Impacted tooth - should it be extracted? An impacted tooth: what it is and what to expect from it Impacted and impacted teeth

- a tooth fully formed in the jaw, but not erupted (or partially erupted) outwards. In some cases, impacted and semi-retinated teeth do not manifest themselves in any way; in others, they cause pain, inflammatory processes (pericoronitis, periodontitis, periostitis, abscess, phlegmon), combined with dystopia. The presence of impacted teeth in the oral cavity is detected using targeted radiography and orthopantomography. Depending on the clinical situation, tactics in relation to impacted teeth may be different (excision of the "hood" in pericoronitis, removal of an impacted tooth, orthodontic movement, etc.).

General information

An impacted tooth is a difficulty in the full eruption of a tooth located in the jawbone or covered by the gum. Retention is a common anomaly of teething. According to statistics, the most frequently impacted are the lower and upper third molars (wisdom teeth), the canines of the upper jaw and the second premolars of the lower jaw. At the same time, non-cut "eights" are found in 35-45% of cases. The treatment of impacted teeth is a complex and urgent problem of modern surgical dentistry and orthodontics.

Causes of tooth retention

The presence of impacted teeth may be due to embryological features. Teeth may remain impacted due to excessively thick walls of the dental sac around the crown of an erupting tooth, dense gingival tissue, and weak growth force. These circumstances prevent the full eruption of the tooth, as a result of which it remains impacted or semi-impacted.

The embryological prerequisites for retention should also include the incorrect position of the axis of the tooth germ, leading to its collision with the adjacent, previously erupted tooth. In this case, it is more correct to speak not of an impacted, but of an impacted tooth - that is, a tooth whose eruption is impaired due to an obstacle from the neighboring tooth, and the result of which was retention.

There is a theory that in the process of evolutionary development, due to the reduction in the human diet of coarse animal and vegetable food, and, consequently, less chewing load, there is a reduction in the jaws due to a decrease in the distal alveolar bone. This leads to a lack of space for the teeth that erupt later than the others (in particular, for wisdom teeth), and may cause their retention.

Risk factors

Risk factors that increase the likelihood of impacted teeth may include:

genetic predisposition
early loss or removal of milk teeth
the presence of supernumerary teeth
developmental anomalies of the jaws
bad food,
general infectious exhaustion and somatic weakness of the body, etc.

Classification

Depending on the degree, full and partial retention and, accordingly, impacted and semi-impacted teeth are distinguished. An impacted tooth is completely covered by gum or bone tissue, is not visible in the oral cavity and is not accessible for palpation. The crown part of the semi-impacted tooth is partially cut through, but most of it remains covered by gum tissue. Taking into account the depth of occurrence, impacted teeth are distinguished with tissue immersion (the tooth is located in the gum tissues) and bone immersion (the tooth is located in the jawbone).

The position of the root and crown of an impacted tooth in the gum or bone can be:

vertical- the axis of the tooth has a normal position, coinciding with the vertical line;
horizontal- the axis of the tooth forms a right angle with the vertical; while the position of the tooth can be transverse, sagittal or oblique;
angular (angular)- the axis of the tooth forms an angle with the vertical, less than 90°. Depending on the inclination, there are medial-angular (with an inclination forward), distal-angular (with an inclination back), lingual-angular (with an inward inclination, towards the tongue) and buccal-angular (with an outward inclination, towards the cheek) position.

It is extremely rare to find reverse impacted teeth (usually the lower eights), in which the roots are turned towards the alveolar margin, and the crown is towards the body of the jaw. Retention of teeth can be unilateral or bilateral, symmetrical. Both milk and permanent teeth can be impacted.

Symptoms of tooth retention

A semi-retinated tooth declares itself as a partial eruption of the crown in any part of the dentition. As a result of constant injury to the mucous membrane adjacent to the erupting part of the crown, it becomes edematous and hyperemic. With inflammation of the surrounding tissues of the gums, a clinic of gingivitis or pericoronitis develops.

Impacted teeth are often asymptomatic and are incidental radiological findings. An objective sign of tooth retention is its absence in the alveolar arch. An impacted tooth with tissue immersion may be defined as gingival protrusion; in this case, during palpation, its contours or individual parts are determined.

With the pressure of an impacted tooth on neighboring teeth, their displacement and resorption of the roots may occur; subjective complaints include discomfort and soreness when chewing food, opening the mouth. Cervical caries, pulpitis or chronic apical periodontitis often develop at the point of contact of the impacted tooth with the erupted tooth. When the nerve fibers and endings are irritated, pain occurs in the area of an unerupted tooth, paresthesia, caused by neuralgia or trigeminal neuritis.

In the area of impacted teeth, follicular cysts are often formed, which can be suppurated, complicated by purulent periostitis, pericystic osteomyelitis of the jaw, purulent sinusitis, abscess, phlegmon. Inflammatory complications are accompanied by fever, general malaise.

Diagnostics

Diagnosis of a semi-retinated tooth is not difficult: during a dental examination, the top of the tooth is detected above the gum, the contours of the tooth are determined by palpation, the crown is detected by probing. An impacted tooth can only be reliably detected by spot radiography or orthopantomography; in some cases, computed tomography is required. A semi-retinated tooth with deposits of plaque or tartar may be mistaken for a tooth root affected by caries.

Treatment of tooth retention

The decision on tactics in relation to an impacted tooth should be made carefully, based on the individual clinical situation and radiological data. Often, specialists of various specializations, such as dental surgeons and orthodontists, are involved in the treatment of impacted teeth.

With a delay in the change of temporary teeth and the absence of physiological resorption of the roots, their removal is indicated. If supernumerary teeth are the cause of retention, they are also subject to extraction. In the case of the development of pericoronitis, its surgical treatment is carried out - excision of the mucous flap ("hood") in the area of the impacted tooth under local infiltration anesthesia.

Surgery

Orthodontic treatment

In the absence of direct indications for the removal of an impacted tooth and there is free space for it in the dentition, the first stage is surgical treatment - excision of the gum or part of the bone, and then orthodontic treatment - moving the tooth to the correct position using braces or buttons.

Forecast and prevention

An impacted tooth is a potential source of serious complications: the formation of a periodontal cyst, the development of caries, pulpitis, periodontitis, ulcerative stomatitis, pericoronitis, periostitis, osteomyelitis, abscess, phlegmon, purulent lymphadenitis, odontogenic sinusitis, etc. In this regard, impacted teeth require mandatory treatment of the most in a suitable way. Impacted teeth can be used as autografts in the restoration of the dentition.

To date, methods for preventing tooth retention are not known. The general principles of prevention include monitoring the correct development of the child's jaws, the timing of teething, timely orthodontic treatment.

You need to know what an impacted tooth is in order to visit a dental clinic on time. Adults face similar troubles when the formed formation cannot break through the gum and appear on the surface. At this point, unpleasant sensations begin to be fought.

What are impacted teeth?

An impacted tooth can appear for a variety of reasons. It is formed right inside the gums, gradually breaking it. If the process slows down and even stops, professional help will be required. Moreover, not every dentist can cope with such problems, even the choice of a suitable treatment requires the results of a complete examination.

Most often, troubles happen with. They grow unevenly, so they linger under the surface of the gums. Although the upper fangs and the second create a potential danger. Because of what there are crooked teeth that even an orthopedist does not correct.

Why do impacted teeth appear?

An impacted upper or lower tooth may appear unexpectedly. The causes of the violation should be clarified in order to ensure prevention. It is available only in some cases, but even these are worth considering without facing dire consequences. What moments are celebrated by dentists?

Thick walls of the pouch;
Dense gum tissue;
Small force of growth;
Wrong axis of growth.

Each of the problems remains relevant. Usually dentists have to cut the gum, but this is the easiest way to support the growth of the tooth. There are cases when other actions are required to get rid of the disease. They are specified in each individual case only after the x-ray.

A semi-retinated tooth appears when an open crown has formed, but in this case, treatment is usually limited to orthopedics. Only the principle of immersion is considered first. What are the options?

fabric;
Bone.

Tissue immersion does not require any special action on the part of the dentist. An experienced doctor in the clinic will quickly prepare the optimal orthopedic treatment. It is enough to restore normal growth without surgery.

Bone immersion is much more difficult. Often such formations are immediately removed, since restoration of the bite becomes impossible. If there is a chance for salvation, the specialists incise the gum, and then release the tooth, changing its growth axis.

This classification suggests that the impacted tooth can be located in the gum in various ways. When contacting a dentist, the patient first undergoes a detailed examination of the condition, and then treatment begins. There is another gradation according to the location of the parts of education:

vertical;
horizontal;
angular.

Each position of the axis affects the bite and the gum. This is a good reason to consult a specialist when the first unpleasant sensations appear. There are important subtleties noted by professionals. It is they who force us to look in advance for a method of orthopedic treatment.

vertical

Vertical - the correct position of the axis, allowing the crown to quickly break through the surface of the gums. In such cases, the problems that some people have to face do not appear. Dentists point out that it is these options that do not require treatment and correction, since the erroneous location is characterized by minor shifts.

Horizontal

The horizontal position is the most dangerous form of the disease. In this case, the tooth grows perpendicular to the rest of the formations, resulting in malocclusion. This is usually the impacted canine, which has to be removed. Leaving it, the patient will disrupt the growth of all other parts, which over the years will lead to complete loss.

Angular

The angular position of the axis is characterized by irregular growth. In this case, a semi-retinated tooth will most likely appear, which will simultaneously affect the surrounding growths. Such situations are common and require orthopedic treatment. The correct actions of the doctor of the dental clinic will allow you to straighten the growth, restoring the bite of a person. Such regular operations are not considered difficult, but still leave marks on the gums.

Diagnosis of retention is a simple examination by a dentist. Usually it is sufficient to identify parts of the crown, outlines of the formation or lungs on the gum. Although treatment requires a thorough examination. It will provide the doctor with all the necessary information for surgery or orthopedics. What methods are used in clinics?

Targeted radiography;
Orthopantomography.

Both methods allow you to explore the space under the gum as accurately as possible. Dentists do this kind of research all the time, taking detailed pictures for later study. Through them, they manage to identify violations and use all available means to eliminate them.

The best diagnosis is considered to be targeted radiography. It is used even when the tooth under the crown hurts. So its effectiveness has been tested in practice. If the obtained data is not enough for treatment, you should think about an additional examination.

When wondering what an impacted tooth is, a person usually immediately turns to a dentist. If he hopes for folk remedies, you should first study the main signs of dysplasia. What symptoms should be highlighted?

Partial germination of a semi-impacted tooth;
lack of formation in the jaw;
displacement of the roots of neighboring formations;
purulent formations at the site of eruption.

Similar signs can be seen on your own. They accurately indicate the appearance of a problem, although in the early stages they can be confused with partial destruction of the root. Because of what, experts prefer a detailed examination to identify even minor modifications.

Methods of treatment

An impacted canine usually becomes a serious problem. Its growth entails pain and a gradual change in bite. In such cases, it will not save you from deformation, so you have to turn to categorical methods of treatment:

Orthopedics;
Removal.

Both options are widely used in medical practice. When choosing, the results of the inspection are taken into account, indicating the possibility of using one or another technique. For this reason, it is impossible to say in advance what actions dentists will have to resort to.

Orthopedics

Orthopedics is the most common way. It is carried out without surgery, but remains available only in some cases. Patients should rejoice at such an offer from specialists who are ready to restore the bite without complicated actions. The only problem with this technique is the long process of jaw restoration.

Removal

Removal is a definitive action, but extraction remains a necessity in certain situations. In the dental clinic, after examination and examination, mandatory recommendations are always given. If the dentist finds it impossible to restore the correct direction of the axis, he appoints an operation. And also it will be required in case of danger of deterioration of the state of neighboring formations.

Treatment of impacted teeth in Moscow

Dental clinics in Moscow regularly accept patients with malocclusion. Growing teeth requires frequent visits to specialists for detailed recommendations and additional procedures. Without such actions, it will not be possible to get a beautiful smile.

Treatment in private clinics is carried out by professionals using the latest techniques and the latest equipment. Due to this, patients quickly get rid of discomfort and calmly enjoy the correct bite. Yes, it is not always easy to achieve the best results, but with due patience, the effectiveness of orthopedics becomes colossal.

Growth failure will create a lot of problems, but even it can be dealt with. To do this, you should immediately seek help from an experienced dentist. Immediately after a full examination, he will select the best way to correct the situation and return a brilliant smile.

Video: orthodontics treatment of impacted teeth

This is the name of a dental anomaly (tooth retention), which is the retention of the correct eruption of a full-fledged tooth.
Such a pathology can affect milk and molars (permanent), but basically the disease affects the eighth molar - the so-called "wisdom tooth".

The main reasons for the formation of retention are the pathology of the formation of the dental germ or the anatomical features of the jaw.
Scientists suggest that this anomaly arose in a civilized society due to the widespread use of soft foods and a decrease in the ability to chew hard foods.

To prove their hypotheses, scientists cite as an example the inhabitants of third world countries: roughage among the natives remains a priority and an anomaly of tooth growth is not observed.

The cause of an impacted (dystopic) tooth may be obstruction in the form of the jawbone and the conflict of eruption with neighboring teeth.

One of the causes of an impacted (dystopic) tooth is the conflict of eruption with neighboring teeth.

Retraction occurs in the following cases:

Embryological features of the oral cavity - too thick tissue of the dental sac or near/tooth gums. The manifestation of embryological anomalies is also revealed in relation to the incorrect location of the longitudinal direction of the dental germ, which may collide with a previously formed tooth;
Lack of potential root growth. The growth force of the tooth is formed as a result of the vegetative ability of the root itself and the protrusion of the dental nipple;
Abnormal development of the jaw, with some hereditary and acquired factors, directs the rudiment of the tooth root to a vertical position;
When the first molar/premolar erupts, the root of the second tooth leans forward;
A large hypertrophied tooth begins to grow in a recumbent form. If there is a previously erupted tooth, there is no prospect of eruption in a vertical position, so it grows horizontally;
The anatomical factor in the occurrence of tooth retention is manifested in the loose consistency of the gum structure, which is adjacent to the area of the rudiment of an erupting tooth. The enamel surface of the tooth does not come into contact with the gum, subsequently the gum does not atrophy (holds the tooth) and the tooth germ tilts due to the pressure of the upper part of the tooth.

One of the varieties of anomalies in the growth of teeth is dystopia - the location of the dental process in an atypical location for it.

These abnormal processes may develop into normal/full teeth, but not grow in a designated area, but (for example) on the top of the gum in a straight or slanted position.
This pathology can be congenital (hereditary) and acquired, the problem most often occurs in adolescence as a result of the belated removal of milk teeth.
Dystopic - an impacted tooth, brings maximum discomfort to a person, in addition, this pathology can be accompanied by displacement of healthy teeth, inflammation of the tissue and degeneration of the oral muscles.

Important: “A dystopic / impacted tooth brings danger to a person, since there is a possibility of decay of the tooth root / crown directly under the gum tissue or in the area of the jaw skeleton!”

Etiology of impacted tooth manifestation

Impacted teeth are distinguished by two types of eruption deformities:

Partial eruption: the top or side of the abnormal tooth is visible on the surface of the gum;
Complete closure: the root and crown are completely hidden under the gum tissue or located in the jawbone.

In nature, there are four anomalies in the development of the tooth:

Vertical;
Horizontal;
medial;
Distal.

The most common growth pathology is medial, when the molar (premolar) is located horizontally in relation to the front row of teeth.

Causes of the anomaly

In medical practice, several reasons are considered for the possibility of retention:

Important: “With timely access to a dental surgeon, this pathology can be avoided, since surgically it is possible to set the correct direction of tooth growth!”

Diagnostic methods

The pathology of tooth development often does not bring the owner a state of discomfort, the reason for contacting a specialist may be a delay in the loss of milk teeth or eruption of molars. In some cases, an inflammatory process or numbness of the area with an impacted tooth occurs.
Impacted teeth during growth provoke the occurrence of stomatitis, decubitus ulcers and other gum lesions, which leads to circulatory disorders and inflammatory processes in the oral region.
Eating in the presence of inflammatory formations becomes painful.
It is recommended to consult a dentist - in a neglected state, the incorrect growth of an impacted tooth changes the location of healthy teeth and deforms the bite.
Examination of the affected area is carried out using radiography and palpation of the gum area: in the presence of a dystopic tooth, a solid swelling is detected.

Wisdom tooth

Most often, retention is found in the eighth teeth of "wisdom teeth", the impacted tooth can be located directly in the jaw for a long time and not reveal any clinical manifestations.

Important: “The wisdom tooth should erupt from the moment of its formation within 3-4 months, in complicated cases, the process of teething increases by two years!”

For a long time before the appearance of the "eight", painful sensations may occur in the oral cavity, this is because it is located close to the nerve fibers and provokes severe pain, neuralgia.
Also, the G8 retention can be provoked by follicular cysts, they increase every year and become a source of such negative complications as osteomyelitis and phlegmon of the oral cavity.
Acute forms of wisdom tooth retention are accompanied by an increase in body temperature to 38-40 degrees (in this case, one should be wary of the possibility of blood poisoning).
Against the background of the inflammatory process, a significant edema is formed in the area of the impacted tooth, while the symmetry of the face is visually disturbed.

Against the background of the inflammatory process, a significant edema is formed in the area of the impacted tooth, while the symmetry of the face is visually disturbed

Pathology can also manifest itself with the timely eruption of a part of the dental crown, but this does not mean that the pathological formation has passed. Under the gum there is an accumulation of food debris that cannot be cleaned in the usual way, suppuration (pericoronitis) begins to occur.
During the formation of a purulent process, the body temperature rises, a swelling appears on the face, severe pain begins, and the ability to open your mouth or chew food disappears.
With such symptoms, there is one way out - this is the removal of an impacted wisdom tooth.

Surgical intervention

The occurrence of an anomaly in the growth of a dystopic and impacted tooth always requires surgical intervention in order to correct the eruption or remove the pathology.

Important: “The main difference between a dystopic and an impacted tooth is the possibility of correcting the growth of a dystopic tooth with orthopedic methods!”

Methods for treating a dystopic tooth require surgical intervention only when correction with orthopedic devices is ineffective.

For example: if the dystopic tooth is in the front and the deformation is not irreversible, orthopedic remedies are used at the very beginning of growth.
An impacted tooth will erupt until the growing capacity of the root system is exhausted.
The main thing in the treatment of this pathology:

determination of the exact location of the tooth;
gum tissue surgery and removal of an impacted dystopic tooth.

This circumstance also has several factors for the development of events:

With the maximum potential functionality of the tooth or in order to preserve the aesthetic features of the structure of the face, to make room for growth, not the impacted tooth is removed, but its neighbors;
If a growing tooth does not play a special function for a person (incorrect location, impossibility of correction and appearance in the extreme parts of the jaw), this tooth is removed.

The removal process itself is as follows:

The introduction of local anesthesia in the parenteral region of the gums;
Cutting the gum tissue or periosteal flap to free the site;
Sawing (excision) of the vestibular and distal walls;
Extraction of a tooth, fragments and other neoplasms using dental forceps;
Wound treatment;
Suturing.

The process of recovery and healing of the wound is painful, complications may appear in the form of suppuration. To prevent this situation, the patient is prescribed to drink a course of antibiotics.
The wound after surgery must be treated at home by rinsing with disinfectants and antibacterial agents, such as Chlorhexidine.
If within a few days after the operation, swelling of the gums is observed - this position is normal, in the healing process - the swelling subsides.

Important: “Timely removal of a hypertrophied tooth will enable the rest of the teeth to grow properly!”

Possible Complications

The postoperative period is dangerous for its possible complications, they can occur due to improper oral hygiene, the remnants of a tooth fragment in the jaw, and the reaction of the gums to surgical intervention.
Worth noting:

if after 3/5 days the pain at the site of surgical procedures has not stopped;
there was a putrid smell from the mouth;
the site allocates purulent masses.

In such situations, it is necessary to contact the surgeon for examination and additional manipulations.
This complication often occurs due to neglect of the doctor's recommendations.

Important: “In the postoperative period, it is necessary to take antibiotics to quickly heal the wound and prevent suppuration!”

Conclusion

When applying the measure at the initial stages of the formation of dystopia, prevention of mutation prevention is possible.
Timely rehabilitation of milk teeth will prevent untimely loss.
It is recommended to control the eruption of permanent molars and premolars.
If necessary, use orthopedic structures to correct and correct growth (braces).
Timely conduct orthopedic and surgical intervention.
The occurrence of retention can be avoided: if you carry out preventive examinations of the oral cavity, control the growth of molars and loss of milk teeth and eat solid food.

Dystopic impacted teeth cause discomfort, sometimes inflammation and swelling of the gums join the inconvenience. Often, such defects lead to displacement of the dentition. If germination is accompanied by problems, you should see a specialist. Despite all the “shortcomings” of the teeth, you don’t want to part with them. However, do not argue with a dentist who claims that an impacted tooth needs to be removed.

Dystopic and impacted tooth

What is an impacted tooth? Retention is a delay in the eruption of permanent teeth. She may be:

Partial. When the tooth erupted, but not completely.
Complete. There is not even a hint of cutting. It is hidden by bone tissue or gums.

Dystopic tooth - what is it? This is incorrectly located in the jaw. It can grow in the wrong place, at the wrong angle, breaking the harmony of the row, on the other side. distoped forms an abnormal bite, tilts the neighboring ones, which spoils the smile.

A tooth may have one such defect or two at once. Wisdom teeth anomalies are very common. They often have two defects at once. A completely impacted "eight" can cause an inflammatory process, caries, periodontal disease and other problems in the oral cavity. Therefore, surgical treatment of a dystopic or impacted wisdom tooth is often prescribed in order to avoid possible troubles and complications.

Surgery: indications and contraindications

The operation is carried out in cases when the following occurs:

But there are also contraindications for removal of wisdom molars if they are dystopic or impacted. These include:

Hypertonic disease.
Severe general condition.
Acute heart disease.
Nervous diseases in the acute stage.
Viral or infectious diseases in an advanced stage.
Diseases of the blood.
Last days before menstruation.
It hasn't been 2 weeks since the abortion.
The impacted "eighth" molar in pregnant women is removed in the second or early third trimester, if it is not possible to postpone for the postpartum period.

Surgical treatment of an impacted tooth, what is it?

The operation to remove an impacted wisdom tooth is not an easy procedure, since the specialist has to work with an uncut tooth, that is, remove it from the gums. Surgery for the patient is painful, so anesthesia is done. It takes up to 3 hours in duration. Operational manipulations can be conditionally formulated in the form of the following stages:

The molars are usually large, so the dentist first crushes them, after which extracts in parts. The recovery postoperative period lasts about a week, then the sutures are removed.

In the case of a running inflammatory process, when the patient already has pus, the removal of the impacted wisdom tooth is carried out urgently. As a rule, surgical treatment is prescribed in a hospital setting. If the operation is planned, the time is set convenient, a mostly non-hot day is chosen.

A dystopian wisdom tooth: what to do with it?

An impacted tooth is not amenable to treatment, unlike a dystopic one, which can be subjected to orthodontic treatment. Patients are usually prescribed to wear braces, they are able to correct the position of the dentition. The process is quite long, with due patience, you can achieve good results.

However, there is a nuance that imposes an age limit. Braces will not help with retining if you start wearing them after 15 years. Another point of irrelevance of orthodontic treatment is the inclination of the premolar or molar due to lack of space in the jaw. Even if you manage to change his position to the correct one, he will still stand in his usual place.

The dystopian is removed in the same way as in the case of the impacted one. The complexity of the operation and the steps involved are similar.

Rules after surgery

After removal it is necessary adhere to a number of rules:

Wound resulting from removal heals for about a month. All this time, you need to monitor your state of health, and with the following signs of a violation of the natural course of recovery, you should seek help from a dentist:

Pain does not subside, you have to constantly take painkillers.
Doesn't stop bleeding.
The temperature has risen.
The swelling of the gums became more pronounced.

The presence of an impacted or dystopian wisdom tooth is a dubious “treasure”. Even if there is no pain and it does not cause discomfort, it is necessary to get rid of such defects. Since most of the processes that are destructive in nature are not visible at the initial stages.

impacted tooth

Impacted and dystopic teeth: treat or remove

Before answering the question - to remove or treat impacted and dystopic teeth, it is necessary to understand what it is, what threat it poses, how to diagnose, and whether it is possible to prevent this pathology.

What is retention

So, what does an impacted tooth mean? In dentistry, an impacted tooth is considered to be a tooth that has not erupted for various reasons, but has formed, remaining entirely in the jaw or partially hidden by the gum. Retrieval is divided into two types:

complete - the tooth has not erupted and is completely hidden inside the bone under the gum. It cannot be seen or felt,
partial - the tooth has not completely erupted and only a separate part of it looks out from under the gum.

The impacted elements deform the gums, provoke their inflammation, and adversely affect the process of chewing food. If the problem is not solved in time, an infection may develop that will harm other internal organs. Also, due to the significant load during chewing, the impacted tooth can break. In such cases, long-term treatment requiring significant material costs will be required.

What is dystopia

Dystopic is a tooth, the formation and growth of which occur with deviations. For example, it develops correctly, but grows in the wrong place, or, conversely, takes its place, but the growth angle is disturbed.

Based on these possible options, dystopic teeth may have the following disorders:

tilt left or right
change in the axis of growth,
violation of the position relative to the rest of the teeth in the row - they are literally "pressed" into the mouth or shifted forward, towards the lips or cheek.

Ignoring such a pathology can cause the formation of a malocclusion, which in turn will negatively affect the aesthetic appeal of a smile.

Important! Retention and dystopia can complement each other i.e. an abnormally growing tooth can be impacted and vice versa. It hurts, interferes, constantly disturbs the patient. The development of dual pathology is fraught with a serious threat to the health of not only the oral cavity, but also the body as a whole. By the way, it is most often found in the so-called wise "eights".

Causes of retention and dystopia

So why do these pathologies occur and can they be avoided? The causes of anomalies may be the following:

genetic predisposition: the patient could inherit the structural features of the jaw,
the presence of wisdom teeth: they erupt quite late and most often combine both retention and dystopia at the same time. Eruption of "eights" can be difficult due to abnormalities in embryonic development (for example, with increased density of soft tissues),
jaw injuries resulting from mechanical damage,
bite anomalies: this may be, for example, the presence of supernumerary teeth - they are “superfluous” and take the place allotted by the main ones, which grow later. Due to bite defects, the load on the jaws increases, which can lead to their destruction, deep damage to the periodontal tissue and functional disorders of the temporomandibular joint,
dental diseases: inflammatory processes in the mouth, caries, premature loss or vice versa, the prolonged presence of milk teeth prevent the formation of a correct permanent bite,
diseases: rickets, infectious and somatic disorders that have depleted the body and disrupted metabolism.

Important! Make sure that the diet contains coarse vegetable and animal fibers, hard vegetables and fruits. It was thanks to this that the jaws of our ancestors received the necessary load, as a result of which the risk of bone tissue atrophy and retention was excluded.

Symptoms and Diagnosis

Often, retention is asymptomatic and is only detected at the dentist's appointment. But it is not difficult to identify a semi-retinated tooth on its own, it can be detected by carefully feeling an excessively protruding gum. Partial cutting of the crown also indicates the presence of incomplete retention, as a result of which the mucosa can be systematically injured, edema appears on it, its shade changes, and the inflammatory process begins. To make a final diagnosis, you need to take an x-ray, and sometimes undergo a computed tomography.

Important! With retention, some patients complain of pain, including when chewing food, inconvenience when opening the mouth. Cervical caries, pulpitis, chronic periodontitis often appear on impacted teeth. Another sign is the formation of follicular cysts. They can suppurate and provoke sinusitis, abscesses, purulent-necrotic processes of the jaws.

Dystopia is detected by a dentist-therapist or orthodontist during the examination. However, the patient himself can notice it. This anomaly provokes the formation of malocclusion, leads to damage to the tongue, lips, cheeks. As a result of injury, ulcers form, pain is felt during meals. Complete oral hygiene becomes impossible, and poorly removed plaque and food debris serve as fertile ground for the development of caries.

What to do with "abnormal" teeth

Important! Even if you do not have obvious signs of retention or dystopia, the best prevention of complications will be annual check-ups at the dentist and x-rays, which will reveal hidden processes. After a thorough diagnosis of the disease, only a qualified specialist will prescribe the correct treatment and give recommendations for care.

Treatment is prescribed based on the characteristics of the clinical history of the individual patient, the results of x-ray examination. The tooth is saved if it does not pose a potential threat to health, and its presence is not fraught with consequences and does not cause concern. But most often, removal is indicated, especially for the lower teeth - in the event of inflammation, the likelihood of infection penetrating into the extensive structures of the bone tissue is greater here than in the upper jaw.

Abnormal elements of a smile are often removed, and indications for removal may be various factors: a delay in the change of milk teeth, the absence of physiological resorption of the roots, the presence of "extra" teeth, improper positioning, lack of space for growth, pronounced clinical symptoms, complications.

Removal is performed surgically. The operation is carried out in several stages. First, the patient is given local anesthesia, the gum is incised, opening the bone, a hole is drilled in it with a drill. Then the problematic unit is removed with tongs, the debris is removed. At the final stage, the bone protrusions are smoothed out, the hole is treated with a special solution and sutured.

Postoperative care

The period after surgery plays a significant role in the successful completion of treatment. Usually the patient receives recommendations that must be followed very carefully:

within 3-4 hours after the operation, you can not eat, drink, smoke,
during hygiene procedures, it is necessary to be especially careful and not get carried away with intense pressure, and even rinsing in the wound area,
when chewing food, you need to use the healthy side: the food should be soft, not too cold or hot, so as not to injure the wound,
in the first two days after the operation, physical activity should be limited.

Often a person does not pay attention to such smile defects, believing that they will not harm, or simply experiencing fear of visiting the dentist. But in most cases, a neglectful attitude to the problem is fraught with serious consequences: the development of bite pathologies, a disorder in the functioning of the digestive organs, and the threat of losing neighboring teeth. If you run it, it threatens to injure the tongue, cheeks and mucous membranes, which also explains why the gums become inflamed. The patient may develop defects in diction and asymmetry of the face, which causes problems in communication and establishing personal contacts.

To minimize the risk of complications, it is enough to monitor the condition of the jaw in children during its development, as well as timely treat emerging problems.

Related videos

Dystopic and impacted teeth: the essence of pathology, removal

Turning to the dentist with complaints of discomfort and toothache, many patients receive a referral for the extraction of an impacted or dystopic tooth. A person who is ignorant of dentistry, such a recommendation can be confusing and make you panic. However, it is often a radical solution to the problem may be the only correct one.

Concept, types of dystopia

Dystopic teeth are those whose eruption and growth develop with deviations. Usually, such a pathology entails the incorrect location of all other teeth, discomfort for the patient, and the need for dental treatment.

The photo shows examples of vestibular and medial tooth dystopia

There are many types of dystopia. For example, the tooth itself can be of the correct shape, but grow in the wrong place, or occupy the right place relative to neighboring teeth, but have a pathological shape, an incorrect growth angle, or be located on the wrong side.

In medicine, the following types of pathology are distinguished:

Vestibular dystopia. Means the growth of the tooth at an inclination in one direction or another.
Torposition. The tooth is turned in the opposite direction.
medial dystopia. The tooth protrudes beyond the dentition.
Distal. The tooth seems to be pressed into the jaw.

The essence and types of retention

Retention also means the pathological development of teeth, but is somewhat different from dystopia. An impacted tooth is a tooth that is fully formed in the gum tissue and periosteum, but not cut outward, or cut through only partially. Sometimes such a pathology is asymptomatic, but more often there is an infection, discomfort in the form of pain, phlegmon, abscesses.

What is an impacted tooth, you can see in this photo:

Science knows 2 types of retention:

With full retention, the tooth is hidden under the gum and bone tissue, it cannot be seen when examining the jaw. And with a partial degree of development of the pathology, the crown can be seen when examining the oral cavity, but its main part is still hidden under the gum.

Reasons for the appearance

The main factor in the appearance of impacted and dystopic teeth is detrimental heredity. All people have a genetic program for the formation of the dentition, and for some teeth there is not enough space for growth.

Specialists in the field of dentistry note several more reasons for the development of such a pathology:

If a single tooth grows before all the following, which could play the role of landmarks.
Sometimes one extra tooth appears in the row, and there is not enough room for all the rest to develop properly.
Excessively dense tissue of the tooth socket.
Loose periodontal structure.
Dense arrangement of crowns.
Traumatic injuries also often lead to bite deformation.
Ultra-early loss of milk teeth often leads to incorrect formation of the entire row.

Types of teeth prone to pathology

The most commonly observed dystopia or retention of the following types of teeth:

A displaced wisdom tooth is a common pathology. The cause of this phenomenon may be heredity or trauma to the jaw. In addition, the molars of the third row are considered a sign of atavism, which may gradually disappear in the course of evolutionary development.
Fangs. This pathology occurs at the age of 10–12 due to the abnormal development of molar type teeth. A dystopian or impacted canine usually means not only a violation of the aesthetics of the oral cavity, but also constant problems when chewing solid food. Besides canine with medial dystopia can permanently injure the soft tissues of the cheeks and tongue, causing discomfort to the patient, provoking the danger of an inflammatory process.

Possible consequences of pathology

Often patients get used to malocclusion without going to the dentist. Especially often this happens when the patient does not experience pain and other discomfort. However, in the absence of timely treatment, the presence of an impacted or dystopic tooth can lead to other violations of the state of the body.

Incorrect bite does not allow you to completely chew food, which is fraught with incomplete digestion, and subsequently - diseases of the stomach and intestines.
With an incorrect location or the presence of extra dystopic teeth, there are frequent cases of loss of an absolutely healthy neighboring one.
If the dentition is formed incorrectly, there may be violations of diction, problems with the pronunciation of certain sounds.
There are frequent cases of traumatic injuries of the inner part of the cheek and tongue.

Removal of impacted and dystopic teeth

Indications for the extraction of an impacted tooth are:

pathological location, lack of space in the dentition;
delay in the loss of retrograde teeth;
destruction of the tooth neck;
if the impacted tooth is superfluous and interferes with the normal growth of the rest;
dentists advise removing such teeth in the presence of complications.

Removal of an impacted and dystopic tooth implies a high invasiveness of the intervention, since it is necessary to exfoliate the mucosa and periosteum, extract the tooth from the bone with a bur, extract it from the bone tissue using forceps, and suture. If the roots of neighboring teeth are exposed, the doctor resects them, and then performs a retrograde filling procedure.

When there are no indications for the removal of an impacted or dystopic tooth, doctors perform an intervention to excise the gums or periosteum. The next stage of therapy will be orthodontic treatment in the form of braces or special buttons.

With regular injury to the cheeks and tongue due to dystopia or retention, dentists can perform a grinding procedure for dental tubercles. However, most often with such pathologies, a radical solution to the problem is recommended. Sometimes, after such a procedure, prosthetics may be required.

Impacted wisdom tooth removal procedure:

Anesthesia of the gum surface with a special gel or spray.
Administration of an anesthetic injection.
Incision of the gums with a scalpel, exposure of the wall of the bed.
Hole drilling for access to the wisdom tooth.
Cutting and extraction of the dental crown.
Separation and extraction of dental roots.
Cleaning and disinfection of the wound, sometimes - the imposition of turunda with iodine.
If the turunda was not installed, a suture is applied after antiseptic treatment.

The removal of a dystopian wisdom tooth occurs in a similar way.

Postoperative period

After the operation, the patient's teeth need enhanced care and medical supervision.

If turunda was applied, during the first three days from the moment of intervention, you need to visit the dentist to monitor the condition of the wound, and perform disinfection procedures. After this time, the dentist will remove the swab and stitch it up.
Daily brushing of teeth should be carried out in a gentle manner, avoiding injury to the operated area.
For 3 days after the operation, the use of rinses for the oral cavity is prohibited..
All food should be pureed, chewing on the operated side is prohibited.
In the first few hours after the intervention, it is not recommended to drink, eat, or use tobacco products.
If the patient is worried about severe pain, then it is not forbidden to take an analgesic pill.
For 2-3 days after the operation, you should not get involved in physical exercises.

What are impacted and dystopic teeth?

We treat or remove: what to do with teeth that have not erupted or have not erupted completely

Sometimes the wrong position of the tooth is considered an exclusively aesthetic flaw, and therefore they are in no hurry to correct it. But if it grows or has already grown in the wrong position, or maybe it didn’t completely cut through or remained hidden under the gum tissue, this can turn into serious problems in the future. Further in this article, we will talk about such concepts as a dystopic and impacted tooth, about what these phenomena are and what methods are used today to solve such problems.

What is dystopia

Consider what a dystopian tooth really means. So they say if it grows incorrectly, with abnormal deviations. It can be tilted to the side, and then you have to deal with vestibular dystopia. Other varieties of this anomaly include medial and distal - if the tooth strongly protrudes forward or goes back, respectively. There is also such a thing as tortoposition - in this case, it will be rotated around its axis. To understand how such a phenomenon looks live, take a look at the photo below.

Thus, dystopia is one of the varieties of malocclusion. It can touch both one tooth and the entire row. The sooner parents begin to deal with the treatment of such pathologies in their children, the easier and faster it is possible to solve the problem.

What is retention

Now let's look at what an impacted tooth means. This concept means that the element was formed, but did not cut through to the end or did not even appear above the gum. If you look at the picture below, it will be clear what is at stake.

The impacted element may not completely erupt, that is, remain inside the bone tissue, or appear as one edge of the crown. In this case, it is customary to speak of full or partial retention, respectively.

Important! One pathology does not exclude another: a tooth can be impacted and dystopic at the same time. Often this phenomenon is diagnosed in relation to wisdom teeth.

Why does pathology develop

Is it possible to predict the appearance of the considered defects? Today, experts in the field of dentistry note that the most common cause of this disorder is a genetic factor. However, even in the absence of a hereditary predisposition, the risk of encountering a similar problem still remains. Among the provoking factors are the following:

lack of neighboring units,
overcompleteness,
injuries due to which the bite was broken,
pathologies in the formation of rudiments,
developmental pathologies of the jaws,
premature loss of milk units,
connective tissue diseases.

When choosing a treatment method, the doctor takes into account the history of the disease. In some situations, simple removal is not enough. Most bite defects require complex therapy.

Symptoms of retention and dystopia

A completely closed impacted tooth sometimes does not cause much concern and is often found only during a hardware study. Meanwhile, in the area of its contact with neighboring tissues, cervical caries, pulpitis, periodontitis can develop, in some cases follicular cysts, inflammation and suppuration are formed. Doctors highlight the characteristic signs of retention, which should be paid special attention to: protrusion of the gums and a "gap" in the alveolar arch.

Tilted dystopian teeth often lead to injury to the inner surface of the cheeks, lips and tongue. The constant presence of open wounds on the mucosa is a direct path for microbes and infection, so often such bite defects become the root cause of the development of inflammatory processes in soft tissues. Often, gum pockets form over the part that remains hidden under the gum, in which pathogenic bacteria actively multiply. In some situations, such problems lead to impaired diction and chewing function.

Diagnosis of the disease

How to understand that a tooth is impacted or dystopic? Most often, the defect can be seen with the naked eye, because such anomalies usually cause serious aesthetic damage to the smile. If there is any suspicion of misalignment of the tooth, you should consult a specialist. For diagnostic purposes, doctors use hardware research methods - radiography, orthopantomography, computed tomography.

Attention! Most often, dystopias are subject to wisdom teeth and fangs. Dystopic incisors are the most rare, and such cases cause the greatest discomfort to the patient 1 .

Sometimes, due to retention and dystopia, wounds, ulcers, and inflammations form on the gums. Touching the surrounding tissues becomes painful. When such symptoms appear, you should immediately seek help from a specialist - only a doctor will be able to identify the form of the anomaly and determine the cause of its occurrence.

Principles of treatment: is it possible to avoid surgery

Treatment of retention and dystopia usually comes down to the use of a combination of individually selected procedures. In childhood and adolescence, some disorders are corrected by orthodontic techniques, including corrective plates and braces. For the treatment of adult patients, prosthetics are more often used.

However, it is often necessary to resort to surgical disclosure of a defective tooth or its removal. As a rule, such decisions are made in relation to impacted eights - it is quite difficult to treat them, and their functional load is minimal. Abnormally located elements of the dentition are unconditionally removed in case of complications, as well as at high risks of damage to neighboring units.

Extraction of an abnormal tooth

Features of surgical intervention depend on the specific situation. Sometimes, if the impacted tooth is large enough, its extraction is performed in several stages. After the procedure, medicine is applied to the open wound, and the incision on the gum is sutured.

“I was looking for a surgeon to remove a wisdom tooth, which not only did not erupt, but was also rotated around its axis. Moreover, the therapist first told me, they say, I would not touch him, otherwise you will become numb, swell up ... Can you imagine?! I left upset, then, according to reviews, I found a wonderful doctor who brilliantly coped with the removal. In general, if you have a similar situation, do not pull! You can't fix the problem on your own!"

Yana, Moscow, fragment of a message on a thematic forum

When removing an uncut element, it is necessary to remove the gum area under which it is hidden. If an atypical tooth is completely covered with bone tissue, then a bur is used. Then the edges are smoothed, and the wound is treated and sutured. During the procedure, the surgeon can use a scalpel or a laser.

Sometimes a doctor may decide to remove not an abnormal, but a healthy tooth - if this allows the dystopic one to grow correctly, which is preferable to keep. This is often done in case of canine pathology.

Features of care after surgery

The recovery period can be quite difficult. If the doctor has not prescribed a different option, then you must adhere to the following rules:

the first 2-4 hours after the operation it is not recommended to drink, eat, rinse your mouth, smoke,
special attention at this time should be given to regular oral hygiene,
do not use rinse aids for the first three days,
give up sports for at least a couple of days after the operation.

Also, the doctor often prescribes antibiotics and painkillers, treatment of the cavity with chlorhexidine. To avoid complications, the patient must strictly follow all the recommendations of a specialist.

How to avoid complications

In some situations, swelling occurs after surgery. This phenomenon is considered normal if the symptom gradually disappears - with the normal development of the situation, the swelling should disappear within a week. There may also be some bleeding from the wound. To stop it, a special medicine is applied to the hole. It is better to give up for a while the use of hard, as well as too cold and hot food and drinks. Daily cleaning should be as gentle and gentle as possible.

Prolonged bleeding, numbness, discomfort when opening the mouth, inflammation, damage to neighboring areas - a reason for an immediate visit to the dentist.

Approximate prices in clinics

Prices for treatment, as well as the removal of abnormal teeth, are made up of a number of factors and depend on the degree of complexity of the pathology, possible concomitant treatment, the qualifications of the surgeon and the pricing policy of the dental center. The cost of removing an impacted element can reach the amount of 6,000 rubles. Please note that you will have to pay separately for the X-ray examination. So, a picture of one tooth will cost about 350 rubles, while an orthopantomogram will cost 1000-1200 rubles.

The curved position of individual elements of the jaw system is a phenomenon that usually does not occur suddenly and out of nowhere. Therefore, parents from an early age need to carefully monitor the process of growth and formation of the jaw apparatus of their children. The sooner an anomaly is detected, the easier it will be to solve the problem, perhaps even without resorting to surgical intervention.

Removal of an impacted and dystopic tooth

Each tooth is characterized only by its inherent position in the jaw, the angle of inclination in relation to neighboring teeth. A dystopian tooth is a tooth that is in the wrong position in the jaw. It may be characterized by inappropriate localization, excessive tilt, or be rotated around its axis. Such a pathological situation creates problems for the surrounding teeth, since a dystopic tooth has a negative impact on their position, contributes to the development of malocclusion. Pathology can be observed with any tooth of the upper or lower jaw.

An impacted tooth is characterized by incomplete eruption. At the same time, it may be noted

partial retention, when there is an insignificant part of the crown part of the tooth;

Full retention, in which the entire tooth remains covered by bone tissue or gums.

Often there is an impacted dystopic tooth. This development of the situation is most typical for a wisdom tooth. An impacted tooth causes a lot of problems, its eruption is accompanied by:

Pain in the gum area

development of periostitis, pulpitis, periodontitis;

Change in the position of adjacent teeth.

In addition, the implementation of therapeutic measures in this case is complicated by its localization and difficult access by a specialist.

Therapeutic tactics for a dystopic tooth

In the case of a dystopic tooth, treatment tactics are determined by its localization and the effect that it has on neighboring teeth. The most acceptable solution is the use of orthodontic treatment with fixed structures, braces. However, in cases where a dystopic tooth is due to a lack of space in the jaw, this treatment method is ineffective. The only correct way to correct the situation is to remove it.

Surgical intervention in this case is characterized as complex, it consists of the same stages as the extraction of an impacted tooth. The deletion may take several hours. There may be cases of removal of such teeth in parts. At the same time, contraindications to the removal of a dystopic tooth are

diseases of the blood system associated with impaired coagulation;

Cardiovascular pathology in the stage of decompensation;

high blood pressure of any origin;

Complicated tooth extraction is always in the competence of the most qualified surgeon, who has sufficient experience in performing similar interventions. The specialists of the Dentist clinic have repeatedly proved their professional level with high-quality removals. At the same time, the development of postoperative complications was minimized.

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To prevent the most unpleasant diseases, it requires

An impacted tooth is one that has not fully erupted. Its germ is in the jaw bone. It had already formed, but for one reason or another could not break through.

This feature appears for the following reasons:

The gum tissue is thick and difficult for the tooth to break through.
loose gums - the reason that the root will deviate from its normal position;
early loss of a milk tooth, after which an adjacent one is displaced to an empty place;
incorrect formation of rudiments during fetal development (the wall of the capsule that surrounds the rudiment is very thick);
hyperdontia (additional set of rudiments);
violations during the change of dairy;
malocclusion;
rickets;
general weakening of the body during the period of tooth growth;
heredity;
anticancer chemotherapy.

What does unerupted and semi-retinated teeth mean, should they be removed?

Sometimes only part of the crown erupts through the gum mucosa. For this case, the term "semi-retinated" is used.

It can be detected with a dental probe or felt with a finger.

If he did not grow at all, his crown did not come to the surface, then they speak of complete retention. In this case, an accurate diagnosis can only be made with the help of an x-ray.

Vertically growing, lying horizontally, dystopic

Depending on how the non-erupted tooth is placed in the tissues of the gums (or the bone part of the jaw), different cases are distinguished:

Vertical arrangement - the tooth has no deviations from the normal axial line and is located perpendicular to the gum. Retention is due to the fact that it is surrounded by dense gum tissue or there is not enough space for eruption.
If a tooth lying on its side is visible on an x-ray, a horizontal retention is diagnosed.

Dystopic teeth, as a rule, erupt, but deviate from the norm in their position:

towards the teeth that are in front of it (medial retention);
in the direction from the person in front (distal retention);
inverse, when the root is located above its crown (rare);
buccal tilt (the crown is directed towards the cheek);
lingual tilt (the crown “looks” at the tongue, inside the oral cavity);
buccoversion - is in a supine position and the coronal part is directed outward;
lingoversion - the position of the tooth, opposite to the buccoversion.

Indications for extraction of jaw units overgrown with gums

Removal of an impacted tooth is carried out when its abnormal position leads to negative consequences:

The retention of one tooth impedes the normal growth of the remaining units of the row and leads to malocclusion.
An impacted tooth injures the cheeks and tongue, which leads to persistent inflammation and ulceration of the oral mucosa.
Before installing a bracket system, when it is necessary to eliminate all the causes leading to a pathological bite.
With pericoronitis - inflammation in the gum area. A condition when the mucous membrane partially covers the tooth, and infection accumulates under this “hood”, which leads to constant pain, swelling.
Before installing prostheses, when the impacted unit interferes with access to the adjacent tooth.

Important! Before the impacted tooth is removed, the orthodontist examines the person. If orthodontic treatment is not possible, if indicated, an extraction of the unerupted one is prescribed.

Extraction of an impacted tooth means its complete extraction from the gum or jaw bone. This procedure is a full-fledged operation, which is often performed in a hospital.

Features of the removal of wisdom teeth under the gum

How is the operation to pull out teeth that have not yet erupted?

Planned (for example, after unsuccessful treatment by an orthodontist).
Emergency (for example, with osteomyelitis, acute inflammatory processes) - the issue is resolved on the day of treatment.
Urgent (destruction of the crown, infection) - the issue is resolved within 2-3 days.

Attention! The operation is performed in the presence of a dental surgeon under strong painkillers. This is necessary, since the impact can be carried out both on soft tissues and on the bone, if the roots have already grown into the jaw.

The removal of an impacted wisdom tooth in the lower jaw takes place in several stages:

Local anesthesia is performed.
The gum is dissected with a scalpel. Access to the impacted lower wisdom tooth is determined by the topography of the latter.

When it is localized near the seventh tooth, the incision is made in front from the outer side of the neck of the seventh to the transitional fold, and behind - from the front edge of the branch obliquely back and downwards also to the transitional fold. Both incisions are connected along the inner edge of the alveolar process.

The flap is retracted.
If it is in the gum, the procedure of its dislocation and extraction begins.
When the impacted tooth remains in the bone tissue, it is first necessary to drill a hole in it with a drill machine.
Remove in parts or entirely with the help of elevators or tongs.
The well is cleaned with a curette and washed with antiseptics.
Bone wound plasty is performed with biomaterials (autobone, hydroxyapatite, tricalcium phosphate).
The mucosal flap returns to its original place, sutures are applied.
Stops bleeding from the hole.

Possible complications after removal: swelling, numbness, trauma

Dry socket, which is characterized by an unpleasant odor and pain. These symptoms appear on the 2nd - 3rd day after the manipulation.
During the operation, nerve endings may be affected. The consequence of this will be numbness of the lips, tongue, chin. Usually the symptom goes away on its own after a while, but in difficult cases, the process can be delayed.
Injury to soft tissues leads to swelling, pain, and sometimes an inflammatory process appears.
Often, the removal of an impacted tooth is accompanied by bleeding, hematoma, cyst formation, and flux.
Sometimes the temperature rises.

Recovery

Do not eat or drink for 3 hours after the procedure.
Do not open your mouth wide, as this may cause the sutures to separate.
The tampon is removed 10-20 minutes after application.
During the day after the operation, you can not eat solid food, cold and hot dishes.
Do not touch the hole, neither with your hands nor with your tongue.
Temporarily (1 - 3 days) do not rinse or brush your mouth. Carry out the procedure with the permission of the doctor. Use antiseptic solutions for this: Chlorhexidine, Miramistin, Rivanol.
Take painkillers. Especially in the first days after surgery. You can use Ketanov, Nimesil, Tempalgin, Nurofen.
To treat purulent inflammation, doctors often prescribe antibiotics.
In any unforeseen situations associated with the appearance of pain, consult a doctor.

Important! Do not use warm compresses to relieve pain. They create an environment conducive to the growth of bacteria that can get into an open wound and again provoke the appearance of pus.

How long does it take for gums to heal

The recovery period takes from 5 to 7 days. The rate of healing is affected by the general health of the patient and the extent of the disease.

Impacted teeth do not always make themselves felt. However, if it was found, it is better to remove it. This will help avoid complications in the future.

An impacted tooth is an element that cannot erupt due to complete or partial overlap by the soft and/or hard tissues of the jaw. It has formed enamel and neurovascular endings, and even remaining under the gum, it is exposed to bacteria and caries.

Which teeth are subject to retention

In dentistry, impacted teeth are more likely to be figure eights or wisdom teeth, which are the last to erupt. Retention of the wisdom tooth is observed in 45% of cases. The reason for the anomaly is the deep location of the rudimentary tissues and the limited area for growth, which leads to difficult eruption with the formation of a gingival hood.

Impacted wisdom teeth are equally common in both the lower and upper jaws. Less commonly, tooth retention is observed in the canines of the upper jaw. Among the lower teeth, “fives” or second premolars may remain unerupted.

ICD-10 code: K01 Impacted and impacted teeth.

The reasons

What can cause tooth retention:

features of the jaw apparatus - too dense gum tissue, weak growth force;
pathology of the formation of the rudiments of teeth or their location relative to the jaw axis in the embryonic period;
early or late change of the milk occlusion, provoking the displacement of normally located non-erupted teeth in the gum;
loose gum tissue, which can provoke the movement of the tooth roots into a pathological position;
supernumerary rudiments or hyperdontia;
congenital pathologies of the palate and upper lip;
malocclusion;
rickets;
chronic fibrous inflammation of tissues;
weakness of the muscular apparatus with the formation of a lack of space for the growth of teeth (may occur when the technique of feeding a baby from a bottle is violated);
endocrine disorders;
low immunity;
deficiency of calcium and fluorine in the body;
genetic factors responsible for the formation of tooth buds and their tissue differentiation;
long-term treatment with medications that affect the normal development and growth of dental elements.

Types of retention

There are several types of retention.

By type of cutting:

Full retention means that the tooth is fully located in the gum. The anomaly is detected against the background of the inflammatory process in the oral cavity.
Partial retention or semi-retention of the tooth - there is a slight exposure and partial coverage of its gum hood. Pathology is dangerous caries. It is often observed with dystopia of the teeth. Below is a photo of a partially impacted tooth.

Symptoms and Diagnosis

A person can determine a non-erupted dental unit on their own, at home. The main symptoms of pathology:

pain in the gums, radiating to the ear, temple, etc .;
permanent trauma to the periodontal mucosa;
swelling, redness and numbness of the gums;
protrusion in the local area of the periodontium;
loosening or displacement of individual dental elements;
discomfort when eating and talking;
development of cysts and purulent complications;
deterioration in general well-being.

A semi-retinated tooth is easily identified by a visual examination by a dentist. If the tooth is retained, it is necessary to conduct targeted X-ray diagnostics. Less commonly, in complex clinical cases, an orthopantomogram and CT of the teeth are prescribed.

Methods for treating an impacted tooth

it is healthy and located correctly in the gum tissue, does not compress neighboring bone elements;
the cause of retention is eliminated, there are practically no interferences for eruption;
there is enough room for crown growth;
it is possible to carry out high-quality dental procedures related to the treatment of caries and pulpitis;
after eruption, the tooth can become a supporting element during prosthetics;
radiography ruled out the presence of complications;
the tooth is involved in the formation of the correct bite and performs the functions of chewing.

Treatment of an impacted tooth is a complex process that requires joint efforts from dentists of various specialties. A set of measures is selected taking into account the picture of the disease and the individual characteristics of the patient.

If the tooth is located correctly and can be saved, the hood of the periodontal mucosa is excised under local anesthesia. This procedure allows you to free the crown for its further successful eruption.

Read also: What is and how to remove the gap between the front teeth

acute or chronic form of pericoronitis;
symptoms of peristatitis, caries, pulpitis;
resorption of the roots of adjacent teeth;
neuralgic pains;
follicular cyst;
tumors of the type of odontoma and ameloblastoma;
lack of space for normal teething in the jaw row;
destruction of the cervical part of the dental element;
the need for orthodontic treatment with the condition of freeing up space on the upper and lower jaws.

How a tooth is removed

The operation to extract the impacted element lasts from 20 minutes to 4 hours. The main stages of the surgeon's work:

Performing manipulations on the organization of local or general anesthesia.
An incision in the tissues of the mucosa and periosteum to gain access to the crown.
Exposure of the bone bed by exfoliating periodontal tissues.
Preparation of the surface of the crown for extraction by cutting a hole in it to gain access to the roots.
Extraction of the tooth with forceps or elevators with a break in all periodontal bonds.
Cleansing the wound from remnants of bone tissue, washing with antiseptics, applying gauze turunda.
Sewing up the hole with suture material or catgut.

With semi-retention, a mucosal incision is not necessary. The surgeon removes the tooth with a rocking motion using forceps. In the lower jaw, uncut teeth are more difficult to remove.

On a note!
Also, the extraction of the impacted unit can be carried out with a laser. The procedure is less traumatic and passes faster in time. Complications after laser removal are minimized.

Postoperative care

Within 20 minutes after removal, you need to keep a swab in your mouth, pressing it against the wound to stop bleeding.
If the bleeding has not stopped and is too intense, you need to contact a specialist again and immediately.
At least 4 hours after the extraction, it is important not to eat anything, it is allowed to drink only clean water. After this time, you can eat only soft and warm food until the wound heals.
With swelling of the mucous membrane, it is recommended to apply a cold compress to the cheek for 10-15 minutes.
In case of inflammation in the area of the extracted tooth, it is important not to warm up the hole and consult a doctor.
A blood clot that has formed in the wound cannot be removed, as it protects it from bacteria.
From the second day after removal, you can rinse your mouth with a weak solution of Furacilin, a decoction of sage or chamomile to prevent infection.
Severe pain is allowed to stop with analgesics.