pieces) that sit deep in the gum tissue. If we talk about pain, thanks to modern anesthetic drugs, they are practically excluded.
The simple removal of the figure eight is no different from the removal of any other tooth - the surgeon uses a forceps to rock the molar and remove it from the gum. After that, 1-2 sutures are applied to the wound to prevent bleeding and infection in the well, and the patient goes home. The whole procedure lasts from 2 to 10 minutes.
Wisdom tooth extraction is a difficult operation.
Difficult removal is performed in cases where the figure eight has a large slope, strongly curved roots or a completely destroyed crown. The operation takes place in several stages, and before the removal, an X-ray examination is necessarily performed so that the doctor can work out the correct sequence of actions. Sometimes for removal you need to cut the gum, in other cases you have to drill a tooth or cut it into pieces to get it out of the gum in parts. The duration of the procedure depends on the degree of complexity - it can take both 20 minutes and two hours. After completion, the doctor stitches and places in the wound a special medicine to prevent the infection process and complications called alveolitis.
Two sutures are put on the hole of the extracted wisdom tooth to stop the bleeding.
With proper surgery and no complications, the wound will stop bothering the patient in 3-5 days, and will heal in 2-3 weeks.
What to do after tooth extraction?
After the removal procedure, you should follow the standard recommendations that doctors give after such operations - do not eat for 2 hours, remove solid foods from the menu for 2-3 days, do not take a hot bath and avoid physical exertion for 24 hours to do not provoke bleeding. After the effect of the anesthetic drug is over, the site of the operation may begin to hurt - to remove the pain, you can take a strong analgesic or a nonsteroidal anti-inflammatory drug (taking aspirin after the extraction of teeth is strictly prohibited). In addition, it is recommended antihistamine, which will reduce the swelling of the gums.
And it looks like a fresh hole after the removal of a wisdom tooth
If the procedure was carried out against the backdrop of purulent inflammation, the doctor may prescribe antibiotics and gargle with antiseptic agents - for example, “chlorhexidine”. It is important to remember that too much rinsing can lead to leaching of the blood clot from the hole and the development of alveolitis.
Possible complications after surgery
Complications arising after the wisdom tooth extraction procedure in 90% of cases are the result of non-professional actions of the doctor or non-compliance of the patient with the relevant recommendations.
One of the most frequent complications is bleeding, which can open within a few hours after the procedure. If it is insignificant, you can try to stop the blood by holding the wound with a sterile gauze pad or by applying a cold compress to your cheek. In cases where these methods do not give effect, and the bleeding becomes stronger, you must call an ambulance or go to a 24-hour dental clinic.
Bleeding after wisdom tooth removal
Another common problem is alveolitis, inflammation of the hole. Its signs are increasing pain and swelling, which are observed two to three days after removal, as well as an unpleasant smell coming from the place where the tooth was located. This phenomenon also requires consultation with a specialist.
If the patient feels numb in the region of the lower lip after the removal of a wisdom tooth, this may indicate injury to the nerve that passes next to the roots of the teeth of the lower jaw - in this case, you should consult with your dentist and neurologist.
To avoid the trouble that wisdom teeth bring to their owners, you should follow simple rules: carefully care for the oral cavity, to clean the teeth every six months, and in the event of any unpleasant sensations, immediately consult a doctor.
Can third molars appear in adolescents
It is believed that the "eight" are cut almost in 14-16 years. This is not quite true: almost always, these teeth appear after 18 years, and then it is quite early. The eruption of "eights" up to this age happens very rarely, and more often they begin to bother us by the age of twenty. These are average statistical data, and it can be argued that the majority of adolescents at the age of 14-16 will not have the G8: they exist, of course, but they are at the budding stage.
"Eights" erupt at a later age, because until the age of 18 a person continues to increase the jaw. These are the last teeth in the row, and for their appearance it is necessary that there is a place in the jaw where they can erupt.
It often happens that these teeth do not appear at all - a person can walk with impacted third molars all his life, if for some reason there is not enough space in the jaw, that is, it has not grown properly.
Problems of the eruption of eights
Difficulties in the treatment of wisdom teeth are often caused by an atypical location of the root canal system, which makes it difficult or even impossible to process and fill them properly. It is for this reason that one should treat the therapy or the removal of the eight with an understanding of the question.
Many patients in dental clinics indicate difficulties starting at the time of the eruption of this tooth and delivering trouble after that.
- Pain when eight comes out of the gums.
- Difficulties with the daily cleansing of even a healthy tooth.
- Jamming food.
- Frequent inflammation of the mucous hood.
Wisdom teeth are cut in adulthood, which causes many problems due to various factors:
- Difficult teething - the process is often complicated by the lack of space in the corner of the mouth, so the tooth has to be “pushed” by its neighbors in order to secure space for itself. In addition, the eight grows at an age when the growth of the jaws stops, due to which the bone tissue becomes dense, which makes it difficult to move,
- dystopia - the wrong orientation of the tooth in the bone, which is quite common. Eight can be inclined in any direction, lie in a horizontal plane or grow corona in the direction opposite to the gum.
- caries - due to the impossibility of good hygiene, around the last tooth accumulation of food deposits and plaque occurs, which contributes to the growth of activity of pathogenic microbes and leads to the destruction of hard tissues. Sometimes wisdom teeth cut through those already affected by caries,
- retention - the location of the tooth in the jawbone or under the gum, which is complete or partial. Eight in this position can not cause trouble, but often it puts pressure on the neighboring seventh, which leads to the resorption of the roots and the appearance of hidden cavities. In addition, the wisdom tooth sometimes causes severe headaches that can radiate to the temple or ear. In such a situation, medical intervention is required,
- pericoronitis - inflammation of the gingival pocket covering the coronal part. Occurs due to falling under the hood of food debris, and the inability to completely remove them leads to decay and inflammation of soft tissues,
- deformation - the growing last molar is faced with a lack of space, so there is his pressure on the next, leading to crowding of the teeth,
- severe pain is the main reason for asking a doctor for help. When the eight can not cut through a thick layer of mucous membrane, it causes excruciating pain, which can only be eliminated by making an incision on the gum and making way for the tooth.
Should I remove wisdom teeth?
What is a wisdom tooth and why does it have such a name? Why do you want to delete it? In fact he is the most common tooth. He has the same structure as the rest, existing in humans, teeth. Dentists call it the "eight", because it is the most extreme - the eighth in a row on either side of the lower and upper jaw. From this it follows that the maximum number of such eights in humans is four. However, it is not at all necessary that all four eights of wisdom erupt through all people. For some, they do not erupt at all.
What is a wisdom tooth for?
The wisdom tooth has such an unusual name due to the late term of eruption. The very first teeth in humans are milk teeth — they erupt between the ages of one and two years. Dairy change to permanent indigenous from 6 to 12 years, eights erupt the most recent between 18 and 27 years. After 27 years, they can also erupt, but this happens extremely rarely.
From a medical point of view at this age, the human body stops its development and its aging begins. This period coincides with the time of the eruption of eights, hence the name.
Where did the popular opinion that the eights need to be deleted come from? For all people, they erupt in different ways: some quickly, others long and painful. This is due to the fact that each person has a different structure and size of the jaw. If the jaw is too small, the wisdom tooth may not cut at all or it will erupt for a very long time and slowly move the remaining teeth, freeing up space for itself. Thus, the eruption may take up to several years and will proceed with pain and complications.
What is a wisdom tooth for and is it necessary for a person? Despite the fact that eights are considered "superfluous", they still have there are some advantages. Subsequently, they can serve as a support in the case of bridge prosthetics. Moreover, the wisdom tooth will cope well with chewing functions, if you have to remove the next.
Of course, the benefits can only be talked about when the eight is positioned correctly and has no complications. But as practice shows, in most cases it causes complications and other related problems.
Side effects from teething
A wisdom tooth can cause various complications, the most common of which is inflammation. As a rule, when teething, tissues that are located near it become inflamed. When this occurs, the tubercle is covered with mucous membranes. Such a tubercle provokes further inflammation due to the gradual proliferation of bacteria. Inflammation can lead to pus, resulting in the development of a disease called pericoronitis. Her symptoms are:
- Gradually increasing pain, pain can be intense, giving to the ears or temples.
- Pain may increase if you open your mouth or yawn.
- The appearance of pain in the cheek or throat.
- Fever, headache.
- The appearance of edema, the appearance of purulent discharge.
- Redness in place tubercle.
If you experience these symptoms, you should contact your dentist. Before taking a doctor, pain can be relieved by an analgesic - analgin, ketorol and others. To rinse your mouth, you can prepare a cold solution: dissolve one teaspoon of soda and salt in a glass of cold water.
With this disease it is not necessary to warm the place of inflammation using a heating pad or any other heat, you can not rinse your mouth with a warm solution. When any heating process of the spread of bacteria accelerates. Do not put a pain pill on the site of inflammation or sore site, as this may cause an ulcer. The pain in this way you are unlikely to remove.
Such a disease is treated by incising and opening the slimy "hood" formed over the figure eight. Next, thoroughly wash the cavity and prescribe medication with anesthetic and anti-inflammatory action. In the case when after opening a lot of pus is formed, a course of antibiotics is necessary. If the disease recurs, you will most likely have to remove this tooth.
Another common problem is occurrence of caries. The reason for this is the inaccessible arrangement of eights. This prevents their thorough rinsing with daily cleaning of the mouth.
Sometimes eights already when teething have initial manifestations of caries and damaged enamel. This is due to the fact that they often erupt very tightly with the others, pressing adjacent ones. Therefore, the existing caries easily passes on to them. In the event of caries, it is imperative to treat the dentist. Only the doctor will decide what is necessary in a particular situation: to heal or remove.
Insufficient space for eruption is the reason for the development of another complication - malocclusion. At the same time, the eights of the eights gradually move aside the adjacent molars, which, in turn, shift all the rest to the center. As a result, crowding and disturbance of the normal location of all teeth occurs.
In addition, these problems can cause even more serious: a cyst of the jaw, inflammation of the branches of the trigeminal nerve and others. In such situations, the question of the removal of a wisdom tooth is always solved in a positive direction.
Do wisdom teeth be removed?
Should I leave a wisdom tooth or still remove? If you are tormented by this question, try listen to your condition. If its teething does not cause you problems, and later you did not find yourself in any of the complications listed above, then you need not pull out the figure eight. In any case, the decision of whether it is necessary to pull it out will be taken by your attending dentist. Therefore, if you have any pain at the place of growth of the eight, you should immediately contact a specialist.
However, it should be borne in mind that complications may develop after removal. Как было сказано, лечение и удаление практически всегда происходит с некоторыми сложностями. Несмотря на наличие наркоза, удалять восьмерку достаточно болезненно. Это зависит от совокупности следующих факторов:
- болевой порог пациента,
- all sorts of complications - cyst, inflammation, suppuration and so on,
- root structure
- inaccessibility of the tooth.
As a rule, after removal, the eruption site is healed for a long time and painfully. Some complications may develop, such as numbness in the mouth. This is normal, however, if such sensations do not pass during the week, it is necessary to consult a specialist.
Moreover, at the site of the tooth extraction alveolitis may develop - Inflammation of the hole. To prevent this, it is not necessary to rinse the oral cavity after removal, as this can lead to the appearance of infection and the further development of complications. If this does happen, you should immediately consult a doctor.
After the examination, the dentist will decide: whether to pull out a wisdom tooth. The decision to remove the eight will depend on the following factors:
The period of growth of eights
The average time for the growth of wisdom teeth is 18-25 years. But they may not cut through at all, and even their rudiments will not be formed inside the bone tissue. In some situations, they can form completely, but remain inside the bone. According to studies, approximately 70-80% of the world's population has the farthest teeth yet.
Only in some lucky ones wisdom teeth grow fully, directly and do not cause any trouble during the eruption. Among the main problems that accompany their growth are the following:
- impacted or polyurethinized teeth that have formed completely inside the bone tissue, but have not erupted (or appeared partially). They can be vertically, horizontally and even rooted up. With the lateral arrangement, such teeth very often exert increased pressure on the adjacent ones, which leads to acute pain,
- a gingival hood is formed above the tooth: this is a small section of the mucous membrane that forms when the tooth is slowly erupting. The difficulty lies in the fact that often under it accumulate bacteria and food debris that are difficult to remove due to the fact that the tooth is very far away - there is practically no way to get to it. This causes acute inflammation, which often develops into purulent,
- dystopia or violation of the situation: the eights have no dairy predecessors, in addition, they grow in the period when the jawbone has already ceased to develop and form. Therefore, they often grow crooked and out of place. At the same time, other crowns may overlap, overlap with neighbors, cause injury to the mucous membrane, which will impede hygiene and provoke inflammatory processes,
- growth immediately with caries: they are very difficult to clean, because they are far away. Patients experience particular difficulties in case of inflammation of the mucous membrane, as cleaning in such situations is accompanied by acute pain.
In general, dysplasia leads to a change in the normal functioning of the entire dental system. There is pain, the patient often complains of pain when opening the mouth and movement of the lower jaw. Due to the pressure on the adjacent teeth, they shift and the bite is disturbed. A rather frequent consequence is the crowding of the incisors, which occurs precisely as a result of the disturbed growth of eights.
When can save wisdom teeth
Despite the fact that modern man has practically no need for the wisdom teeth, they still have practical benefits. First, they can participate in chewing food, however, provided that they grow opposite each other, that is, they are antagonists - only in this case they will have the right load. Secondly, if they grew up straight, without disturbances, are completely healthy, they may well be used as a support for a bridge or removable prosthesis.
Therefore, if the eight have no violations, if the conditions that accompany their growth (inflammation of the gingival hood, soreness) can be stopped, if their position allows treatment of caries or even pulpitis in the future, you should try to keep your teeth as long as possible, because removal is always extreme measure.
In the treatment of "wise" teeth, classical infiltration anesthesia is applied. At the lower "eights", as a rule, conductor is used - it is more efficient and allows you to capture a more extensive area. The effect of its impact and lack of sensitivity persists for a long time.
Upper wisdom teeth in 70-80% 1 cases are easier to treat than lower ones. But even in the event of pulpitis, there is no need to hurry - the tooth without a nerve will be lifeless, but it will be able to last more than one year.
Treatment of pathologies with the growth of eights
With the growth of a wisdom tooth, it is imperative to consult a doctor, especially if there is pain, acute inflammation of the mucous above its chewing surface. Specialist consultation is also required when pain of unclear etiology appears - oppressive, spreading throughout the lower jaw, appearing during chewing and opening the mouth. In such a situation, you need to take a panoramic picture, which is to establish the exact cause of such a state - it is quite possible that the tooth is inside the jaw bone and outwardly imperceptible.
If growth is accompanied by swelling and redness of the mucous membranes, discharge of the gums from the crown, acute pain, supportive therapy is necessary. It is extremely important for the patient himself to carry out the highest possible oral hygiene - brush a growing wisdom tooth in the morning and evening, use an irrigator after each meal. It is this tool that will most effectively remove food debris and bacteria, stopping inflammation.
In case of a serious inflammatory process, plastic surgery to excise the hood may be required - part of the gum is cut off under local anesthesia, the space is cleaned from deposits. At the same time, drug therapy is prescribed, which will stop the inflammatory process and restore the condition of the tissues.
In the Smile-at-Once clinic, the issue of the removal of the 8th tooth is solved individually. We definitely take a panoramic picture, which allows us to assess the position and degree of impact on the entire dentition. If it is possible to save the tooth and carry out its treatment, the doctors of the clinic must use it.
Tooth of wisdom: remove or treat?
There are a lot of “pros and cons” points in the issue of tearing out the eight. The decision depends on the degree of destruction, the presence of inflammation, the effect on neighboring teeth, as well as on the state of human health.
Third molars do not carry functional value if they are not involved in chewing, but sometimes this is the only chance of a patient for non-removable prosthetics. When a piece of the crown broke off, do not rush to enroll to the surgeon, because with good condition of the canal system, as well as the possibility of full access, the destroyed tooth should be restored with a pin construction.
Removal is not recommended in certain cases.
- For hypertension of the second or third degree without a cardiologist examination.
- The need for anesthesia during the removal of the eight does not allow to risk the health of the future baby during pregnancy.
- With the growth of the tooth in the area of malignant lesions.
- If less than three months after a heart attack.
When can I save the wisdom tooth?
In certain situations, it makes sense not to remove, but leave the problem molar, because he is still able to benefit, and also play an important role in choosing a method of orthopedic treatment. If the decision is made to leave the eight, ask the doctor if such teeth are being treated at your chosen clinic, and also inquire about the appropriateness of therapy in your particular case.
Treatment of the wisdom tooth should be done in some situations:
- The eight is necessary as a support - if there are no adjacent molars, the tooth remains the only one on which a bridge can be fixed. When it is removed, there is the option of implantation or removable prosthetics,
- the tooth is positioned correctly in the row - the eight is involved in the chewing process and has an antagonist, does not injure the soft tissues, so the therapy allows it to be preserved and prevent the extension of the contacting tooth of the opposite jaw (Popov-Godon phenomenon),
- pulpit pains - when the diagnostic image reveals a convenient location of the pulp chamber, while the channels are not twisted and are contoured to the very top of the root, endodontic treatment is possible,
- periodontitis - if a destructive focus is detected in the apical zone, tooth reorganization continues for a long time period, and a favorable outcome is possible with good endodontic access and high-quality processing of the canal system.
In which case, the eight need to be deleted?
In certain situations, it is necessary to think about whether to leave the problematic tooth and whether there will be benefit from the treatment, because sometimes its safety may not only be impossible, but also be harmful to health. In most patients, the eight initially have a more fragile enamel, and sometimes erupt with already affected lesions.
Basic prerequisites for extraction of the eighth tooth:
- atypical position - when the crown is tilted to the side, there is no participation in chewing food, and when the tooth axis is displaced in the direction of the cheek, this contributes to the frequent biting of soft tissues,
- little space for teething - when the eight is cut in conditions of insufficient space, it puts pressure on the front teeth, which causes their crowding. To prevent bias, it is recommended to remove the source of problems
- complete retention - with severe pains of impacted molars in the gum, surgery is required,
- negative impact on the adjacent tooth - often the eight grows at an angle, because of which it rests against the seven and can cause both the destruction of the crown and the resorption of its roots,
- a high percentage of destruction of the coronal part - if the tooth is affected so much by caries that it is not possible to put a filling that will meet the quality criteria, then it is advisable to part with it,
- pericoronitis - when the inflammation of the gums surrounding the tooth cannot be removed by excision of the mucous hood, pus is formed there, and bone destruction is determined on the roentgenogram of the bone around the original source of pain, then extirpation is the only way to stop further spread of the process.
- an abscess - the development of apical periodontitis is often accompanied by the addition of purulent infection with the formation of a cyst on the top of the tooth. Due to the impossibility of good channel processing and infiltration output, the eight must be removed.
I do not know where this conviction comes from, but I was sure that if a wisdom tooth ached, there was no point in treating it. You just need to go to the surgeon. When there was a strong pain from the eight, I did. The doctor carefully examined the oral cavity and examined the X-ray, after which he made a verdict: the tooth should be treated, because the channels are wide and even, they can be cleaned and sealed. I could not believe that this was possible, but nevertheless I followed the recommendations of the dentist and signed up for treatment. It turned out that it was pulpitis. For two times I restored the eight. Fortunately, she didn't bother anymore.
The last molar tormented me for a couple of months. Food got clogged under the gum every day, I tried to brush it out with a brush, rinsed it with various solutions — nothing saved me from discomfort and an unpleasant smell. After some time, decided to go to the doctor. The dentist examined the tooth, and said that he might have to part with it, as the crown was tilted to the side. After viewing the snapshot, his assumptions were confirmed: the wisdom tooth lay sideways, and a bone had already begun to dissolve around it. The removal was hard, but now the hole is overgrown.
I am very glad that I once listened to a dentist and did not tear out a sick eighth tooth. When it came time to do prosthetics, it turned out that this was the only support for the bridge. And if I had it removed or cured badly, I would have to wear removable plates, because I cannot afford implants.