Tooth extraction

Statistics show that 20-25% of the human population are born without all four wisdom teeth. Changes in eating habits and diet and consumption of more processed foods have reduced the need to chew forcefully, and as a result, human jaws are gradually becoming smaller. Wisdom teeth are beginning to run out of space and either fail to erupt at all or put pressure on adjacent molars.

It is not uncommon for wisdom teeth to not fully erupt or to press against adjacent teeth or the jawbone and soft tissues. This process is usually disrupted when there is a lack of space in the dental arch or the root of the wisdom tooth is in an irregular position. Everyone’s situation is different, so if you want to know what the condition of your wisdom teeth is, see a specialist, an oral and maxillofacial surgeon or a periodontist. During the appointment, you will have a clinical exam and an X-ray.

There are clear indications for removing wisdom teeth. First of all, we ask if the patient has any complaints related to the wisdom teeth (pain, swelling, recurrent gingivitis); if so, we perform a clinical examination.

Reasons for removing wisdom teeth:

• There is a cavity that cannot be treated.
• The teeth have erupted irregularly.
• There is soft plaque build-up around the teeth.
• Oral hygiene is difficult.
• Eruption or other cysts and tumours of the jaws form around them.
• The teeth are blocking the eruption of the second molars, or are pressing against the adjacent teeth and may damage them.
• The teeth are located along the mandibular fracture.
• More space is needed in the dental arches for orthodontic treatment.

As these problems progress, inflammation may occur in the surrounding tissues and abscesses may form, spreading to the soft tissues and neck.

Research has shown that after the removal of wisdom teeth, the health of adjacent teeth can improve by up to 85%, whereas without removal, 25% of patients develop cavities on the distal surface of the second molar, and eventually not only the wisdom tooth but also the second molar have to be removed.

Wisdom teeth are often removed as a pair, in the upper and lower jaw of the same side. This is because when left without a “partner”, the upper wisdom tooth can supra-erupt, block the movements of the lower jaw, and rest on the buccal mucosa and injure it. But there are exceptions. If the wisdom tooth is in contact with the second molar and is healthy, we do not remove it.

If you do not have any symptoms, your wisdom teeth are involved in chewing, there is no tooth decay and you can manage to clean them – there is no reason to remove them. A common mistake is assuming that they are unnecessary and that you will not feel any changes after removing them. Always weigh the pros and cons of surgical intervention. Wisdom tooth extraction is surgical intervention, which, like any other surgical procedure, comes with certain risks.

We also do not recommend wisdom tooth extraction for patients under the age of 17, as the growth areas of the jaws may be damaged.

If the wisdom teeth erupt properly and are involved in chewing, there are exceptions when we treat early-stage cavities. Unfortunately, the treatment of a wisdom tooth usually turns into a challenge due to its position in the dental arch and the difficulty of access. If more complex treatment is required (e.g. root canals), we usually remove these teeth, because the anatomy of their root canals is very diverse and quality treatment is almost impossible.

A lot also depends on the patient’s motivation to invest in the treatment and restoration of the wisdom tooth and its care afterwards.

During tooth extraction, we try to create the most comfortable environment possible for you, and use the most modern dental tools, equipment and instruments. Today, the tooth extraction procedure is relatively quick and painless because we use strong and fast-acting local anaesthetics.

In order to minimise trauma to adjacent structures, we usually make incisions, drill the bone, split the tooth and suture the operated area. During the surgical removal of teeth, you may feel pressure or stretching, and some vibration during splitting. Each case is different, as are the patients and the anatomy of their jaws and wisdom teeth, but wisdom tooth extraction usually takes no more than half an hour.