Complicated tooth extraction. What tools are used. Contraindications for removal

• How can you transfer the procedure of tooth extraction with minimal loss to your health, nerves and wallet;
• Why teeth sometimes have to be removed and what indications the dentist-surgeon is guided by, passing the appropriate verdict;
• In what situations is it better to wait a little with the extraction of a tooth or not even remove it at all;
• What are the stages of the procedure and what awaits you in the dentist's office;
• Is it possible today to remove teeth without terrible forceps, without pain and with minimal trauma;
• How difficult and lengthy can be the removal of problematic teeth - impacted, semi-retinated, resorcinol-formalin and even ordinary molars, but with specific roots;
• How can the patient help the attending physician so that the tooth extraction goes smoothly;
• What to do if you need to urgently remove a tooth at night, on weekends or holidays;
• Is it possible to remove teeth in hospitals today for free and what is often hidden behind the cheapness of the service ...

Tooth extraction (extraction) is considered a dental operation and involves surgical intervention. In other words, when you go to extract a tooth, you are going for a surgical operation, and therefore this procedure should be taken with all responsibility.

Next, we will consider many nuances that will help an ordinary unprepared person go through this test with minimal loss to the nerves, wallet and health (mistakes and negligence of the patient can lead to very serious consequences).

On a note

Situations are different: sometimes a tooth has to be removed urgently, sometimes it is planned, but in both cases the question immediately arises: which dentist is more appropriate to contact? Which doctor can most competently and painlessly remove a tooth?

Someone can immediately say without hesitation that you need to contact a dentist-surgeon. On the one hand, this is the correct answer, but in practice things may not be so simple. The fact is that in clinics, hospitals and even in private dentistry Often there is a situation where one dentist works at a mixed appointment. That is, he treats (preserves) teeth that can still be saved, and also removes “bad” teeth, conducts professional teeth cleaning, and in addition, the same doctor also deals with prosthetics of missing teeth. In total, we get 2-3 or more specialties “in one bottle”. Is it worth contacting such a specialist?

Of course, everything depends on the professionalism of the doctor and his experience, but in practice, most dentists focus on one area of ​​work, having significantly less experience in other areas. For example, there are dentists at a mixed reception who devote a lot of time to dental treatment, but the removal is not very high quality. Here much still depends on the complexity of the work ahead. But after an hour and a half of torment, during which the doctor cuts, drills and even chisels with tools, it is unlikely that any of the patients would like to hear that, they say, the tooth is too complex and cannot be removed (it happens).

That is why it is best to remove a tooth from a dentist-surgeon who specializes only in this manipulation in its various forms.

In addition, there are also maxillofacial surgeons - relatively speaking, they are even higher in level than dental surgeons. These specialists are not limited in their work only to “pulling out” teeth (even the most difficult ones), but they can also help with injuries of the maxillofacial region, dangerous complications periodontitis (periostitis, osteomyelitis, abscess, phlegmon, lymphadenitis), congenital and acquired deformities, TMJ diseases, tumor processes, etc.

For example, with significant problems with opening the mouth, when it is necessary to remove a wisdom tooth with diffuse swelling of the face and neck, dislocation of the jaw or fracture, it is worth contacting maxillofacial surgery.

Why do teeth sometimes have to be removed?

Before performing a tooth extraction, the dentist determines the indications for this in advance, that is, weighs all the pros and cons. There are such clinical situations when a tooth can be considered controversial - this means that a dentist, even taking into account the available indications, cannot unambiguously say whether it is worth the risk of saving it, or still remove it from harm's way.

It is not uncommon for situations when in one clinic they offer to immediately pull out a bad tooth, and in another they undertake to save it.

On a note

Sometimes, in order to recognize a tooth as subject to extraction, a council of dentists of various profiles gathers: a therapist, surgeon, orthopedist, orthodontist, periodontist.

How can one explain such uncertainty in dental practice?

In life, as you know, everything is not as simple as it may look in books and textbooks. The indications and contraindications for tooth extraction that exist today were developed back in Soviet times by reputable scientists, and most of them have passed into modern protocols that guide dental surgeons in their practice. However, they may not always be suitable for a specific clinical situation, and there are a number of reasons for this:

• Improving equipment, instruments and methods of dental treatment increases the chances of saving teeth, sometimes contrary to existing protocols;
• At the same time, thanks latest methods diagnostics and modern approaches in dentistry, a dentist alone or collectively may decide to extract a tooth, even if there are indications for its preservation.

The following are examples of the main indications for tooth extraction:

1. The failure of endodontic treatment in the area of ​​the periapical inflammatory focus (in other words, when a cavity with pus has formed on the root of the tooth, and healing procedures have no effect)
2. Emergency cases - sick teeth, which are the source of an active microbial process, not subject to treatment and provoking diseases such as periostitis, osteomyelitis, abscess, phlegmon, lymphadenitis, sepsis, etc.;
3. Technical difficulties associated with curved or hard-to-pass canals, leading to the impossibility of conservative treatment, as well as perforation of the tooth cavity or root wall;
4. The location of the teeth, leading to permanent trauma to the oral mucosa or tongue;
5. Tooth mobility of the third degree and its extension due to bone resorption in periodontitis or periodontitis;
6. Location in the fracture line (teeth that interfere with the reposition of fragments and are not subject to conservative treatment);
7. Complete destruction of the tooth crown when it is impossible to use the root for orthopedic purposes;
   
8. Supernumerary teeth interfering with prosthetics or causing injury soft tissues that violate the aesthetics and chewing;
   
9. Protruding teeth with the loss of the antagonist, as well as those that interfere with the creation of a functional prosthesis;
10. In case of bite anomalies, according to orthodontic indications, even teeth that are not affected by caries can be removed;
11. Some types of root fractures as a result of mechanical trauma.

Wisdom teeth are a separate category, which a number of dentists recommend removing urgently, while other doctors suggest trying to save them, even at some risk of complications.

On a note

There are situations when orthodontic treatment (for example, on braces) cannot be started without the removal of wisdom teeth, even if they have completely erupted and do not interfere with the bite.

The same ambiguous situations often arise in relation to the preservation of teeth, for example, when it is impossible to pass root canals, perforate the wall, or break off an instrument in the canal. In one clinic, the extraction of such a tooth may be recommended, and formally this falls under the indications, while in another dentistry they may offer to save the tooth with the help of the latest technologies(for example, a microscope plus removal of instrument fragments from the canal using ultrasound).

In other words, when removing teeth, it is very important individual approach, common sense and medical logic, combined with the experience and professionalism of a doctor. And not a simple old-fashioned method of chopping from the shoulder, which took place in Soviet times, not from a good life: a tooth is badly damaged - under the forceps, there is no third channel - under the forceps, a slight edema appeared in the area of ​​​​the transitional fold in the projection of the tooth root - also urgently "Tear out" without waiting for periostitis.

Such antediluvian tactics (which, unfortunately, are still sometimes found in some polyclinics by patients tired of the flow and low salaries of doctors) are currently unacceptable and fraught with negative consequences in patients.

Situations when you can wait a little with the extraction of a tooth or not remove it at all

Despite the variety of options noted above, involving the extraction of a tooth, there are also many situations when it is better not to remove a problematic tooth or to postpone it.

The most common situation is associated with pediatric dentistry, when parents of babies with carious lesion a milk (temporary) tooth is urgently required to pull out a tooth, accompanying it with something like this: “It will fall out anyway - why treat it?”.

This logic is too straightforward and does not take into account the fact that the change of teeth should normally occur at an appropriate age: symmetrical groups of teeth gradually become mobile and in many cases fall out on their own. If the tooth is removed prematurely (even a year earlier), then there is a high risk of malocclusion and the development of anomalies in the eruption of permanent teeth.

In other words, at early removal milk teeth (especially multiple), future permanent teeth can literally “spread” in different directions, or even not erupt in a single or group version. Such a prospect is not needed by any sane parent, so it is better now to save the child from surgical intervention, having cured caries or its complications, rather than later investing effort and money in correcting the bite and the child's psyche.

On a note

Meanwhile, there are clinical situations where acute conditions, health threatening and the life of the baby, require the immediate removal of a temporary tooth. Or when the tooth can no longer be saved even with modern methods of treatment.

As for the impossibility of cooperation between a child and a doctor at the stage of dental manipulations: there is not only treatment and extraction of teeth under anesthesia, but also various forms of superficial sedation and premedication, which allow the procedure to be carried out as comfortably as possible and minimize the possibility of a child becoming afraid of a white coat in the future.

Cases when a person wants to pull out an innocent tooth are quite common and during adult dentistry especially among men and women over 45-50 years of age. This is largely due to old memories of the remnants of Soviet dentistry, when a tooth, at any opportunity (even with caries), was sent under forceps. Until now, such categories of citizens often get an appointment, especially in budget (free) dentistry with requests or even demands to remove a tooth in case of caries or pulpitis.

For example, a tooth began to hurt from cold, hot, sweet, or night pains of a aching nature had just begun, and the patient was already negatively disposed to the treatment of the tooth. The motives can be different: from “love to pull out teeth” (quickly, inexpensively and there is no terrible drill with its sound) to 100% certainty that after treatment the tooth will still have to be removed (the negative experience of past decades, when teeth were treated for a long time, but in the end, I still had to apply for removal).

So, what is important to keep in mind: modern dentistry has long crossed out these prejudices. Now, not only with caries (even deep) and pulpitis, but also with most periodontitis, the teeth are treated remarkably, and they do not need to be rushed to be removed at all. And even if the tooth, it would seem, has broken at the root, it is not yet a fact that the root will need to be removed, since it is quite possible to restore the functionality and aesthetics of the tooth with the help of a root inlay and a crown.

Stages of tooth extraction: how it all happens in most cases

After the decision to remove the tooth is made in accordance with the indications, the stage of preparation for the procedure begins.

The photo below shows an example of a broken anterior tooth to be removed:

The nature of the preparation depends on the characteristics of the future manipulation (under or without anesthesia, with or without premedication), but the most basic steps include:

1. Collection of anamnesis (especially allergic status);
2. Psychological preparation of the patient (many are afraid, so it is important for the doctor to calm the patient and set him up in a positive way);
3. Medical preparation of the surgical field (rinsing the mouth with antiseptics, treatment of the injection site).

On a note

It is recommended to sign up for tooth extraction in the morning, when you and the doctor are still full of energy. If anesthesia or sedation is not planned, then it is better to eat well before the procedure - this way you will have more strength, and the blood will clot better.

If it is possible to remove a tooth with forceps, then the removal is called simple, and it is carried out in several stages:

In some cases, sutures may be required.

To remove the tooth was not painful, both domestic anesthetics (for example, Lidocaine) and imported ones (drugs of the articaine series) can be used. The most effective today are recognized as "artikain", however, it is also very important correct technique anesthesia - much depends on the level of professionalism and experience of the doctor.

Today in dentistry there are different variants anesthesia during the extraction of a diseased tooth. During conduction anesthesia, a group of teeth is “frozen”. A good example is the torusal or mandibular technique: during its implementation, the patient does not feel the lip, the tip of the tongue and the cheek on the corresponding side.

Infiltration anesthesia is done in the projection of the tooth root onto the gum: in this case, freezing occurs only in the removal zone: this is almost always enough for everyone upper teeth, as well as the lower ones - from the first to the fifth. For 6, 7 and 8 lower teeth infiltration anesthesia will not be enough, so a torusal is done. If this conduction technique is not done or done poorly, then during the removal of the lower large molars it can be very painful.

Of the modern methods, intraligamentary anesthesia (intraligamentous) can also be noted. It is done with a special syringe and has a lot of advantages (does not cause facial numbness, comes on quickly, lasts for 20 minutes, which is enough for most outpatient removals).

For difficult removals, anesthesia is sometimes used. A characteristic difference complex removal of a tooth from a simple one, in addition to the time it takes, is the use of a drill (for sawing a tooth into pieces, cutting out a bone), screws, ligatures and some other specific tools (sometimes a tooth is literally split into pieces with a chisel and hammer).

The photo below shows an example of a tooth sawn into three parts using a drill before removal:

On a note

It is not always possible for a dental surgeon to determine in advance whether a tooth extraction will be difficult or simple. In many cases, the doctor can only roughly guess which tooth should be expected to have difficulties, and which one will almost “jump” out of the hole during removal.

Sometimes a specialist immediately sees a potentially complex tooth (resorcinol-formalin, semi-retinated, impacted, with specific roots) and warns the patient in advance that the procedure will be difficult and slow.

"I deleted it yesterday lower tooth wisdom. It was a real nightmare ... For more than an hour they sawed a tooth, hollowed it out with a hammer, broke out the roots, almost broke the jaw. They cut the bone and turned everything there completely. The most terrible feeling is when the doctor tried to break out a tooth several times, I thought that he would dislocate or break my jaw. All four roots of the tooth stuck out in different directions, so it was removed badly. Now half of my face is swollen, the pain is terrible, I can’t swallow normally and open my mouth. The doctor said that he had not seen this for a long time ... "

Natalia, Moscow

Option to remove teeth without "terrible" forceps: ultrasound technique

In order to minimize tissue injury during tooth extraction, and therefore to speed up and make the subsequent healing process more favorable, there is a so-called atraumatic method of tooth extraction. Such removal could be classified as complex, but the application additional funds(drill, periotome, etc.) in this context, on the contrary, simplifies the procedure, reduces it in time and makes it minimally traumatic.

Suppose the patient has a severely damaged upper sixth tooth (at the level of the gum or even under the gum), however, the roots do not exist independently, but are connected into one whole. With the help of a drill, the crown part of the tooth in the middle is carefully sawn out: in this case, each root becomes independent. Periotome allows you to quickly and accurately remove them without damaging the septa, walls of the alveoli, as well as the gingival margin.

The photos below show the individual stages of the atraumatic method of removing three teeth at once with a preliminary cut:

On a note

If, however, only forceps are used in this case, then the cheeks of the forceps would have to be advanced deep under the gum in order to “loosen” and “dislocate” the soldered roots. In 50% of cases it will work, but with varying degrees breaking off the outer and inner wall holding the root. After such root removal, uneven or sharp bone tissue remains, creating new problems for both the doctor and the patient.

Often with forceps removal complex teeth cannot be carried out at all, and the result is only a waste of time and useless “biting” with forceps of both the alveoli and the roots.

Atraumatic tooth extraction can also be accompanied by the use of ultrasound. It is this technique that modern clinics are currently actively using as a "know-how". The piezosurgical apparatus allows, using an ultrasonic scalpel, to separate the periodontal ligaments that hold the tooth bloodlessly and remove it from the hole.

The main advantages achieved by tooth extraction using ultrasound:

• Bloodlessness;
• Acceleration of work;
• Antiseptic effect;
• No overheating;
• Help in the removal of complex teeth (impacted, semi-retinated, dystopic, resorcinol-formalin).

This type of atraumatic tooth extraction is ideal for subsequent immediate implantation, when the implant is installed immediately in a fresh hole.

Features of the removal of potentially problematic teeth (impacted, semi-retinated and resorcinol-formalin) - should we be afraid?

To remove impacted and semi impacted teeth(that is, not erupted or erupted only partially and largely hidden in the jaw bone), as well as resorcinol-formalin teeth (that is, previously treated with resorcinol-formalin paste and made fragile by this), the doctor can apply as anesthesia, if there are indications for him, and local anesthesia.

Most often, these teeth are removed under local anesthesia.

The picture below shows an impacted wisdom tooth:

From the practice of a dentist

Some budget dentists (especially in small towns and villages) who work on a mixed basis (therapy plus surgery) are afraid to remove teeth from this category. Seeing a semi-impacted or, moreover, impacted tooth (according to the picture), they can immediately refuse to remove it and send the patient to maxillofacial surgery at the nearest regional clinic or dental center. The motivation for this can be both unwillingness to mess with these teeth (the procedure may take 1-2 hours of painstaking work), and the fear that the lack of experience and tools will not allow you to remove all the roots - which means that the exhausted patient will still have to be sent to another a more qualified dentist.

Stages of complex tooth extraction:

1. Preliminary preparation (premedication, treatment of the surgical field, etc.)
2. Anesthesia (general or local);
3. Creation of access to the removed tooth;
4. Instrumental technique to improve the conditions for the "dislocation" of the roots of the tooth;
5. Extraction of roots;
6. Hemostasis;
7. Preservation of the hole to prepare for implantation (according to indications);
8. Suturing (according to the situation);
9. Appointment of recommendations.

Creating or improving access to a tooth involves the use of elevators, a periotome, trowels, a drill with a set of burs and cutters, and (rarely) chisels and a hammer. After partially creating access to the tooth to be removed (gingival retraction, flap detachment), the tooth is removed with an elevator, and if this is not possible (as with impacted ones, for example), then the alveolus bone is sawn with cutters in the projection of the tooth location. At the same time, cooling is applied to the area being prepared, since the bone tissue should not overheat, otherwise necrosis will develop.

When the tooth to be removed becomes visible, the surgeon can immediately begin to use elevators to “pick up” it. Often, the tooth can be sawn (or split) into pieces to make work easier.

On a note

How long can such a complex removal take? Depending on the complexity of the procedure, the availability necessary tools and the experience of the doctor, the procedure can take from 10 minutes to 2 hours.

After extracting the diseased tooth and removing the granuloma or cyst (if any) from the hole, suturing is performed and recommendations are made. In a number of situations, the hole is preserved before subsequent implantation so that there is no atrophy of the bone walls. For this, natural bone substitutes are used, or synthetic (inorganic bone matrix).

After a complex tooth extraction, the doctor necessarily prescribes home treatment to ensure the most comfortable postoperative period and prevent alveolitis, which may include preparations of various directions:

1. Painkillers (Ketorol, Ketanov, Nise, etc.) for pain relief in the first days after surgery;
2. Antibiotics and sulfa drugs(to eliminate a bacterial infection in the maxillofacial area);
3. Antihistamines (to reduce swelling and other manifestations of the inflammatory response);
4. Preparations for rinsing and treatment of the removal area (gels, ointments) with anti-inflammatory, wound healing, analgesic, antiseptic and antibacterial action.

On a note

Generally speaking, the list of recommendations that exists in the arsenal of Russian dentists is huge, and each dentist adheres to his list of necessary postoperative treatment. Someone prescribes the same thing to each patient, while someone has an individual approach (which is the most correct).

But it should be borne in mind that some dentists may not say anything at all to the patient, even as parting words or advice. If you had a tooth removed and were not given recommendations, be sure to ask for them, or find out from another doctor, as this helps to avoid unnecessary anxiety and very unpleasant complications.

How to help your doctor so that a tooth extraction goes smoothly

Despite the fact that anesthesia is used in dentistry before tooth extraction, there is always a risk that the procedure may not go as smoothly and painlessly as we would like. Often this is due to the fact that the patient is not ready for the procedure and behaves not quite correctly.

Let's see how to prepare for tooth extraction, in order to at least help a good doctor to carry out the manipulation without any problems.

Firstly, surgical intervention on a “neglected” tooth, when the stage of an acute process has reached its climax (because of pain, you cannot even touch the root, a “flux” has arisen) is tolerated in many cases much worse than the planned removal of a “calm” tooth. Moreover, in this context, it does not matter which particular tooth will have to be removed: the root (six, seven, eight) or some front tooth is to be removed.

It is not difficult to imagine what unforgettable emotions a patient (as well as a doctor) can experience when you have to remove a diseased tooth or its remains against the background of periostitis and other purulent complications when anesthesia almost does not work, and any touch on the tooth causes hellish pain. But the tooth needs to be loosened! At the same time, there is still a risk that the rotten crown part may break off, and you will have to separately “pick out” the roots ...

It is interesting

Often anesthesia is done in the projection of the root of the tooth, when pus is everywhere under the gum in this area. At the same time, the “sufferer” demands from the dentist-surgeon that everything be absolutely painless: “Give a strong injection, doctor, if only it doesn’t hurt!” However, it is immediately clear that where the pus is located, a priori they are “not happy” with the new solution: there is nowhere to put the existing exudate.

A bad doctor, as a punishment for such a patient who walked too long to the doctor's office, will simply inject the entire portion of the anesthetic at a time, and in terms of sensation, the procedure will be similar to removing a tooth without anesthesia, when there are already "sparks from the eyes" from pain. A normal surgeon will gradually inject the gum with an anesthetic in 2-4 stages, release milliliters of purulent fluid to eliminate pain during the administration of the drug and try to achieve stable anesthesia for painless tooth extraction.

So the patient's excessive patience before going to the doctor can give rise to a lot of problems. Therefore, if it is known for sure that a badly damaged tooth is to be removed, then it is better to get rid of it as planned: make an appointment and, in the absence of contraindications, once and for all end the problem before the tooth gets sick.

For tooth extraction, the ideal option would be to sign up in the morning:

There are a few more practical tips that help the patient safely endure the tooth extraction procedure:

1. Before removing a tooth, you should eat well (unless anesthesia or sedation is planned). A well-fed person copes with stress better, faints much less often and blood coagulates better, which is important after the procedure;
2. Do not take alcohol for courage. The risk of edema and prolonged bleeding in drunk people is increased, not to mention inappropriate behavior;
3. In case of great fear of the procedure or fear, you can resort to sedatives (Tenoten, tincture of valerian, motherwort, Corvalol, etc.) 20-60 minutes before the operation, depending on the activity of the remedy. In this case, the choice of the drug must be coordinated with the attending physician or district physician and have an idea of ​​​​the measure (especially regarding alcohol tinctures, since their reception can smoothly turn into alcohol intoxication);
4. It's good to have a positive attitude. If you are initially set up for a successful outcome of the procedure, then almost always the removal goes well, and the healing time is as short as possible. How more people tells himself that nothing will work out and the more he winds himself up, the more anxiety he causes to himself and the doctor, sometimes simply because of anxiety wrong actions(use of unnecessary ointments, rinses, dangerous folk remedies etc.);
5. When planning complex operations (removing difficult impacted tooth, all wisdom teeth at once, etc.) it is recommended to consult with your doctor about starting anti-inflammatory, painkillers and even antibiotics before the intervention.

If the tooth is declared unfit, then in emergency cases it is removed promptly. But there are situations when the patient is going to apply for a planned tooth extraction - in these cases, it sometimes makes sense to postpone the procedure.

1. SARS and acute respiratory infections in the active period;
2. Painful and heavy periods;
3. Cardiovascular diseases, when their treatment is accompanied by the intake of certain drugs (for example, anticoagulants - Warfarin, Xarelto, etc.);
4. Pregnancy (on some terms - an exclusively individual approach);
5. Acute diseases (acute appendicitis, acute pancreatitis and etc.).

It is not difficult to guess that after the disappearance of many of these conditions, you can safely consult a doctor about scheduled removal tooth.

What to do if you need to urgently remove a tooth at night, on weekends or holidays?

You can often observe panic among residents of large cities and metropolitan areas, when a badly damaged tooth suddenly starts to hurt on weekends or holidays. That is, emergency surgical care is required, and a person is squeezed within four walls and does not know where to go for a tooth extraction and what, in general, to do.

Meanwhile, no matter what day it is (Sunday, March 8, New Year or another holiday), since in cities there is a round-the-clock emergency dental care with a duty schedule of dental surgeons. It is enough to contact the regional dental clinic or regional hospital with the Department of Oral and Maxillofacial Surgery.

But not only in large cities there is an "ambulance" in dentistry. Even in the district center at night, on weekends and holidays, as patients say, it is possible to “pull” teeth after a preliminary call to the post. It usually looks like this: you call ambulance or to a medical assistant's post, you will find out the possibility of urgent tooth extraction. The specialist contacts the duty dentist, and he comes to the office within an hour to help you (if on holidays the dentist keeps his appointment according to the schedule until a certain time, then at night he most often has to be called).

As for the private sector, everything is much simpler here. There are dentists that are open 24/7. Doctors in such clinics work in 3-4 shifts, and are ready to remove a tooth at any time when required.

On a note

The night shift is popular not only with people caught off guard by pain, but also with late-night parents of toddlers who have toothaches. In addition, many people employed in business have free time only after 22:00, and some even after 00:00.

Is it possible to remove teeth in hospitals today for free?

But what about those people who do not have money to extract teeth in a private clinic? Moreover, the price for such services today varies, depending on the region and the complexity of the procedure, from 500 rubles. up to 20,000 rubles

Someone may even be surprised by such a high price - to pull teeth for 20 thousand rubles for one pulled tooth? Isn't it too expensive?!

On a note

The fact is that 20 thousand rubles is also not the maximum for tooth extraction, since there are complex clinical cases that require increased time and materials.

Usually, an additional mark-up is made for the following types of removal (the following are the wordings from the price lists of the clinics):

• "Atypical tooth extraction" (that is, complex);
• "Laser" (using a laser scalpel);
• "With the use of ultrasound";
• "Without tongs";
• "In a dream" (anesthesia or superficial sedation).

The list can be continued and expanded. Moreover, for example, under atypical removal in clinics, they often mean not only complex extractions of teeth, but also the removal of any wisdom tooth in general, even if the removal is simple. This is most often done for commercial purposes, as a kind of fear-mongering in patients with wisdom teeth allows you to set in the price list increased price for getting rid of them.

So is it still possible to remove a tooth cheaply?

First, given the great competition, private dentistry exposes different prices for the same service, and the price can be very democratic, regardless of what kind of tooth it is: a canine (or as it is often called by patients, " eye tooth”), wisdom tooth or any other chewing. It happens that in one clinic you can remove a wisdom tooth for 1000 rubles, and in another they will offer a price of 5000 rubles.

And there, and there, the removal is paid, and the main question that confronts the patient is whether it is possible to trust a more budget option?

According to the recommendations and reviews of relatives, friends and colleagues, you can almost always find professional doctor which is good for removing teeth. Whose office wall, though not hung with dozens of certificates and letters, but who knows his job well and is attentive to the patient. There are small private offices where they can remove a tooth for 500 rubles painlessly and efficiently without cheating for coffee, magazines, leather chairs and other surroundings.

Another thing is that you need to go to such a specialist on the recommendation of trusted people, and not just go to remove a tooth in the first clinic that comes across, where they will offer the lowest cost of the service.

Is it possible to remove a tooth qualitatively, but for free?

Free cheese (especially in dentistry) can only be in a mousetrap - perhaps this is the first thing that can come to mind in such a case. However, annually, hundreds of thousands of citizens receive free surgical care under the usual compulsory medical insurance policy.

The principle is as follows: a person who is attached to this institution applies to a hospital or clinic at the place of residence for the purpose of removing a tooth. He gets a ticket to the dentist, and he removes one or more decayed teeth for free using this coupon. If there is no attachment, and the coupon does not pass through the computer, then, of course, you can also remove the tooth, but for a fee.

If the dentist cannot perform the extraction (for example, we are talking about an impacted or resorcinol-formalin tooth, or there is a diffuse edema that threatens life, pediatric specialization is required, etc.), then the patient has the right to receive a referral to free care, where the medical institution, the referral diagnosis according to ICD-10 and the need for this or that manipulation will be indicated.

On a note

There is also a list free drugs, which the dentist under the MHI policy can provide to the patient at the stage of assistance. This is especially true for anesthesia.

Not all hospitals (especially in villages, settlements, small towns) are regularly and fully allocated the right materials. Most often supplied domestic drugs for anesthesia (Lidocaine, for example), although today there are even anesthetics of the articaine series on the list under compulsory medical insurance, which, however, practically do not reach the addressee. In order to work as comfortably as possible and be able to provide high-quality anesthesia to the patient without risking his health, dentists are forced to extract a tooth for a fee, where a person pays money for " good shot". Of course, it's cheap compared to private clinic, and costs about 100-400 rubles, depending on the region.

But this does not mean at all that free tooth extraction “under lidocaine” will necessarily be painful. Free removal in many budgetary institutions can mean increased risks, starting from the fact that the anesthetic injection will be made on hastily and will not work as expected, and ending with a long queue of the same sufferers in the corridor for many hours, with the likelihood of getting a three-story obscenity from a tired surgeon for any inaccurately spoken word.

So here everyone chooses where to apply for a tooth extraction and how much he is willing to pay for this service. In conclusion, we can only note that having decided on the budget, you should not look for a clinic, but first of all for a good doctor - this will be a guarantee that tooth extraction with high probability it will be almost painless and without any problems.

Be healthy!

An interesting video with an example of atraumatic tooth extraction by ultrasound

What to do after tooth extraction to avoid complications

Tooth extraction in dentistry can be of several types - simple and complex. A simple extraction is used when it is required to remove teeth with one root, but a complex tooth extraction is used in cases where the root is complex and has several branches. Usually during this process special tools are used, with the help of which the whole procedure takes place. But still, this removal method has certain features that should be carefully considered.

The operation of complex extraction of teeth is usually used in severe cases. Usually when you need to use additional tools, drugs.

Wisdom teeth due to lack of space in the jaw arch may occupy a non-physiological position. They, especially the upper ones, can cut through to the side of the cheek and injure its mucous membrane. Based on this, a decision can be made to remove them.

The most common conditions in which this removal method is used include the following cases:

• If there are impacted (not erupted) wisdom teeth;
• If they have eights that have the wrong location. They are also called dystopian;
• Apply during any extraction of molars with two or three roots;
• If the area of ​​the root of the tooth has a strong curvature or destruction;
• The presence of fusion of the bone tissue of the jaw with the roots;
• Often used in cases where there is a cyst or fistulous passages;
• If before that the tooth was treated with the use of rosacin-formalin paste, which led to increased fragility of the bone tissue of the tooth.

This operation usually takes longer. In addition, strong anesthetics are necessarily used during it. Carry out this procedure in several stages.

Differences between complex deletion and simple deletion

Operation easy removal usually used in simple cases:

1. When the tooth is loosened, for example, during periodontal disease;
2. The tooth has one root;
3. To remove a milk tooth.

The most simple and painless is the removal of loose milk teeth. Usually they do not require additional anesthesia, sometimes it happens completely unnoticed by the patient.

But difficult removal is applied in more difficult situations when there are various pathologies or multiple root branches. It is also often used when teething wisdom or to remove the 8th molar. Therefore, when this large tooth erupts, many try to postpone the visit to the doctor, take painkillers and delay the inevitable.
It is best to visit a doctor immediately at the first appearance of this molar, he will examine it and if he sees any deviations, he will immediately remove it at the first stage. And if this is not done on time, then it may not grow as it should or lead to various complications, which ultimately complicate the entire process of treatment and subsequent removal.
What is the difference between complex and simple removal:

1. Usually, local anesthesia is used for downtime. And a doctor with extensive experience can remove a milk or loose tooth in a couple of minutes, while not using painkillers. But during a complex operation, when the tooth has pathologies, several roots, or if the root grows in the wrong direction, potent drugs for pain relief, sometimes even potent anesthesia is used;
2. duration. A simple operation usually takes 5 to 20 minutes. But difficult surgical intervention is a rather lengthy process, often it lasts from 30 to 60 minutes. Sometimes it can take place in several stages;
3. For complex removal, special tools are required.

   Attention! Special instruments are used to lift, retract or cut the gingiva, some of which are designed to grasp a deeply seated root of a tooth or to saw through the root if required. Appearance these devices from the outside looks very intimidating, but this is so, it seems only at first glance. They are designed in such a way that during operation they cause a small degree of mechanical damage.

   For simple removal, conventional forceps and elevators are sufficient;

4. For complex operations, deep incisions can be made in the gums. But do not be afraid, everything is performed under anesthesia, which acts for some time after the operation. Usually, after a deep incision, sutures are applied, which are removed after 7-10 days;
5. Severe and long period after a complex operation. Be sure to strictly follow all the recommendations of the doctor. This will help avoid the appearance severe inflammation or contracting an infection. Often, swelling or bruising can form at the site of removal on the cheek, so sometimes you need to sit at home for a couple of days;
6. Often a doctor will prescribe antibiotics even if there is no inflammation or suppuration. This will prevent the introduction and spread of infection.

Contraindications

Many, having heard the doctor's diagnosis that it is necessary to remove a tooth, experience incredible fear to the point of yeast in the knees. Of course, but how not afraid, the tools alone are worth something! Yes, and the idea that these devices will pull out, and sometimes knock out a tooth with a complex structure or with large quantity which is just terrifying. But still, you should not be afraid, the doctor knows his job, it is important for him to do everything carefully, but at the same time, so that the tooth is completely removed. However, there is a certain category of patients for whom complex removal is contraindicated.

Diseases of the heart, blood vessels, pregnancy and lactation, correct growth molar, as well as taking special medications - this is just part of the contraindications to tooth extraction.

Usually contraindications are the following diseases and states:

• The presence of exacerbations of pathologies of the heart and blood vessels;
• Relapsing heart attack;
• Stroke;
• If there is a hypertensive crisis;
• Not recommended for women during childbearing and breastfeeding;
• If the wisdom tooth erupts in the right direction;
• If the patient is taking drugs that interfere with normal blood clotting.

If the wisdom tooth grows in the correct position and no abnormalities are detected during examination, then the doctor will leave it in these cases. But it is imperative that during the entire period of tooth growth it is worth constantly checking and undergoing an examination. The doctor must fully control the entire process of growth and development of this tooth.

What tools are used

If with simple removal only a few tools are used - forceps and an elevator, then with complex devices for the operation there are much more. The mere sight of them is worth something, which is why many are so afraid to remove their teeth and try to delay this moment as long as possible. But many dentists are advised to see a doctor immediately after they appear. discomfort, otherwise the whole process may be complicated and then, in addition to removal, additional measures will have to be applied, which are also quite unpleasant. Moreover, all tools are designed so that during all manipulations cause a minimum level of mechanical damage.

Application of tongs, excavators and elevators

Often, when removing, it is necessary to use several devices at the same time, usually forceps and elevators are used. With the help of these devices, roots are pulled out, as well as teeth with an increased degree of destruction. To begin with, the doctor loosens the tooth or the remains of the tooth along with the root with an elevator, and after that, he dislocates it with forceps and removes it from the gums.

For different groups teeth, there are forceps of various shapes. All of them have a working part - cheeks, a lock and handles. They have a technical similarity, they differ only in details, which is due to their functional purpose: for the teeth of which jaw, for which specific teeth, for teeth with a crown, for roots.

When there is a fracture of the crown or root of the tooth being removed, the use of additional instruments will also be required. If the pearl is not deep enough, then you can try to dislocate the tooth using an elevator. But if there is a deep fracture, then it is better to use an excavator device.
Due to the fact that the excavator has an angular working surface, this tool enters the hole with ease. They try to move this device into the area between the wall of the alveolus and the fragment of the tooth. Then the tooth is dislocated and its tip is gradually loosened.
But it should be borne in mind that the removal of broken roots of the upper chewing teeth should be done very carefully. This is necessary in order not to accidentally push them into the region of the maxillary sinus.

Bit Application

The chisel attachment is used when the removal of the outer wall is required. alveolar process. This is usually required when a tooth breaks off, and there is no way to get it with an elevator or excavator.
In addition, this device is used when the bone tissue has a compacted structure, and the elevator cannot be placed in the area between the wall of the alveolus and the root.
How to apply:

1. Usually in these situations, the surgeon places the working part of the bit in the area between the root and the socket, then he strongly restrains it;
2. An assistant with a hammer makes a couple of blows on the area of ​​​​the chisel;
3. After that, the device moves to the area between the root and the wall of the alveolus;
4. After that, the tooth is dislocated. This process is carried out in the same way as when working with an elevator.

But it is worth remembering that during this process there is no severe pain. Of course, it is important to apply strong anesthesia. However, this procedure can leave a lot bad memories at the patient.
Extraction of teeth with a chisel recent times rarely used by doctors. This method replaces the usual sawing of the roots with a drill.

The use of a drill

A drill is usually used in several situations:

• During the separation or sawing of the tooth into separate parts;
• When removing the bone tissue that surrounds the tooth.

When removing multi-nerve teeth with a destroyed structure, it is sometimes simply impossible to use forceps to remove them from the hole. This is due to the fact that during this process there is a fracture of the crown or root of the tooth. Therefore, in these cases, it will be best to cut the tooth into several roots. After that, it can be easily removed in parts.

A drill is a rotary tool that develops a high spindle speed with a small torque. Drills are used to process small objects, which is an integral part of dentistry.

During this manipulation, long diamond burs are used, which are designed for the turbine handpiece. During the removal of the molars, which are located on the lower jaw, the tooth is sawn into several parts. Usually it is sawn into distal and medial roots, which are then dislocated with an elevator. AT upper area teeth have three roots, namely one palatine and two buccal, for this reason, the tooth is sawn into three parts, and a cut is often made in the form of the letter T.
With this method of removal, the surrounding tissues, the mucosa are practically not damaged. For this reason, this method has become popular among many dental surgeons.
What are the features of the process of sawing a tooth out of bone tissue:

1. This method is usually done with tungsten carbide burs that are designed for a straight handpiece. Water cooling is required;
2. Using this method, the impacted wisdom teeth, large molars, as well as the tops of the roots, which have a thick outer wall of the alveolar process, are removed;
3. Removal of this type is usually performed only after making a gum incision and cutting out a mucoperiosteal flap.

How is a complex removal performed?

Before performing surgery, the surgeon prescribes to undergo necessary examinations. First of all, X-ray diagnostics is prescribed. Thanks to this method of examination, the doctor will be able to see general state root system, as well as the location of the tooth in the jaw.
The main features of complex removal:

• First, anesthesia is given. This can be done locally or general anesthesia, the main thing is that a potent medicine be used;
• Usually, the drug is chosen depending on the characteristics of the patient's body, its individual tolerance of the constituent components of the anesthetic;
• If the wisdom tooth is partially impacted, then in order to gain access to it, a gum incision is made and the flap is raised;
• After that, the molar is removed with an elevator;
• After removal, the flap is moved into place and the doctor sews it up;
• When there is complete coverage of the tooth with bone tissue, a large part of the gum is cut. This is necessary to gain access to the area of ​​the tooth;
• The molar is dissected into 2-3 parts, which are subsequently removed by the elevator;
• In situations where the third molar is located near the mandibular nerve, surgery becomes more complicated. This is because the roots of the tooth can completely surround the area of ​​the nerve. The gum is incised and the flap is exfoliated. Next, a part of the crown and bone tissue is removed, this is necessary to gain access to the roots of the tooth;
• After this, a careful separation and extraction of the roots is carried out, but it is important not to touch the nerve area;
• Surgical intervention to remove the cyst also has increased complexity. The cyst, which forms at the top of the root, enlarges over time and destroys the bone tissue. Therefore, in order to remove the cyst, only the surgical method is used;
• When the cyst is removed, the mucous tissue is cut. Further, with special small burs, bone tissue is removed;
• After that, the cyst is removed;
• Next, the region of the root apex is cut off and sealed. This is done to ensure that there is no recurrence in the future;
• The cut mucosal tissue is sutured into place.

This diagram shows the stages of wisdom tooth removal: anesthesia - tissue incision - flap of gum tissue - sawing the tooth with a drill - removal of the crown - removal of the roots - stitching the hole.

healing process

As a rule, the first 5-7 days after removal are quite painful. The doctor recommends taking painkillers for the first few days to reduce discomfort. In addition, during this time there may be a slight swelling, swelling.
It is also important that the blood clot that appears in the hole after tooth extraction is completely preserved. Therefore, in the postoperative period, it is important to observe important conditions:

• Within 2-3 hours after the operation, it is not recommended to drink drinks or liquid food;
• Do not wash, clean or warm the well;
• On the first day after removal, it is not recommended to carry out baths, rinses, lotions;
• Be sure to chew food on the opposite side.

Effects

Usually, the rehabilitation period after tooth extraction takes an average of 3 to 5 days, sometimes it can be a whole week. It all depends on the characteristics of the organism. Usually, at first, the following unpleasant symptoms can be observed:

1. Pain in the mouth;
2. Appearance a small amount blood;
3. The temperature may rise slightly;
4. slight swelling;
5. Swelling of the cheek in the area extracted tooth.

All of these symptoms are considered normal. Over time, they go away on their own.
However, you should immediately consult a doctor if symptoms are observed:

• The appearance is very high temperature body;
• In the area of ​​\u200b\u200bthe hole, where previously there was removed pus, it was filled with pus, but at the same time there is no blood discharge in it;
• If there are prolonged, endless bleeding from the hole;
• The presence of bad breath;
• The appearance of puffiness;
• Strong pain sensations.

If all these unpleasant symptoms suddenly appear, you should immediately consult a doctor. These symptoms indicate the appearance of an unhealthy process in the area of ​​​​the extracted tooth, perhaps an infection has appeared. If you delay, then the infection will spread further and this will lead to damage internal organs body.

Attention! Difficult removal is a difficult procedure that should be carried out only according to indications. Do not be afraid of this operation if it will be carried out experienced doctor, then no pain will arise, especially since everything is performed under anesthesia, which eliminates discomfort.

In addition, this method of extraction will help to avoid serious complications that may occur if the tooth is not removed in a timely manner. Therefore, you should not delay the inevitable, it is better to study all the features of this procedure and go to the doctor for examination and further removal.

It often happens that all efforts aimed at preserving and treating a tooth are powerless. Unfortunately, this happens more often than we would like - and therefore, in order to ensure the most comfortable and painless process, the President Clinic has special rules according to which we extract teeth.

Do you want a tooth extraction procedure to become a simple procedure, and not a dreaded inevitability? Then you should visit one of our clinics. But before that, let's make sure that your tooth really needs to be removed and in which cases you should not do it.

Indications for tooth extraction

In dental practice, there are few cases when not treatment is recommended, but tooth extraction. These include:

• diseases and exacerbation of diseases of the teeth and gums - such as sinusitis maxillary sinuses, purulent periostitis
• cases where wisdom teeth interfere normal life, eating - scratch inner surface cheeks or damage adjacent teeth
• swelling and fracture of the jaw - in such a situation, the teeth located near the treatment area are removed
• teeth, due to which the entire dentition is deformed - this often occurs with malocclusion
• if the tooth is not subject to prosthetics or restoration
• cases where the tooth interferes with the installation of crowns or other types of prosthetics

That is, tooth extraction is recommended only in particularly difficult cases, when its presence can cause harm to health or others, healthy teeth, interfere with treatment or cause insufficient treatment of the disease.

It is also worth knowing that there are cases when tooth extraction is not recommended. These include the extraction of teeth during an exacerbation of chronic heart and mental illnesses, acute infectious diseases and pregnancy at certain times. In this case, you will have to wait for the end of treatment or the time suitable for tooth extraction.

How is a tooth removed?

Tooth extraction is often a simple but very delicate procedure. We know this very well - and we made sure that the tooth extraction was:

• painless. To do this, the patient is given an anesthetic, usually novocaine or lidocaine. This is the most frustrating part of the tooth extraction process.
• fast. To do this, the doctor uses special instruments - surgical or classical, depending on the type of tooth extraction procedure. In the first case, the tooth is removed using a small incision in the gums or hiding the bone, in the second case, the tooth is slightly loosened and quickly pulled out.
• without unpleasant consequences. After the procedure, the doctor will tell you what is recommended to do for a quick healing process and what not to do in order to avoid problems.

It's all. In fact, tooth extraction is a simpler operation than it seems - and almost painless.

Extraction of teeth in children occurs in almost the same way - only in a special office and an experienced pediatric dentist. With the help of competent communication, the main cause of anxiety is neutralized - fear, after which the tooth is removed as quickly as it was listed earlier.

But not only quick removal will be the key to the absence of discomfort and speedy healing. The main factor is proper care per oral cavity and small hygiene rules after tooth extraction. It is about them - the recommendations of the dentist and hygienist, you can find out below.

Feedback from our patients

Faced with the need to extract a tooth. Made an appointment. Came. Removed so that I did not even have time to figure it out. This made me very happy. I recommend

Vyacheslav

Very happy with doctors! Excellent, attentive! Removed two teeth, painlessly and stitched. All very, very much. And next time only to the President!

Valentine

Proper oral care after tooth extraction

After tooth extraction, it is worth adhering to certain rules and recommendations of the dentist - they help to avoid both discomfort and complications.

1. Do not eat for several hours after the procedure. This can damage the surface of the gums that has not yet healed, and cause an infection.
2. Carefully monitor the place where the tooth was - and if it bleeds heavily, see a doctor.
3. If necessary, you can take painkillers.
4. Do not drink, smoke or eat hot food. All of these actions can help dissolve the blood clot that usually forms in the socket after a tooth is pulled out, which can lead to pain or increase the healing time of the gums.
5. If the extraction of the tooth was difficult ( surgically) after a day, it is worth starting to rinse the damaged gum with a solution recommended by the dentist.
6. Also, if a tooth is removed surgically, do not use a hard toothbrush or illuminating mouthwash.

Of course, in most cases, after tooth extraction, neither pain nor special discomfort is annoyed. But to be sure of quick healing, you should follow these recommendations - and, of course, contact the doctors from the President Clinic. Also, after removal, you can contact our clinic for a consultation on prosthetics and implantation so that your smile remains the same

Prices for tooth extraction

The total cost of services depends on the equipment used in one or another of our clinics.

For more information about the services of the clinic, follow the link.

Usually, a dentist, looking at a person who has been walking around for years with diseased decayed teeth, concludes for himself: such a patient does not feel sorry for himself. Those teeth that cannot be treated must be removed, and the sooner this happens, the better.

An infection that has entered the body contributes to a decrease in immunity, a person with bad teeth has to waste resources on fighting microorganisms. Often, a potential client of a dental clinic complains of frequent colds. If you postpone the extraction of a tooth for an indefinite period, sooner or later the body's resources will be depleted, it will not be able to resist the infection, and acute inflammation will occur.

Indications and contraindications for the extraction of molars

It is not always necessary to extract a tooth. The decision on the need for an operation to remove the tooth is made by the doctor performing the initial examination. The reason for the removal of a molar tooth can be:

It is worth noting that the doctor is not always ready to perform the operation on the patient. There are a number of contraindications for removal:

• exacerbation of chronic diseases;
• viral diseases (ARVI, influenza, etc.);
• pregnancy (first and last months).

Also, the doctor may refuse to operate on people suffering from dystrophy, cancer patients and persons under the influence of alcohol or drugs. Only the dentist makes the decision to remove the tooth.

How to calm down and tune in the right way?

This article talks about typical ways to solve your questions, but each case is unique! If you want to know from me how to solve exactly your problem - ask your question. It's fast and free!

Although modern dentistry is at a high level, and the risk of complications is minimized, many are still afraid to visit a doctor. A person is afraid of the surgeon, he is afraid that the pain during the operation will be unbearable.

You should not be afraid of the surgeon, during the procedure the patient will be anesthetized, the pain will appear when the anesthesia ceases to act. Reduce fear and have a positive mindset sedatives, for example, valerian or motherwort tincture.

You can ask a nurse working in a dental clinic 30 minutes before the molar is pulled to enter sedative drug to calm down.

Does it hurt to pull out a molar with and without anesthesia?

Modern dentistry has in its arsenal a lot of pharmaceuticals allowing painless operations to remove teeth. The anesthesia administered by the doctor acts for several hours, only in the postoperative period, when the effect of the drug stops, the person has unpleasant pain at the wound site. It is not necessary to endure pain after surgery, the doctor may recommend taking painkillers.

Many people who made the times of the Soviet Union remember with horror what kind of torment they had to experience at the dentist's office. Today, the procedure for removing a tooth with an injection is absolutely painless, so the answer to the question of whether it hurts to remove a tooth lies on the surface.

Although modern pharmaceuticals offer wide range all kinds of drugs for dental procedures, there are exceptional cases when the anesthesia administered does not bring the desired results. The operation can be painful if the patient long time is taking pain medication or narcotic substances, as well as in the case of acute inflammatory process. The intensity of pain can be affected by the complexity of the operation, the location of the tooth (upper or lower jaw).

In some cases, the introduction of general anesthesia is recommended: the need to tear several molars at once, allergic reactions to local anesthetics or inability to set yourself up for surgery. While the surgeon performs manipulations, the patient sleeps. It is administered under general anesthesia exclusively in a hospital, taking into account all possible contraindications.

Removal Features

Most common cause tooth extraction is the development of caries and the impossibility of restoring the tooth with treatment. There are times when a tooth needs to be removed due to mechanical damage, in particular - a fracture of the root. Before the doctor proceeds with the extraction of the tooth, it is necessary to conduct an x-ray examination, the results of which will determine the location of the root.

After the introduction of an anesthetic and numbness of the gum part, the surgeon proceeds to the operation. He, separating the gum, grabs the tooth with forceps and pulls it out with swinging movements. Sometimes the dentist, in order to avoid injury to the jaw, has to divide the tooth into parts, after which each part is removed separately. When performing a complex operation, the surgeon can make an incision in the mucous membrane to open access to the tooth for its removal - the patient is placed under general anesthesia.

In children

Children can be bothered by both milk and molars. The tactics of treatment in each individual case will be different. It often happens that baby tooth the child has not yet fallen out, and a permanent one is already erupting in its place. In this case, the milk tooth, which interferes with the full eruption of the permanent one, will have to be pulled out.

Parents often ask the question: is it possible to eat before the operation? Indeed, shortly before surgery, doctors recommend eating so that the child does not experience hunger in the postoperative period.

If the child complains of a toothache, the dentist will conservative treatment, it is important to keep the dentition intact. Dentists try not to pull out baby teeth ahead of time, since an incorrect bite may form, however, there are indications to pull out such a tooth immediately:

• complete destruction of the crown;
• inflammation of the root or nerve;
• a cyst formed in the tooth root, or granuloma.

In pregnant women

A pregnant woman wants the child in her womb to develop harmoniously and naturally, therefore, faced with the need to remove a tooth, main question, which interests her - will they harm medications used for anesthesia to an unborn child? The doctor, having learned that the woman is in position, must choose the most suitable remedy, which excludes the possibility of penetration through the placenta and cannot harm the fetus.

It is painful to remove molars without anesthesia, and the use of drugs such as Scandonest and Mepivastezin during pregnancy is highly undesirable.

It is contraindicated for a woman who is in the first or last months of pregnancy to remove molars. At this time, any intervention in the body and stress, as well as the use medical preparations can carry a threat to both the expectant mother and the fetus.

Wisdom tooth extraction

Wisdom teeth, or figure eights, located on the lower or upper jaw, can be removed at any convenient time, both before eruption and after, without or with a nerve. Often after the removal of the figure eight, patients experience complications in postoperative period. The crown is large, and access to it is limited. Often the molar grows incorrectly, towards the cheek or adjacent tooth This further complicates the surgeon's work.

If the wisdom tooth cannot be treated conservatively, then its removal should not be delayed, especially if there is no antagonist. best time to remove the eight is considered adolescence. During this period, the tissues of the jaw bones are not fully formed, and the roots, as a rule, do not yet have time to grow strongly.

Possible Complications

Any surgical intervention does not exclude the occurrence of complications in the postoperative period. A patient who has had a molar removed with an injection may experience throbbing pain at the site of the operation, discomfort in the throat and swelling of the cheek. These symptoms should not be ignored, as they may indicate the onset of the inflammatory process. This situation is possible due to:

• the presence of fragments of the tooth in the alveolus;
• dislocation or fracture of the jawbone;
• damage to neighboring molars;
• inflammation of the peripheral nerve.

Preventive measures after surgery

The human body perceives the operation to remove molars as a trauma, responding with post-traumatic inflammation. It is impossible to predict the consequences of the postoperative period and say for sure whether it will hurt or not, but following certain rules, you can minimize negative impact and speed up wound healing.

• as soon as the doctor has completed all the necessary manipulations to remove the tooth, the patient must close his mouth and stay in this position for 15-20 minutes to form a blood clot in the hole;
• you must refrain from eating for two hours;
• smokers should forget about cigarettes for 2 days;
• it is forbidden to act on the wound with any improvised means (toothpick, finger, etc.) that can infect the wound;
• it is necessary to refrain from drinking alcohol until the wound heals, and if antibiotics are prescribed, alcohol will be prohibited during the entire course;
• if pain occurs in the postoperative period, the use of painkillers is possible, but undesirable, a cold compress can be a good substitute;
• for two days, you should refrain from taking hot baths, visiting a bath or sauna, as well as a solarium;
• it is not recommended to sleep on the side of the extracted tooth in the first days after the operation, as well as to perform excessive physical exercise;
• do not rinse your mouth for three days after the operation.

Wisdom teeth grow later than others. Often there is no room for them. Caries of eights is difficult to treat. If there are problems with them, the best option is to remove them. Eights do not take an active part in chewing food, and their absence does not create cosmetic defect, so their extraction is often resorted to.

All about the features of wisdom teeth and their removal

Wisdom teeth, they are also figure eights, located at the outer edges of the jaw. They cut through much later than the others. For some, this process occurs at a fairly mature age. The problem is that there is not enough space in the jaw for the normal location of the eight, so it grows at an angle, interfering with the sevens, and the roots are bent.

If the figure eight is affected by caries, then the location features do not always allow quality treatment, therefore, the easiest way out of the situation is the removal of a wisdom tooth, which has neither functional nor aesthetic value.

Delete or not

Does everyone wisdom teeth need to be removed? No, many people live with eights all their lives and do not experience problems. If the figure eight is healthy, does not grow at an angle and does not shift the rest of the molars, then no action should be taken. Such cases are rare, but they do occur in practice. In such cases, the wisdom tooth can be used for chewing, and also serve as a support for prostheses.

For most people, the maxillary molar causes problems already at the beginning of its eruption. If the figure eight grows at an angle, it causes serious damage to the soft tissues, and also rests on neighboring molars, which also begin to hurt. An inflammatory process develops in the mouth, accompanied by edema, hyperthermia, and difficulty in chewing. With these symptoms, you should contact your dentist as soon as possible. Otherwise, the condition may worsen, and the inflammatory process will spread.

If the figure eight has not completely cut through, then cleaning it is very difficult. Often it is partially covered by a gum pocket. In such cases, caries develops, which is difficult to treat and prone to relapse. It is better to get rid of such a problem in time.

Not all people erupt even by the age of 30-40. But that doesn't mean it's missing. Located in the thickness of the jaw bone or under the gum, they can cause problems. Often there are clinical cases when patients complain of pain in the jaw or in the ear, but visible reasons no. During the examination, it turns out that the cause is the figure eight, which did not erupt. If it causes trouble, then urgent removal is necessary.

Delete eight much harder than other teeth. This is due to the peculiarities of the location, as well as powerful, twisted roots, which often interfere with extraction or break off.

The duration and complexity of the extraction process depends not only on individual characteristics patient, but also on the professionalism of the doctor, who must conduct a detailed examination and choose the right tactics.

If the wisdom tooth has not completely erupted, an x-ray must be taken before its extraction, which will give accurate information about its position, configuration and number of roots.

Removal from above usually proceeds more quickly and painlessly than from below. This is due to the fact that the bone tissue of the lower jaw is denser, and the root system is more branched.

If you want the procedure to be quick, painless and without complications, choose an experienced dental surgeon. Attention to the patient and professionalism is the key to the success of this not always simple operation. Even the complex removal of wisdom teeth by a qualified doctor will be almost painless.

The operation itself is painless, as it is performed under anesthesia. After extraction, pain occurs, the intensity of which is associated with the complexity of the surgical intervention. Taking painkillers allows you to solve this problem and quickly return to a normal rhythm of life.

Easy removal

The simple removal procedure usually lasts no more than 10 minutes. In this case, there is no need to cut the gum or saw the tooth. It is removed from the hole with forceps. A special drug is placed in the hole to prevent the development of inflammation. Gingival closure is not required in most situations.

At proper conduct procedures, the risk of complications is minimal, and the restoration of normal health occurs as quickly as possible. Severe pain can be observed in the first two or three days, then this unpleasant symptom disappears.

Complex removal of wisdom teeth

If during the examination it is revealed that the figure eight has massive branched roots, is significantly deviated to the side or partially erupted, the crown is completely destroyed, it is necessary to develop a removal tactic that will allow you to complete the operation as quickly and with minimal damage.

With the complex removal of wisdom teeth, the following techniques are used:

• gum cutting;
• drilling of bone tissue;
• sawing the tooth and extracting it in fragments;
• suturing of the mucosal defect.

If an experienced surgeon takes over the case, the operation lasts up to half an hour, but in difficult cases, the process can take up to two hours.

To prevent complications, the cavity after removing the figure eight is washed with antiseptics and a special drug is placed in it, which has an antibacterial and anti-inflammatory effect. After that, the wound is sutured.

figure eight extraction- one of the most difficult operations. That is why there may be serious complications.

During the operation, adjacent sevens may be damaged, as well as a jaw fracture. Such problems are associated with wrong choice treatment tactics and low qualification of a dentist who did not understand enough anatomical features patient.

In mature patients, nerve trunks can be damaged, which leads to impaired sensitivity and numbness. AT young age such problems are less common.

A few hours after a visit to the dentist, bleeding may develop. This is usually triggered by intense rinsing, eating hot food, irritating the wound with the tongue or third-party objects. The risk of this complication is high in patients with hypertension and impaired blood clotting. Light bleeding can be stopped with a swab, ice on the cheek, or hemostatic sponge. If these measures do not solve the problem, you need to urgently contact a specialist who will suture the wound.

to the most frequent postoperative complications refers to dry socket. Normally, a blood clot forms at the site of the extracted tooth, due to which the wound heals quickly and without problems. For some, a clot does not form. This is typical for smokers and people who do not pay attention to oral hygiene. The main manifestation of dry socket is the appearance acute pain a few days after surgical intervention. In this case, you should immediately consult a doctor.

The dentist will clean the hole, place a special gel in it, prescribe painkillers and antibiotics. This will achieve fast healing gums and avoid inflammation. Regular rinsing of the mouth is shown, as well as the rejection of rough, hot and cold foods.

Running inflammation leads to a widespread purulent process: phlegmon or osteomyelitis.

If the operation was successful, then the process of further recovery depends on the patient. If he strictly follows all the recommendations of the doctor, then the risk of complications is minimal. If simple rules are violated, serious complications can occur that require long, complex treatment.

A cold compress can help reduce the risk of bleeding and reduce swelling. Cold constricts blood vessels, so the risk of hematoma and swelling is significantly reduced. In addition, this simple procedure can reduce pain.

A few days after the operation, physical activity is contraindicated, as well as visiting a bath or sauna. Violation of these recommendations can cause bleeding.

In the first days after extraction, pain, swelling occurs, and the temperature may rise. This is the normal course of the postoperative period. You can get rid of unpleasant symptoms with the help of painkillers and antipyretic drugs. In order for unpleasant symptoms to pass faster, you need to give up hot, cold and rough food, rinse your mouth gently after eating. Within 2 hours after the operation, you should refuse to eat. You can only brush your teeth the day after the intervention. If pain and swelling occur, it is strictly forbidden to apply a heating pad to the cheek and touch the hole. It is also recommended to stop smoking at least in the first days. If the operation went without complications, then following these rules is enough for a quick recovery.

Complex removal involves the appointment of additional drugs in the postoperative period. Most patients are shown antibiotics to prevent the development of inflammation. In most cases, dentists recommend lincomycin or penicillin preparations. The dosage and frequency of administration should be strictly observed. If the doctor has prescribed an antibiotic for 7 or 10 days, take it during this time, even if you feel well and the hole is almost healed. To prevent problems with gastrointestinal tract along with antibiotics, you need to take drugs to maintain normal microflora in the intestines - probiotics.

After complex removal, most patients develop edema. To reduce it, it is recommended to take antihistamines, for example, suprastin. This simple exercise will help improve well-being in the postoperative period.

When to sound the alarm

Eight removal is not an easy procedure, so you should not expect that you will feel good immediately after the operation. But it is necessary to distinguish which symptoms are a variant of the norm, and which should be the reason for an immediate visit to the dentist.

The temperature can last up to 5 days, but in most patients the fever disappears already on the 3rd day. If more time has passed, and the temperature does not decrease, and even more so it grows, you should not waste time. This symptom may indicate serious inflammation. Sign up for an appointment as soon as possible dental clinic. The doctor will conduct an examination and determine if there is cause for concern. If the temperature returned to normal, but after a few days it rose again, you should not leave this situation unattended. Most of these patients require emergency care.

Pain is always present after the intervention. Normally, it gradually fades away. If a pain syndrome sharply resumes or rapidly increases, you need to rush to the doctor. The sooner you get to a specialist, the easier it will be to deal with complications.

Many patients experience bleeding after removal of the figure eight. If the blood was quickly stopped by improvised means, there is no need to sound the alarm, but if all your actions are ineffective, then further self-treatment is dangerous.

After the operation, try not to plan business trips or vacation trips. This can prevent you from seeking dental care in time if the need arises. This is especially true for those who have undergone a complex removal of a wisdom tooth.

The next day after the operation, be sure to see the doctor who performed the procedure. This must be done even if nothing bothers you. A scheduled visit will help identify problems on initial stage and avoid emergency trips to the clinic.

Where to remove the problem eight

If you need remove wisdom tooth, responsibly approach the choice of a specialist to whom you entrust this procedure. The outcome of the operation depends on his professionalism.

Choose a modern clinic with necessary equipment and using effective and safe drugs for anesthesia. The possibility of conducting an x-ray examination before surgery will allow developing the optimal treatment tactics, and the availability of new equipment for sterilizing instruments will help to avoid infectious complications and infection with dangerous infections.

Pay attention to the qualifications of the surgeon. He must have experience in such operations. Check out patient reviews.

A good doctor will collect before treatment detailed information about your state of health. The presence of chronic diseases can significantly affect the course of the operation, and the tendency to allergic reactions is a reason for conducting allergological tests for anesthesia drugs. The specialist must conduct a detailed examination and plan the operation in advance. This will allow you to remove the problematic eight in the shortest possible time.

If you need a complex removal of a wisdom tooth, the doctor will justify this need for you, give detailed information about the nuances of your clinical case and the planned course of the operation.

Eight removal- a complex and unpleasant process, so many try to avoid this procedure. If your wisdom tooth grows unevenly or is affected by caries, then it will still have to be removed sooner or later. It is better to do it in a timely manner and not endure the pain that it causes. In addition, if you postpone a visit to the surgeon, you can earn serious complications. You need to understand the need for this operation, be patient, choose a qualified specialist and boldly go to see him. After a few days, you will be glad that you got rid of the eight, which caused so much trouble.