Wisdom Teeth

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Wisdom Teeth Removal Treatment Surgery in India
An overview by India Dental Clinic and listing information of wisdom teeth removal treatment surgery centers in India and maxillofacial dental surgery hospitals performing impacted wisdom tooth extractions in India. Affordable cost of wisdom teeth pulling surgery in India encourages patients to go in for tooth extraction treatment. A fully grown up adult will have 32 teeth in mouth, 8 teeth in each quarter of a mouth. The last ones to erupt are the four molars, one in each quarter, known as ‘wisdom tooth’. They typically emerge between the ages of 17 and 25 – the so-called “age of wisdom.” Often they need to be removed and because of their position they can present unique problems both before and after surgery. When the wisdom teeth start erupting, often there is short of space. This space crunch therefore does impede their full growth (eruption) into the mouth. They often have a piece of gum over the back part of their biting surface; this makes them vulnerable to infection (pericoronitis). Lower wisdom teeth are very commonly infected. Such infections give symptoms such as swelling over the back part of the jaw, inability to open the mouth (trismus), pain especially to bite on the area, a bad taste, and bad breath.

Since wisdom teeth are the last teeth to erupt, they often create space by pushing other teeth in line when they finally emerge. This may also cause malocclusion. In some cases, wisdom teeth come through the gums only partially or not at all (impaction). When a wisdom tooth is impacted, it usually must be removed (extracted). In some cases, wisdom teeth emerge normally and do not cause any pain or other symptoms. However, many patients do experience symptoms. A tooth that only partially erupts creates an opening for bacteria to create an infection (pericoronitis), leading to tenderness or swelling around the gums, jaw stiffness and general illness.  Wisdom teeth are also susceptible to dental decay and gum disease (periodontal disease) and their presence may contribute to decay or gum disease in the adjacent molar tooth. There are other more unusual reasons why wisdom teeth are removed in hospitals such as cysts, tumours, and fractures of the jaw in this region.

The listed dentists of India Dental Clinic would rather first adopt a conservative dental treatment approach of just monitoring the eruption progress of wisdom teeth of both upper and lower jaw. A new school of thought is not remove wisdom teeth unless impacted. Many dentists believe that impacted wisdom teeth are almost certain to cause problems at some point, and recommend surgical extraction regardless of whether or not the patient is experiencing symptoms. Dentists typically prefer to remove wisdom teeth when the patient is between the ages of 16 and 21, before the tooth roots become implanted in the jawbone.

Such grown up adults who did not get the wisdom teeth extraction done during adolescence may also have them removed. Extraction usually takes between five and 30 minutes. In cases of more serious impaction, an oral surgeon may have to perform the extraction. Upper wisdom teeth are usually very straightforward to remove unless badly decayed. Lower wisdom teeth are often removed under a local anaesthetic with or without sedation. After the area is numbed, gently cutting the gum and moving it to one side exposes the tooth. Some teeth require a little piece of bone to be removed and this is done with a drill. Just as when a filling is done the drill requires water irrigation and so the nurse will suction around the wound to enable the dentist to see the tooth. Sometimes the tooth will be cut into pieces to aid its removal. Following the removal the wound is washed and the gum stitched into place. The dentist may use dissolvable stitches. Some dentists prefer to use non-dissolving stitches and will make an appointment to remove them, usually between 1 and 2 weeks later. If they do need to be removed then this is usually straightforward and painless.

Maxillary Sinus Trauma: Some times one encounter rare complications like the sinus floor and associated membrane get perforated. This causes a small amount of blood to collect in the sinus that will drain from the patient’s nose or pass into the back of the mouth. It is neither serious nor poses any threat to the patient. Simply wipe it from your nose or gargle warm water in your throat to clear the blood. However, there are rare instances when a sinus perforation will not heal and a fistula develops that represents a communication between your mouth and sinus cavity. An open fistula can lead to fluid and debris getting into your sinus through the opening and draining from your nose. If we feel you are risk of developing a fistula after your surgery, we will make every effort to repair the area at the time of surgery. After surgery, we ask you to not “blow” your nose and if it is necessary to sneeze, you should sneeze with your mouth open but covered to prevent excessive pressure from developing within the sinus. If a fistula does develop after surgery in spite of best efforts by the surgeon, please be aware that most fistulas resolve spontaneously but please call dentist for instructions. Rarely is a second surgery necessary to close the fistula.

Fistula develops early on as a birth defect (associated with a cleft palate).  An oromaxillary fistula is an abnormal passageway between one of the sinuses on either side of your nose (maxillary sinuses) and the roof of your mouth. It is also faced as a complication of removing a tooth, or from infection or trauma. Sometimes the roots of a tooth are so close to the bone under a maxillary sinus that the bone is damaged when the tooth is removed. This can open a passage between the mouth and sinus. It is for this reason a CT scan is advised by dental clinics in India before the surgery is planned.

In the cases of difficult lower wisdom teeth extractions most dentists would prescribe antibiotics in order to avoid any potential infection. There are many ways in which the patient can help the wound to heal. The medication prescribed should be taken in the manner directed. Most patients find that any pain is easily treated by painkillers such as paracetamol or ibuprofen (assuming that there are no reasons why they may not take this medication e.g. stomach ulcer). However if the pain becomes severe then it may be that a dry socket is developing. A return to the dentist will be necessary. Dry socket is a painful condition that occurs when the socket’s blood clot dislodges and the underlying bone becomes exposed. It can be prevented by closely following post-extraction instructions (e.g., no smoking or alcohol). The pain is deep seated and described as throbbing. Risk factors include difficult extractions, smokers, poor oral hygiene and ladies on the oral contraceptive pill. There is no way to prevent the problems associated with a wisdom tooth. Hot salt water mouth rinses should be used regularly for 5 minutes 4 times a day for a week. The water should be tepid but not too hot as to burn. A tablespoon full of salt should be allowed to dissolve in a coffee mug sized amount of this water. The mouthwash is then held over the wisdom teeth socket until it is cooled and then spat out. However, careful oral hygiene such as regular brushing and flossing can help reduce the risk of tooth decay, infection or other complications. Additional specific advice as per your situation would be provided by India Dental Clinic.


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