Is your wisdom tooth troubling you? Should you have your wisdom teeth removed?
WHAT are the main reasons for taking wisdom teeth out?
We dentist don't normally take out your wisdom teeth, unless they are causing problems. Dentist will only remove wisdom teeth: when it is clear that they will not be able to come through into a useful position because there is not enough room, multiple episodes of pain and swelling, if they have only partly come through and are decayed - such teeth will often decay as it will be difficult to clean them as thoroughly as your other teeth if they are painful.
WHY are x-rays needed for wisdom teeth?
The dentist will usually take x-rays to see the position of the impacted wisdom tooth, the angulation of the impation, the cause of impaction, depth of impaction, the position of the root, the relationship of the root and the nerve, any pathology around the impacted wisdom teeth, and to assess whether there is room for the tooth to come through into a useful position. Some dentist do it without x-ray, but it takes risks.
WHAT to expect during the surgery of removal wisdom tooth?
After checking the difficulty of your case, Your dentist will advise you whether the tooth should be taken out at the dental practice, or whether you should be referred to a specialist (oral surgeon) at a hospital. If it is to be taken out in the dental clinic, that area would be numb by injections prior to the procedures, some clinic may have sedation for those who scare or feel anxious with the procedures. A general anaesthetic (where you would be asleep) can also be used, but this will only be given in a hospital and normally involved removing of all wisdom teeth at once.
Before the minor oral surgery (MOS):
The procedure of taking out impacted wisdom teeth is a minor oral surgery. For each surgery cases, the dentist will have to get the patient agree and sign prior to the surgery. The dentist will explain the procedures to the patient, informs the possible complications, what to expect after the surgery and get your agreement for the surgery. Please ask the dentist if you have any question before you sign it.
After that, the dentist will inject to numb the particular area.
During the minor oral surgery:
To remove the wisdom tooth, your dentist will open up the gum tissue over the tooth and take out any bone that is covering the tooth. Then separate the tissue connecting the tooth to the bone and remove the tooth. Sometimes the dentist will cut the tooth into smaller pieces to make it easier to remove. There are possibilities where the root remnant cannot take out. In such case, the root can be left there. After the tooth is removed, you may need stitches. Some stitches dissolve over time and some have to be removed after a few days. Your dentist will tell you whether your stitches need to be removed. A folded cotton gauze pad placed over the wound will help stop the bleeding.
WHAT should I expect after a wisdom tooth is taken out?
After the surgery, you feel discomfort. The amount of discomfort will depend on how easy the removal of the tooth was. There is usually some swelling and discomfort for a few days afterwards. Usual pain-killers given by dentist will usually deal with any pain. It is best to stay fairly quiet and relaxed and avoid smoking and drinking for 24 hours afterwards to make sure there are no bleeding problems. There may be some stitches to help the gum heal over . You will need to see your dentist again about a week later to check on the healing, and to remove any stitches remain in the mouth.
Very occasionally there is a possibility of some numbness of the lip after the removal of a lower tooth - your dentist will tell you if it is possible in your case.
Removing wisdom teeth may produce some swelling for a few days but as soon as the area is healed, there will be no difference to your face or appearance. Your mouth will feel more comfortable and less crowded, especially if the teeth are impacted.
Any other treatment options?
Coronectomy was developed as a relatively new preventive method to decrease the prevalence of nerve injury compared with the conventional total removal of the lower third molar. The crown of the impacted lower third molar is often the cause of the food impaction, dental caries, or pericoronitis that troubles the patients. By removing the crown and leaving the root(s) behind, the problems are solved and the risk of an nerve injury is obviated. Research found that coronectomy produce no complications in terms of infection, pain, or the development of pathologies within the first 3 years. However, the long term efficacy of this treatment is not proven yet.
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我们为什么要拔除智慧牙？
Ask.Dentist: "Not all wisdom teeth need to be removed. Please have a check with your dentist to see if it is necessary to keep or to remove."
Ask.Dentist.MY next topic: "What can you do for my missing teeth?"..Don't miss up!
我们为什么要拔除智慧牙？
我们牙医一般不会建议拔你的智慧牙，除非他们造成困扰及问题。你的牙医将建议拔除智慧牙当：因为没有足够的空间使它不能长到有用的位置（阻生牙），因为阻生造成多次的牙肉疼痛和肿胀，因为它会很难清洗干净而造成蛀牙。
拔智慧牙前为什么需要拍X光照？
牙医通常会采取X光片，看看智慧牙的位置，倾斜的角度，阻生的原因，阻生的深度，牙根的位置，牙根与神经线的距离，阻生智慧牙周围的任何病态，并评估是否有空间让牙齿长出到有用的位置。有些牙医在做拔除智慧牙手术前并没有拍X光照，但这样做是有风险的。
拔除智慧牙的手术过程是怎样的呢？
牙医检查你的案件的难度后，会建议您拔除智慧牙手术应该在牙科诊所里进行，或者转介到医院由专科（口腔外科医生）进行 。如果手术在牙科诊所里进行，牙医会使用局部麻醉。对于那些感到焦虑的病人，有些诊所可能有镇静让你在无焦虑的情况下进行拔除手术。如果你需要一次剔除所有智慧牙，那么你需要在医院里，在全身麻醉（你会在那里睡着了）的情况下进行拔除手术。
拔除智慧牙手术/小型口腔手术（ MOS ）前：
拔除智慧牙是一种小手术。在每一个手术前，牙医必须得到患者同意并签署手术同意书。在签署前，牙医会为病人先解释手术程序，并告诉病人可能出现的并发症及手术后的康复情况。如果你有任何问题，你签字之前请咨询你的牙医。
之后，牙医会开始注射局部麻醉药。局部麻醉后，你会感觉你半边的嘴唇，脸颊内侧，及舌头边缘麻痹。
要拔除智慧牙，首先牙医将在覆盖在阻生牙上牙龈组织开刀，然后掀开牙龈组织。这时，被覆盖着的智慧牙就能清楚的看到了。之后，牙医会将覆盖牙齿的周围骨骼给稍微的磨去，才能取出牙齿。有时牙医必须将牙齿切断成小块，以使其更容易除去。有时，在拔除牙齿时，牙根会断了然后残留在里面。在这种情况下，由于企图将残留的牙根拔除会伤及神经线，所以根可以留在那里。牙齿拔除后，牙医会将开刀的地方进行缝合。一些缝合线会在嘴里慢慢消失，有的不会。你的牙医会告诉你，你是否需要再进行复诊以拆除嘴里的缝合线。缝合后，牙医会将一个折叠的纱布垫置于伤口以帮助你止血。
智慧牙拔除手术后会怎样呢？？
手术后，你会觉得不舒服。不适度要看手术的难易度，简单的手术通常不会有太多的不适。一般上，手术后后的几天通常有一些肿胀和不适。只要依照牙医的指示按时服食止痛药，痛楚就会减少。记得手术后要好好休息，避免吸烟和饮酒，以确保没有出血及痊愈的问题。有些缝合线需要你在一个星期后再次到你的牙医去复诊，以拆除遗漏在口中的缝合线。
如果在手术后，你嘴唇上的麻痹没有消失，记得复诊时告诉你的牙医。这情况是因为拔除手术时伤及了神经，而导致麻痹。复原的时间因伤及的程度而异。
手术会使我的脸或嘴有别吗？
手术后你的脸可能会肿胀几天，但只要复原好了，你的脸与外观就不会有什么差别。手术痊愈后，你嘴里了牙齿会减少拥挤，不会有阻生牙带来的问题及困扰。
除了手术拔除智慧牙，还有任何其他的治疗方案吗？
除了手术拔除智慧牙外，智慧牙冠切除术是以减少神经损伤的发生率的一个较新的预防方法。智慧牙带来的问题往往是因为食物嵌塞，蛀牙，及冠周炎（pericoronitis）。传统的智慧牙拔除手术带有伤及神经的风险。而通过牙冠切除术将智慧牙的牙冠取出，然后将牙根遗留在里面则能够避免牙神经损伤及风险。研究发现， 智慧牙冠切除术的首三年内没有产生感染，疼痛，或病状及没有任何并发症。然而，这种治疗的长期疗效目前为止还没有得到证实。所以，如果你的智慧牙没有触及神经，那么将智慧牙完全拔除的手术还是最好的。
牙牙学医：“不是全部智慧牙都需要拔除的。如有智慧牙方面的问题，记得让你的牙医检查看是否有拔除的必要”
接下来，牙牙学医会继续分享："我没有了牙齿怎么办？“
