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Τρίτη, 25 Ιουνίου 2013

I want to have my wisdom tooth extracted

Today's post is about the problems ascossiated with the thrird molar a.k.a. wisdom tooth.
Lets begin with the backround story of the defendant.
Third molar a.k.a. wisdom tooth
                          
                               
 It erupts in the mouth between 17-21 years of age.It is the last tooth of the mouth and a residue of evolusion of the huan species.Meaning that because it used to be useful for our past human ancestors,it has outgrown its usefulness therefore future generations might not have third molars in the mouth. ,
It is positioned quite back in the jaw,so not only does it not contribute to the chewing of the food but it can very well cause problems ie caries due to the innability to properly clean the back teeth with the toothbrush.Also when it erupts, some people tend to believe that it causes their teeth to become crooked.This is partially true;when the third molar erupts it exercises pressure in the area.If there is a problem with the alignment of the teeth,then it becomes more evident.
 

     "So what do we do doctor?Do we extract the tooth,even though it is healthy?Isn't it wrong to do so?"

                          

 I stringly believe that when the wisdom tooth is healthy,we dont extract it.In the picture below (picture 1) you can see a panoramic x-ray of a mouth in which three out of fourr wisdom teeth have normally erupted in the mouth,without causing any problems,and the fourth is on his way out.The only discomfort that the patient might feel is pressure due to eruption and perhaps a little painful sensation.Occassionally some patients state that they have problems opening their mouth widely or are a bit feverish,but that is all.

                           
                                                        Picture 1
On the contrary in the xray below(picture 2) the wisdom teeth appear not to have the sapce required in the mouth;therefore a surgical extraction is needed because they will undoubtably cause problems when the start to erupt.


                        
                                                          Εικόνα 2

  Some doctors believe that if we extract a wisdom tooth then we must extract the opposing wisdom tooth,because it will cause a problem.It is my opinion that I don't extract healthy teeth.I notify the patient that there is a possibility that it will happen,but not now. If he wants to get it over with so as not to go through with this again,I extract both of his wisdom teeth.Or else we wait until the other wisdom teeth causes trouble,and then we procceed with the extraction.
 Another case scenario is what happens when the wisdom tooth has caries.If the caries can be dealt with by means of a dental filling,I do a dental filling In the picture below you can see a wisdom tooth where the dental caries has been removed and the cavity is shallow.I see no reason not to do a filling but rather to extract the tooth just because it is a wisdom tooth.

 

If the cavity is deep however,and we reach the dental pulp then we perform the extraction
.
 

A root canal treatment in wisdom teeth is not recomended because the inner morphology is atypical,and overall they are not worth fighting for.It is only recomended when the others molars have benn extracted and the wisdom tooth is the last tooth which can hold a fixed dental prosthesis(bridgework).

This is all I have to say about wisdom teeth.Don't forget;always brush! 


                                     

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