Removal of molars: extraction or exodontics

And the removal of the molar tooth, and exodontics, and extraction - whatever the name of this dental procedure - is its only one: the tooth will be pulled ... By the way, the great master in this case was the first Emperor All-Russian Peter I, who always carried with him tools, among which there were also tongs for the extraction of teeth.

When it comes to the removal of the molar, it means the chewing tooth - molar or premolar. The total number of permanent teeth in an adult is 28-32: 8 incisors, 4 canines, 8 premolars (small molars) and 8-12 molars (large molars).

[1], [2]

Removal of the molars: when you can not do without it?

To an urgent removal of teeth, as a rule, resorted to in case of acute purulent inflammations that affect the bone, or with intolerable toothache, which does not allow for treatment. However, there are other reasons for removing the molar. Extraction is applied when:

• root canal of tooth is impassable (in case of chronic circumcision gingival inflammation - periodontitis);
• The crown of the tooth is destroyed by caries so much that it is impossible to restore the tooth;
• the tooth is very mobile and staggers (with periodontitis);
• anomaly of the dentition disrupts the function of chewing, articulation and traumatizes the oral mucosa;
• "Superfluous", that is, unbroken in time (retinirovanny) teeth cause pain or cause inflammation;
• there was a fracture of the root of the tooth;
• teeth were on the line of jaw fracture;
• this or that tooth interferes with full or partial prosthetics of teeth;
• eruption and growth of the wisdom tooth have deviations, resulting in discomfort, anomalies of the dentition or trauma to the oral mucosa.

Method of removal of molars

Today, before tooth extraction, dentists in many cases (after examining the patient's teeth) are prescribed an x-ray of the jaw - in order to clearly see the position of the roots of the tooth. Removal of the molar is always performed under local anesthesia. Dental surgery divides the extraction of teeth from dental alveoli by the usual (simple) and surgical (complex). Simple removal is carried out with a normally viewed location of the root of the tooth, and the tooth itself can be well fixed with tools.

By the way, the first special tongs for tooth extraction - called "pelican" - was invented by the French doctor Guy de Scholiak in the middle of the 14th century. Now surgeons-dentists have a whole arsenal of tools.

And the method of removing the molar depends on which tooth the exodontics needs. The extraction of teeth (and roots) is carried out by forceps, with which the tooth loosens (to break the integrity of the periodontal tissues), turns around its axis and ... Is ready! And the correct choice of the instrument by a doctor is a pledge not only of a successful procedure, but also of a lack of complications in many respects.

The shape of the forceps is different - according to the anatomical form of the teeth and their location in the dentition. For example, premolars of the upper jaw are removed with S-shaped forceps, premolars of the lower jaw - forceps with wide cheeks, and molars of the lower jaw - forceps with special thorns (which come between the roots of the tooth). And for the teeth on the right and left side of the jaw are designed "right" and "left" forceps. Elevators are also used to remove the teeth (and root of the teeth) of the upper jaw. The doctor takes this tool when removing the molar or its root with forceps is not possible or fraught with damage to the mucosa and bone tissue of the alveolar process.

Surgical (complex) method of tooth extraction is used when neither forceps nor an elevator to it simply can not be reached: the tooth closes the mucous or bone tissue (this happens with retanated and atypically located teeth). And also when the gum tissue completely closes the apical (vekushechnye) pieces of roots of long-removed or broken teeth.

In some cases, the surgeon dissects the soft tissues covering the tooth, in others - it cuts the jaw bone. There are situations when the dentist has to remove the tooth in parts, first dividing it.

Effects of removal of molars

It is natural that the consequences of removal of molars depend on the degree of its complexity. But the most frequent of these are swelling of the gums or cheeks and pain.

Swelling of the gum tissue and cheek after tooth extraction is the result of their trauma during the operation. If all the recommendations are followed, swelling will pass in a few days. To reduce and relieve puffiness, doctors advise making cold compresses on the cheek - for 8-10 minutes with a repetition of the procedure 3-4 times a day every half hour.

Quite often, the swelling of the gums (where it passes into the cheek) increases, the pain increases and the body temperature rises. In this case, the blood clot in the hole is dense, and after a few days the skin on the cheek from the side of the removed tooth acquires a cyanotic shade. These are characteristic signs of the formation of hematoma with suppuration, at which it is necessary to go to the doctor. Itself will not pass or take place, and can pour out in abscess or phlegmon.

Pain is a natural and, alas, inevitable consequence of removal of the molar. And with a complex removal, it can last a whole week. If the cause of the pain is a fragment of the tooth left in the hole, the doctor must remove it and clean the hole. In this situation, dentists recommend rinsing the mouth with 0.05% aqueous solution of the bactericide Chlorhexidine (2-3 times a day). The drug can cause tooth enamel staining, tartar deposition and taste disturbance. It can not be used by children, pregnant and lactating women.

Recently, as an anesthetic, it is recommended that doctors take Nurofen (or its analogs - ibufen, ibuprofen) more often. Nurofen is prescribed by adults for 0.2-0.8 g 3-4 times a day - after meals or with plenty of water. This drug is usually well tolerated, but it has contraindications: acute ulcers and exacerbations of gastric and duodenal ulcers, ulcerative colitis, hemopoiesis depression and hemorrhagic diathesis, optic nerve diseases, portal and arterial hypertension, heart failure and pregnancy.

If, on the 3rd-4th day after the removal of the molar tooth, dull pain appears, which rises to the ear from the extraction site, and an unpleasant aftertaste is felt in the mouth, this is the so-called dry hole symptom. This consequence of removal of the molar is a result of the displacement of the blood clot. At the same time, there is no blood or purulent discharge. However, to treat a dry hole, you need to see a doctor.

The consequence of removal of molars is alveolitis. This acute inflammation of the walls of the socket, which is manifested by severe pain on the second-third day after tooth extraction. Pain does not help to remove any painkillers. The general condition deteriorates, the temperature can rise to + 37.5-38 ° C. Because of pain, eating is difficult. At the same time in the socket of the removed tooth the decomposition of the remains of the blood clot takes place: the hole is covered with a gray coating with putrefactive odor, its mucous blushes and swells. The lymph nodes under the lower jaw are enlarged and become painful when pressed. With such symptoms, one should not go to the dentist, as the alveolitis after tooth extraction can cause the osteomyelitis of the jaw, phlegmon or abscess.

[3], [4]

What to do after removal of the molar?

First of all, what to do after removing the molars is not necessary.

After removal of molars do not:

• during the day, rinse your mouth and even spit, so as not to disturb the blood clot that is in the socket of the removed tooth (this clot is extremely important for healing the wound - later it forms fibrous tissue, which then turns into bone);
• brush your teeth (during the day) and use mouth rinses;
• during eating, chew with teeth located in the extraction zone of the tooth, drink and eat hot (at least the first 24 hours after removal);
• Expose your body to physical exertion for at least 24 hours (sports, hard work, etc.);
• smoking and drinking alcohol - at least 48 hours.

And now - what you need to do after removing the molar tooth:

• if 8 hours after tooth extraction the bleeding does not go away, you need to bite the gauze swab quite a bit for 45 minutes. Did not help - go to the surgeon who removed the tooth;
• 24 hours after tooth extraction, gently rinse your mouth (after eating and before going to bed) with a slightly warm solution of table salt - a teaspoon per glass of water;
• after eating, make soda, saline (teaspoon per glass of water) or herbal baths of the mouth with a decoction of chamomile, sage, oak bark, calendula, St. John's wort (a tablespoon of dry grass to a glass of boiling water). When the broth cools down to room temperature, it is collected in the mouth (do not rinse!), Hold for half a minute and spit.

The price of removal of molars

The cost of removing the molar tooth, as well as the cost of all dental procedures, depends on the degree of their complexity, the level of the private clinic and the location of the institution. And the last two factors have the greatest impact on the price list of services of Ukrainian dentists.

For example, in Kiev the cost of tooth extraction varies in the range of 150-1440 UAH. Plus 50-70 UAH. - for anesthesia. Removal of the wisdom tooth will cost 450-650 UAH. In Kharkov, for removing the molar tooth, ask from 150 UAH. Up to 420 UAH., and for anesthesia of this procedure - an average of 50 UAH.

Dnepropetrovsk dentists in their price lists indicate the cost of removing one tooth 180-350 UAH. And anesthesia - from 40 UAH. Up to 140 UAH. In dental clinics in Simferopol, the price of removal of the molar is 60-150 UAH., And for anesthesia will have to pay from 20 to 70 UAH. For Sumy residents tooth extraction costs at least 90 UAH., And with an anesthetic injection - 130 UAH.

But in the Russian Krasnoyarsk removal of the molar tooth resulted in 300 thousand rubles (that is, 75.6 thousand UAH.). This is the amount by a court decision that a patient will receive from one of the private dental clinics, whose specialists have damaged the bone tissue during removal of the diseased tooth. As a result of the provision of poor medical services, a woman with edema of the whole face had to spend a week on a sick leave. First she asked for help from another doctor, and then - with a statement of claim to the court.