Undercutting the hood of a wisdom tooth. Methods for excising the hood over a wisdom tooth in case of inflammation: how much will the gum hurt? Using local antiseptics

Wisdom teeth got this name for the reason that their eruption begins later than the rest of the teeth, at about 17-25 years old, and in some people they are absent altogether. The appearance of eights is often accompanied by certain complications: swelling of the gums, pain, and sometimes pericoronitis or inflammation of the nearby gum area. What are the causes of discomfort and how to alleviate the condition during the eruption of third molars?

Wisdom teeth and their features

In the medical environment, figure eight, third molars or wisdom teeth are considered rudimentary organs that have lost their main purpose after a person began to consume processed food. It is believed that in a few decades, they will generally become a rare occurrence in dental practice.

Wisdom teeth have a number of characteristic features that distinguish them from their counterparts:

eights have no dairy predecessors;
the tooth begins to form at about the age of twelve, and the formation process ends no earlier than 24 years.

Another difference between the eights and the rest of the teeth is the number and structure of the roots. It should be noted that the number of dental roots is individual for each person, but on average the situation is as follows.

Table. The number of roots in different types of teeth.

Tooth names	Number of roots
Central and upper incisors	1
Canines and lateral incisors	1
First upper premolars	1
First lower premolars	2
Second premolars	1
First and second molars from above	3
First and second molars from below	2
Third molars (wisdom teeth)	2-5

The roots of eights differ not only in number, but also in structure - they are often strongly curved, which greatly complicates their treatment and removal.

Wisdom teeth complete the dentition, that is, they have not two "neighbors", but only one. On the other hand, the gum hangs over the tooth, and in the gap there is a small space called the hood. Otherwise, the structure of the third molars does not differ from the structure of other teeth, since they also consist of a root, a neck and a coronal part covered with enamel.

Why do wisdom teeth hurt when teething?

Unpleasant sensations during the growth of wisdom teeth are caused by various factors, including the characteristics of their growth. Eights begin to grow when a person's jaw is practically formed, so they have to not only "pierce" the gum tissue and mucous membrane, but also move the rest of the teeth. Sometimes, due to a lack of space, wisdom teeth grow only half or even grow in a horizontal direction, causing a lot of inconvenience. In the process of eruption, third molars can touch the nearby nerve, as a result of which the person feels constant discomfort.

Should you leave a wisdom tooth in place or is it better to remove it? Only a doctor can make such a decision, based on the peculiarities of the structure of the teeth in each case. If the figure eight grows in a horizontal direction, causes severe pain, is affected by caries or injures the soft tissues of the oral cavity, it is better to remove it - the absence of a tooth will not affect the function of the dentition in any way. But in the absence of problems, dentists usually recommend leaving it in place, since in the future the third molar can help with prosthetics of other teeth.

What is pericoronaritis?

Pericoronaritis is an inflammation of the area of soft tissue that covers the wisdom tooth (called the hood). It most often affects adolescents and young people during the period of wisdom teeth eruption, but sometimes it occurs at an older age. This is one of the most common complications that accompanies the process of developing third molars.

The main cause of pericoronaritis is the proliferation of harmful bacteria in the tissues of the hood. When a wisdom tooth erupts, soft tissues become inflamed and hang over it, as a result of which something like a pocket forms between the tooth and the gum. This area is very difficult to clean from food debris with a conventional toothbrush and often creates a favorable environment for microorganisms that cause an infectious process. Another reason that can cause the disease is mechanical trauma to the gums. During the period of eruption of a wisdom tooth, the tissues become loose, so it is very easy to injure them - this can happen even when chewing solid food.

Symptoms of pericoronaritis

The first few days, the disease does not bring any inconvenience, but over time, a person begins to feel the following symptoms:

swelling of the gum tissue in the area of the wisdom tooth, in severe cases - edema of half of the face;
discomfort when opening the mouth, talking, eating, which can radiate to the head and ear;
putrid odor from the mouth;
temperature increase;
inflammation of the submandibular lymph nodes;
the appearance of pus that flows from under the hood when you press on it;
headache, general weakness.

Sometimes the hood becomes so inflamed that any movement or touch on the cheek causes unbearable pain in a person. In addition to unpleasant symptoms, pericoronaritis is also dangerous because the inflammatory process can spread to nearby tissues, in particular, to the chewing muscles. If untreated, phlegmon, abscesses and osteomyelitis, a purulent inflammation of bone tissue, become a complication of pericoronaritis. In addition, infected exudate accumulates under the hood, which enters the throat and digestive tract, causing all kinds of diseases.

Since there are a lot of blood vessels in the gums, the infection can spread throughout the body, leading to a deterioration in immunity and exacerbation of chronic diseases.

The diagnosis does not cause serious problems, as it has pronounced symptoms. Diagnosis of pericoronaritis is carried out on the basis of patient complaints and examination of his oral cavity. Sometimes, to identify concomitant pathologies (improper teething, root inflammation, etc.), an X-ray examination is performed.

Drug treatment

Therapy of the disease depends on the degree of its development and the state of the soft tissues. If the disease has not gone too far, therapeutic treatment is possible. The cavity under the hood is washed with weak antiseptic solutions or sulfonamides - such as furacilin, potassium permanganate, calcium chloride, etc. Anti-inflammatory and analgesic drugs are taken internally, and antibiotics are used for severe inflammation. Sometimes a tampon soaked in special solutions that suppress the growth of microorganisms and eliminate inflammation is injected under the hood.

Treatment with folk remedies

Therapy with folk remedies includes rinsing the mouth with a soda-salt solution (a teaspoon per glass of water), as well as decoctions and infusions of medicinal plants with antiseptic, anti-inflammatory and analgesic effects (chamomile, oak bark, sage, calendula). A good effect is the lubrication of the inflamed area with iodine, but this must be done carefully so as not to cause a burn of the mucous membrane of the gums. If the temperature rises, severe pain and malaise, it is better to refuse home treatment and consult a doctor as soon as possible.

Surgery

Surgical intervention in the treatment of an inflamed hood is necessary in the following cases:

if drug therapy does not work;
when a large amount of pus accumulates under the hood;
with severe pain and swelling that make it difficult to chew food, swallow and other actions;
if the patient has fever, headaches and general malaise.

Excision of the wisdom tooth hood is a simple procedure that is performed on an outpatient basis, but requires some preparation and adherence to the doctor's recommendations in the postoperative period.

It is very important to relieve the acute symptoms of the disease before the operation. To do this, rinse your mouth with disinfectant solutions (Miramistin, Chlorhexidine) or herbal decoctions, you can take painkillers, non-steroidal anti-inflammatory drugs (Ketorol, Ketanov, Ibuprofen, etc.).

The operation is performed under local anesthesia, therefore it does not cause any discomfort to the patients. After anesthetizing the affected area, the doctor removes part of the gum overhanging the wisdom tooth (using a surgical laser or scalpel), thus eliminating the "pocket" where food and harmful microorganisms accumulate. Next, the wound is treated with antiseptics, and a tampon soaked in iodoform is placed on top of it. In the postoperative period, the patient is advised to rinse his mouth with antiseptics, take anti-inflammatory and analgesic drugs, in some cases antibiotics. The healing process usually takes 7 to 10 days, and if the inflammation resumes, patients are advised to remove the wisdom tooth.

Prophylaxis

It is very difficult to prevent inflammation of the wisdom tooth hood, but it is quite possible to reduce the likelihood of a pathological process developing. Preventive measures include good oral hygiene and regular visits to the dentist, which will identify not only pericoronitis, but other problems as well. To clean hard-to-reach places, you should use not only a toothbrush and paste, but also floss, an irrigator and other special products.

The eruption of a wisdom tooth in most cases is accompanied by unpleasant symptoms, but with timely diagnosis, proper treatment of complications and prevention of their development, the process will be as painless as possible.

Video - Excision of the hood with erbium and diode laser

Rarely does anyone have a wisdom tooth and grows without problems. Many of us state that the third molar comes out for a long time, it is very painful and often with complications.

One of the most diagnosed complications is pericoronitis. This is an inflammation that develops in the soft tissues that cover the figure eight (otherwise under the hood).

General idea

The hood over the wisdom tooth is a formation formed from the gingival mucous tissue located above the erupting unit. They form a dense, but not airtight, cover.

Small food fragments easily fall under the formation, which cannot be removed from there independently with a toothbrush. It creates a favorable environment for microorganisms, the activity of which subsequently leads to an infectious process in this area.

Usually, pericoronitis develops on the lower jaw, and mainly in adolescents and young people during the eruption of their third molar, and in isolated cases in older people.

The first and main reason for the development of the process- reproduction of pathogenic microorganisms in the tissues of the problem fragment. The second factor is severe mechanical injury to the gums.

When a wisdom tooth appears, the gum tissue becomes heterogeneous and friable, which makes it easy to damage it (this can even happen while chewing hard foods).

Complications and symptoms

During the first few days, the onset of inflammation is asymptomatic. Over time, the following symptoms of the disease appear:

swelling of the gums;
unpleasant putrid odor;
soreness in the area of the erupting figure eight.

If treatment was not started at the initial stage of the disease, the list of symptoms expands, and their manifestations intensify:

puffiness increases, and now it spreads to the face;
pain develops when trying to open the mouth, when chewing, swallowing food and talking;
the mobility of the jaw worsens;
the temperature rises sharply to high values;
submandibular lymph nodes become inflamed;
a purulent exudate appears, which begins to flow out even with slight pressure on the hood.

Against the background of these symptoms, malaise, general weakness and headache are observed.

Important! You should not reach a state when more severe symptoms of the disease begin to appear. This is very dangerous for your overall health. Seek medical attention at the first sign of pericoronitis.

Indications for excision

There are often situations when the inflammation of the hood is so strong that a light touch to it or movement of the jaw causes intolerable pain.

Considering the consequences and scale of the spread of the disease, specialists carry out excision of the hood if there are:

unpleasant putrid odor, developed due to the formation of a purulent mass under the tissue cover;
acute gingivitis, in which constant severe soreness does not allow you to lead a usual lifestyle, eat, can push you to migraines and lumbago in the ears;
swelling that spreads to the cheeks and gums when a person cannot open his mouth normally;
pain when chewing and swallowing food;
swollen lymph nodes due to the penetration of pyogenic microbes into them;
heat against the background of a general painful condition.

Removing the hood in dentistry is the classic way to treat pericoronitis, since drug therapy in most cases stops the disease only for a while or does not give any result.

Antibiotics only stop inflammation for a while, and once they stop, it continues. This is due to the fact that food residues constantly fall under the tissue cover, and there is a continuous development of pathogenic microflora.

Antibiotics stop their development only for the period of treatment, but the problem repeats as soon as the drugs stop working.

Important! If the operation is not carried out in a timely manner, then subsequently it will be necessary to treat not only the inflammation of the gum tissues, but also those complications to which the disease has led.

Training

Since the procedure for removing the hood over a wisdom tooth is a surgical procedure, the patient undergoes standard training before the procedure.

It consists of several compulsory examinations, which allow assessing the general condition of a person, developing a plan for the upcoming treatment, and choosing the type of anesthesia.

The preparation includes a number of activities.

Taking anamnesis

The analysis of general medical information about the pathologies that a person has at the time of his visit to the doctor is carried out, the causal factor of the manifestation of inflammation of the gum tissue is being clarified.

Complete examination of the patient

It is carried out in order to prevent the development of unforeseen complications both during the operation and after its completion.

The patient is invited to pass tests that are standard for all surgical interventions:

general urine analysis;
clinical and general blood tests;
examination for the presence of viral forms of hepatitis;
analysis for syphilis and HIV infection.

At this stage, the body's response to drugs is also determined. that are supposed to be used during the operation. If an allergy is found to at least one of them, it is replaced by another, non-allergenic one.

Examination of the dentoalveolar apparatus

Computed tomography and radiography are prescribed. Both examinations give a projection of the inflamed area in three planes.

According to the image, it is convenient for a specialist to examine and study the condition of the jawbone, the correct growth of the third molar, the number of roots and the peculiarities of their structure.

The presence of images helps the doctor decide on further actions, accurately calculate the time, sequence and volume of the upcoming operation, and prepare the necessary instruments.

If it is seen that the third molar is growing correctly, a decision is always made to preserve it, and then only the inflamed tissues above it are removed.

Preparation of the oral cavity

If the inflammation is acute, specialists always decide to remove this process. For this, the patient is prescribed rinsing the oral cavity with antiseptic solutions and applying compresses with a disinfectant composition.

At the same time, therapeutic measures are taken to improve the condition of the mouth and prevent the development of postoperative complications, i.e. performed:

professional dental cleaning;
anti-inflammatory therapy;
treatment of caries and other dental diseases.

For the entire period, while the preparatory stage for excision is underway, the patient is prescribed pain pills or dental drops that have anti-inflammatory and analgesic effects.

Only after all these events have been carried out, the date of the operation is set.

Course of action

Removing the tissue over the third molar is a simple procedure performed on an outpatient basis. The operation takes place in the following sequence:

Administration of anesthetic. If there is no allergy, local anesthesia is given.
In special cases, when we mean individual intolerance to a certain group of drugs and pregnancy, the manipulation can be carried out without anesthesia.

After the introduction of an anesthetic drug (after 10-15 minutes), sensitivity is lost, and you can proceed to excision.
Removing the hood. The specialist marks the site for removal, and using a scalpel (laser), excises the fragment so that the coronal part of the tooth is completely exposed.
Antiseptic treatment with the addition of hemostatic drugs... The doctor thoroughly rinses the wound area, flushing out pus, food debris, and blood.
Applying a compress with antiseptic agents (ointments). But the application is carried out only after the bleeding stops.

Upon completion of the operation, the doctor sets the date for a second visit, and based on the severity of the condition, medications are prescribed, which the patient must take during the entire recovery period.

Important! Antibiotics are prescribed by the dentist according to the patient's individual indications.

Watch in the video how the laser excision procedure is performed.

Recovery period

Despite the fact that excision of the hood is considered a simple operation, it takes a certain time for the patient to recover, the wound site heals.

How long the pain and discomfort will last, the tissues heal, depends on the individual characteristics of the human body and the severity of the implementation of medical recommendations.

Throughout this period, it is necessary to adhere to the implementation of the following recommendations:

For the first few hours after the operation, you should not eat or drink anything.
All further food taken should be at room temperature, soft. Solid and tough foods should be avoided.
During the first days, try not to chew on the operated side.
Gently brush your teeth, trying to bypass the wound area, do not rinse your mouth intensively.
Eliminate heavy physical activity, baths, saunas.

As a rule, the following are prescribed for the entire postoperative period:

Taking analgesics. To relieve pain, Ketanov, Ibuprofen or Ketorol tablets are usually prescribed (no more than 4 pcs per day).
Rinsing with antiseptics Chlorhexidine, Miramistin, Furacilin, oral baths prepared on the basis of herbal infusions (usually chamomile, sage or calendula), or compresses with Holisal gel.
Taking anti-inflammatory drugs (antibiotics). They are prescribed in extreme cases, when the body cannot cope with the consequences of inflammation on its own.

Important! Usually, with strict adherence to all medical prescriptions, it takes about 7-10 days to recover.

Need for figure eight extraction

In some cases, excision of the hood above the figure eight is not enough. Such manipulation will not work if:

There is not enough space on the jaw arch so that the third molar can erupt without any complications. A unit is removed if it grows in the wrong direction.
There are no units adjacent to the wisdom tooth... Then there is no sense in preserving it, and it is better to remove it before it begins to give a person some difficulties.

It is noted that the hood is formed only over the elements that have not yet erupted. Their extraction in dentistry is considered a complex operation, since there is no approach for extracting a tooth with conventional instruments.

The dentist has to dissect the problem tooth into parts with a drill. Only then can the unit be carefully removed from the well.

The operation for the simultaneous excision of the hood and extraction of the third molar entails some additional difficulties for the doctor and patient.

The procedure is significantly increased in time, there is a risk of accidental damage to the tongue. In the person himself, the simultaneous carrying out of two manipulations causes panic fear and stress.

Usually, before such an operation, general anesthesia is placed, thanks to which the patient does not notice all the doctor's actions and tolerates the procedure easily, and the specialist calmly carries out the manipulation, avoiding unpleasant embarrassment.

Important! The procedure takes about an hour. It is effective and completely safe for the patient, even though general anesthesia is administered.

Price

The cost of the operation for excision of the hood consists of the price for anesthesia, additional examinations and the procedure itself, accompanying medications.

The approximate average cost is 2-3 thousand rubles. (it all depends on the status of the clinic, its location).

If the hood and the third molar are removed at the same time, the cost rises and reaches 4 thousand rubles, and in some clinics even up to 7 thousand rubles.

Home therapy

For some reason, people come to the dentist when unbearable pain appears and complications appear. The same is observed with pericoronitis.

People are trying to drown out the first signs of the disease with folk remedies. They really help to relieve symptoms for a while, but do not fight the cause of the phenomenon itself.

If you still can't get an appointment with a doctor, you can alleviate the condition by doing the following:

Rinse your mouth with a solution of soda and salt every 2 hours (1 tsp. Salt and soda in a glass of warm water).
Lubricate the inflamed area with iodine. But here it is important to do everything very carefully so as not to burn the mucous membrane.
Rinse the mouth with an infusion of medicinal herbs - chamomile, oak bark, calendula, sage (pour 1 teaspoon of each plant with a glass of boiling water, insist 1 tsp, strain and use as directed at least 4 times a day).

If the pain intensifies, the temperature rises, and general malaise appears, home therapy should be abandoned and immediate medical attention should be sought.

The inflammatory process develops very quickly. Only a doctor can correctly assess the condition and prescribe the appropriate treatment. That is why self-medication with medications is also unacceptable. Their improper use can lead to worsening of the disease.

Important! It is impossible to delay visiting a doctor with a difficult teething of a wisdom tooth, because this is fraught with the development of complications that are dangerous to general health.

Problems in case of refusal of treatment

Without treatment, it is impossible to stop the rotting of food debris and inflammation. The acute form of the disease quickly turns into a chronic one, characterized by a sluggish course of suppuration and frequent exacerbations.

Inflammation in this form affects not only the tissues surrounding the third molar, but also adjacent ones, passes to the bone jaw tissue, chewing and facial muscles, leading to more serious pathologies:

changes in bone structure;
the formation of phlegmon and abscess;
osteomyelitis of the jaw.

Purulent exudate accumulated under the hood begins to flow out, causing an inflammatory process in the oral cavity. There is an inflammation of the cervical lymph nodes, there is soreness of the submandibular.

If the lymphatic system cannot fight the infection, lymphadenitis is diagnosed in patients in such cases.

Pericoronitis also provokes ulcerative stomatitis, actinomycosis. If the multiplication of microorganisms under the tissue cover is not stopped, they quickly enter the respiratory, digestive and circulatory systems, leading to all kinds of diseases.

If, at the same time as the inflammation of the hood, there are problems with the correct eruption and growth of the figure eight, these complications can be joined by:

complete or partial destruction of the roots of units adjacent to the third molar;
change in bite;
erosion and suppuration on the cheek;
neuralgic changes in the trigeminal nerve;
numbness of the jaw;
destruction of the jawbone;
distortion of the shape of the face.

Important! The named consequences require complex and long-term inpatient treatment, and in almost all cases it will not be possible to avoid surgical intervention. Therefore, treatment should begin as early as possible, at the first symptoms of pathology.

The video presents the dentist's opinion on the procedure for excising the hood above the figure eight.

According to medical research, in the process of evolutionary development, wisdom teeth have lost their primary functions, and modern people simply do not need them. However, for many, they never appear.

Expert opinion

Biryukov Andrey Anatolievich

doctor implantologist orthopedic surgeon Graduated from the Crimean honey. institute in 1991. Specialization in therapeutic, surgical and orthopedic dentistry including implantology and prosthetics on implants.

Ask an expert

I think that you can still save a lot on visits to the dentist. Of course I'm talking about dental care. After all, if you carefully look after them, then it really may not come to treatment - it will not be necessary. Microcracks and small caries on the teeth can be removed with ordinary toothpaste. How? The so-called filling paste. I single out Denta Seal for myself. Try it yourself.

According to some dentists, after a couple of centuries, teething of eights will be rare.

Now experts advise refusing to remove molars - they may be needed when installing a prosthesis. The eruption of such teeth is a lot of pain.

The main causes of pericoronitis

The eruption of a wisdom tooth occurs between the ages of 18 and 25. The scientific name for the chewing organ is "third molar". When it appears between the chewing organ and the gum surface overhanging it, there remains a free space, called the hood. Most often, food particles penetrate there and remain.

Over time, food debris deteriorates, which leads to the development of microorganisms. This provokes a foul-smelling breath, inflammation of the hood and the formation of pus.

The main causes of inflammation in the hood area are:

dystopia of the third molar - its location at an angle or parallel to the row, often common for the lower jaw;
half-retention - the condition is accompanied by the eruption of only part of the tooth, while the rest is still in the bone;
thickening of the mucous tissues of the oral cavity in the area of the wisdom tooth;
small width of the dental arch, which does not allow the figure eight to cut through normally.

All such cases are accompanied by the formation of a hood over the third molar, even if in the future it will take its usual position in the dentition.

Symptoms of pericoronitis

The early stages of the disease are almost asymptomatic. However, after a couple of days, the accumulation of food pieces provokes the development of inflammation. The process is complicated by the lack of the ability of saliva to penetrate under the hood. As a result, the balance of acid-base balance is not fulfilled.

Symptoms of the development of pericoronitis are:

swelling of the gums;
difficulty swallowing;
inability of a person to fully open or close his mouth;
headaches, dizziness;
putrid odor from the mouth;
high temperature;
advanced stages are accompanied by facial swelling.

Signs become enough to worsen a person's well-being. If therapy is not timely, the results can be dire. The problem is that the infection spreads to nearby tissues.

These are the chewing muscles, as a result of which even a weak movement of the jaw is accompanied by acute pain.

Pericoronitis treatment methods

If inflammation of the gum surface around the third molar develops, therapy often involves removing the hood. If there is a pronounced purulent inflammation, then excision becomes undesirable due to the likelihood of developing complications of an inflammatory nature.

To facilitate the outflow of the purulent department, the hood is dissected, then anti-inflammatory therapy is prescribed. Complete elimination is carried out after suppression of active inflammation. In addition, sometimes it may be necessary to remove the figure eight.

Excision of the hood over the wisdom tooth

The method involves excision of the overhanging mucous tissue over the molar, which has begun to appear. The procedure involves the elimination of conditions for the development of pathogens. This is a microsurgical intervention that is characterized by low trauma. In rare situations, a large amount of gum tissue is excised.

Excision of the hood over the wisdom tooth is performed by a dental surgeon using local anesthesia. When visiting a competent specialist, correctly delivered anesthesia, the procedure is painless.

Pain occurs after the passage of anesthesia (after half an hour), for this reason, it is better to take an analgesic before the onset of pain.

Excision involves the following stages:

the use of local anesthesia;
direct excision of the overhanging gums. The dental surgeon uses a scalpel and surgical scissors in his work;
disinfection of wounds by means of special antiseptic agents;
the imposition of an iodoform turunda in place of the excised hood.

The procedure ends with the receipt of medical recommendations, the appointment of a second examination.

Removing the wisdom tooth hood

Removing the hood of the third molar is quite a simple operation. For carrying out, local anesthesia is used.

The procedure is facilitated by the presence of one of the prerequisites:

crowding of the chewing organs;
no need for the functioning of the third molar;
insufficient jaw width.

Features of excision of the gums

Manipulation to remove the hood itself is not particularly difficult. But it requires adherence to certain medical recommendations, which will help prevent relapse. Usually excision is carried out as follows. The dentist advises the patient, gives some details of the procedure. After that, anesthesia is applied based on the collected history.

The operation is performed with a scalpel or surgical scissors. The dentist makes an incision in the soft tissues, then dissects them away from him. This procedure releases the crown of the molar.

In this case, the lobes of the gums occupy an extreme position from the masticatory tubercles. The procedure will provide the patient with normal oral cavity care, as the mucous membrane will move away from the coronal part of the molar.

Usually, the dentist prescribes a therapeutic course that includes baths. This is easy to do at home. You will most likely need a regular solution of salt or chlorhexidine. When taking medications, do not forget about the obligatory consultation with a specialist. This is due to the likelihood of complications, as well as bleeding. As a rule, the dentist takes into account the level of complexity of the disease; when purulent inflammation is detected, antibiotics are prescribed.

It is important to remember that the dissection of the hood does not guarantee protection from the problems caused by the growth of the wisdom tooth every time.

Cases of repeated gum re-covering of the molar are common. This is usually caused by the slow growth of the rudiment. If the molar remains partially impacted after the procedures, it is removed.

In what cases is a wisdom tooth removed?

Removing the hood over the third molar is often insufficient. This kind of therapy does not provide the desired effect in the following situations:

The oral cavity does not have enough space for further eruption of the tooth. Extraction is prescribed when it is directed towards the adjacent masticatory organs or bone tissue.
Absence of adjacent molars with a wisdom tooth. Such situations do not bring any sense for the safety of the figure eight. For this reason, it is removed before it starts to cause problems for the patient.

The hood is formed exclusively on wisdom teeth that have not erupted to the end. This means that the procedure for removing them will be rather difficult. There is no access for removing the element from the well using simple dental devices. For this, a drill is used, with which it is divided into several parts. The dentist then carefully removes the molar particles from the alveolar bone.

The peculiarity of wisdom tooth extraction with a hood is the complexity of its implementation. The process entails additional difficulties. The operation lasts much longer than the usual clipping of excess soft tissue. Most patients are stressed by this, especially those suffering from panic fear of treatment at the dentist.

For such cases, general anesthesia is used. It promotes the patient's immersion in a serene sleep and lack of response to the specialist's manipulations. Panic is not the only reason to use anesthesia.

It is used with an increased gag reflex in humans. During the operation, the dentist can hook the tongue, causing the gag reflex. To prevent unpleasant embarrassment, it is better to completely turn off the person's reflexes through general anesthesia.

Do you feel anxious before visiting the dentist?

YesNot

Due to the short duration of the operation, the anesthesia used does not pose a danger to the body. Despite this, it is not recommended for women to use such pain relievers during the first and last trimesters of pregnancy.

The effect of anesthesia on the fetus has not yet been fully studied, however, it is not always possible to exclude such a complex operation that requires general anesthesia.

Most modern qualified dentists do not support the removal of a wisdom tooth, as it may be useful for further prosthetics. Others, on the contrary, strongly recommend removing it. This will avoid dental problems.

Most people, for various reasons, are afraid of visits to the dentist, this is a condition for painful teething of wisdom teeth. People act intuitively and turn to traditional medicine. It is important to know that such actions are erroneous, they will only temporarily relieve the symptoms without solving the root of the problem. In addition, it can blur the overall picture, act as the source of the course of the disease.

It is not recommended to resort to independent acquisition and administration of bactericidal drugs. Because such drugs have a local effect, the inflammation process will only deepen its effect. The process can be purulent complications in the lymph nodes and pharynx.

Wisdom teeth are very different from other molars. They have a more complex root system and are the last to erupt. Firstly, this happens already at a conscious age, according to statistics, from 18 to 25 years old, although there are cases when eights appear only after 30 or even forty. Secondly, this process can take a long period, and often proceeds with a number of complications. The most common of these is the formation of a hood over the tooth, accompanied by bouts of pain. In this case, it is often necessary to remove this part of the gum.

Symptoms and description of the hood over the tooth

In the process of teething eights above the teeth, a hood often forms. It is a gum tissue that overhangs in places where the dental crown did not have time to erupt.

Since the eights erupt gradually, in the interval between the mucous membrane and the crown, which still remains inside, a free space is formed in the form of a hood. Food debris easily gets there and cannot be completely removed, even with the most thorough cleaning. This creates a favorable environment in which harmful microorganisms multiply, resulting in inflammation. This complication is called pericoronitis.

Symptoms at the initial stage of development of inflammation are reduced to:

swelling of the gums;
pain in the area of eight;
unpleasant taste in the mouth;
odor from the mouth.

Without proper treatment, the situation is aggravated and the initial symptoms are joined by:

When is excision of a part of the gum indicated?

When a gingival pocket overhangs a third molar, it is always necessary to consult a dentist. He will determine the condition of the hood and decide if excision is required. If the appropriate measures are not taken in time, then the entire molar will overlap, and the inflammation will begin to spread to the adjacent soft tissues. This, in turn, is fraught with the development of an abscess or phlegmon, the fight against which consists in carrying out special incisions on the affected gum.

Excision of the hood is done if:

Inflammation of the gums over the wisdom tooth

It takes some time for the gum over the erupting wisdom tooth to become inflamed. At the beginning of the formation of the hood, there are no unpleasant sensations, and the person may not notice the presence of a problem. However, when food gets under the pocket, pathogenic bacteria begin to multiply rapidly under suitable conditions.

Unfortunately, saliva is unable to penetrate the gap between the wisdom tooth and the overhanging gum and perform its protective functions. This makes it impossible to wash out food residues and restore the acid-base balance, which contributes to the development of unfavorable flora.

Features of the growth of the gums in a child

If in an adult the gum grows only when wisdom teeth are erupting, then the child is faced with a similar problem when his milk teeth climb. For some, this process is quick and imperceptible, while for others it is not.

Other unpleasant symptoms can join the reddening of the gums and the formation of a hood. At this point, it is important to consult a doctor in a timely manner. If the child is small, then he will constantly crawl into his mouth with his fingers and can easily infect or injure the gum, and this is fraught with inflammation and the formation of pus.

Operation stages

The only option to cope with a hood over a tooth that has become inflamed is surgery to remove the build-up over the tooth. It is not particularly difficult, it is carried out quickly, in several stages:

Conducting local anesthesia. An injection of a selected anesthetic drug is injected into the gum next to the damaged soft tissues. This is usually enough so that the patient does not get hurt during the operation.
Pre-treatment of education with antiseptic agents.
Removing the hood. After the injection begins, with the help of special surgical scissors or a scalpel, the doctor makes several incisions in the gum overhanging the wisdom tooth.
Washing the wounds at the incision sites. For this, solutions with antiseptic and analgesic properties are also used.
Stopping bleeding.
Applications of iodoform turundas or with Alvogel.

How long does it take for the gums to heal after the intervention?

Despite the fact that the very excision of the gingival part that has grown over the tooth, the procedure is simple, and soft tissues are injured, which means that a certain period is required for the healing of the resulting wounds. How much the incision will hurt and heal depends on the quality of the procedure, the neglect of the problem and the patient's compliance with all recommendations.

After the hood has been cut off, oral care plays an important role. The more accurately you follow all the dentist's prescriptions in the period after the operation, the faster all the unpleasant consequences of cutting the gums can disappear. Usually, the rehabilitation process takes several days, after which you should visit your doctor again.

Treatment of the gums after surgery

Treatment of the gums, after a certain part of them has been incised, comes down to simple procedures that the patient is able to carry out himself at home. They consist in:

Creation of trays for the oral cavity with Miramistin, Chlorhexidine 0.05% or water-saline solution at least 2 times a day for 5 days. They have an antiseptic effect.
Lubrication of the affected tissues with Cholisal gel.
Taking analgesics if the damaged area is very painful after removal.
A course of antibiotics if pus is present.

It often happens that the removal of the formation above the figure eight does not help. Despite the fact that the hood was cut, after a while it grows back. This is due to the fact that a wisdom tooth can grow for a very long time. The third molar can even come out only halfway and stop.

In such a situation, dentists advise to immediately remove the wisdom tooth, and not to suffer, continuing to constantly cut the neoplasms. This way you can avoid many problems and after a while return a healthy smile to the photo.

At home

Before embarking on home therapy, it is important, under the supervision of a doctor, to eliminate the inflammatory process and possible complications. Traditional methods are effective only as auxiliary procedures to speed up recovery.

Rinse your mouth with broths, tinctures or plain water. It is important to rinse gently.
Brush your teeth with low intensity horizontal translational movements.
Take warm food. Hot or cold can irritate the injured mucous membrane. Salt and spices are also best removed from the diet.

It starts from about 16-17 years old.

In some people, a wisdom tooth does not appear at all. This is not a pathology due to the fact that the wisdom tooth is a rudiment. It has lost its functionality over time since people began to eat soft, cooked foods.

The figure eight cuts through a large area of the gum that has already formed over the years. This area, which hangs over the erupting wisdom tooth, is called a hood in dentistry.

On examination, an erupting eighth tooth and a swollen gum area above it, significantly increased in size, white or red, depending on the stage of inflammation, should be visible.

After the initial examination and diagnosis, the doctor appoints the date of the operation and treatment during preparation in the form of baths with a disinfectant and local compresses. More details about the period of preparation for the operation will be discussed below.

It is important when diagnosing to understand in which direction the wisdom tooth itself is growing. If he has a normal direction of growth, that is, upwards, then there are no contraindications to excision of the hood, but it also happens that the tooth grows sideways, towards the other teeth and puts pressure on them. In this case, it is necessary and excision of the hood will not help.

Why does the hood need to be removed?

After pericoronitis is diagnosed, the doctor usually directs the patient to prepare for hood excision. This is a classic way to solve the problem that has arisen, since the treatment of inflammation in this area can be ineffective and dangerous.

Gum inflammation can be relieved with regular use. But at the end of the course of taking antibiotics, the inflammatory process will continue.

This is due to the fact that the space between the tooth and the gum is constantly filled with food and there is a continuous process of reproduction and development of pathogenic microbes.

During the action of antibiotics, they temporarily stop their development, but as soon as the antibiotic stops working, the problem comes back again. Since the appointment of antibiotics is an aggressive method of treatment and negatively affects the body as a whole, it is better to leave this method in this case.

In the photo, the arrow indicates the inflamed hood on the wisdom tooth

In addition, if the process is started, then the condition can worsen irreversibly. The next stage in the development of the disease will be a violation of the chewing process, the problematic functioning of the facial muscles and, associated with this, difficulty in opening the mouth, increased pain.

The inflammatory process and decay can spread to soft tissues, and pyogenic microbes can be transmitted through the lymphatic or circulatory system.

The consequences can be severe and require long and difficult hospital treatment, and most often with surgery. Therefore, no matter how scary it is to go to the dental clinic, the trip cannot be delayed and the hood must be excised.

After removing the hood, the space where bacteria multiplied disappears, so the inflammation should not be repeated anymore. The wisdom tooth continues to grow normally, because now, nothing bothers it.

Also, after the diagnosis is made, it is necessary to take into account the presence in the anamnesis of excision of the gums in the same place earlier. It happens that the gum is excised, but after a while it becomes inflamed again. Then the question is raised about the effectiveness of such a method in the individual case, and most often it is necessary to remove the entire growing tooth.

Preparation for excision and surgery

The main task in preparation for the procedure is to relieve the acute inflammatory process. This happens by rinsing the mouth with particular intensity in the area of inflammation. For rinsing, use chamomile infusion, if there is no allergy to it.

For allergy sufferers, we apply a soda-salt solution based on the proportions: for one glass of water, half a teaspoon of soda and the same amount of salt. Rinse 3 times a day.

Pain medication can be taken to relieve pain. Usually Ketorol is prescribed or, but not more than 4 tablets per day and dental drops, which have a local analgesic effect.

Dental drops are applied to a small piece of gauze and a compress is made directly to the site of inflammation. Such a compress will reduce pain syndrome and has a beneficial effect on relieving inflammation.

The very procedure for removing the hood is carried out under the local in the absence of contraindications to it. In case of individual intolerance to painkillers or during pregnancy and lactation, the procedure is carried out without the use of an anesthetic.

After an injection of an anesthetic drug, the sensitivity of the area is reduced as much as possible, and the procedure. The dental surgeon marks the area for removal and cuts off the excess gum with a scalpel so that nothing covers the tooth area, since if a piece of the gum remains, the inflammation can recur if food gets under it or if there is insufficient hygiene.

Then the wound should be washed with a special antiseptic and hemostatic agent. After stopping the bleeding, the doctor applies a compress using the healing medication Alvozel or Iodoform Turunt.

Rehabilitation of the patient at home

Miramistin is used in a volume of 10-15 ml per application. Furacilin solution can be prepared independently. To do this, in a pharmacy you need to purchase a ready-made powder at a dosage of 0.02 g or tablets of the same dosage and crush them into powder. Then dissolve it in warm water and rinse.

Miramistin is also used in the form of irrigation, for this you need to purchase a special solution with a spray, in the form of a spray and spray the wound 3-5 times a day.

Also, to reduce pain and disinfect the wound, you can rinse your mouth with a decoction of herbs: chamomile and sage. To do this, pour one teaspoon of each herb with a glass of boiling water and leave for 15-20 minutes.

Strain half of the broth through cheesecloth and dilute with warm water for one rinse. The rest can be left for next time.

Before rinsing again, strain well so that no particles remain, and dilute with warm water.

When choosing a rinse, it is necessary to take into account the individual characteristics of the patient and consult a doctor on this issue in advance so as not to worsen the condition with an allergic reaction.

In addition to rinsing, you need to apply compresses with dental gel 2-3 times a day. It promotes rapid wound healing and pain relief.

Holisal relieves heat, pain and inflammation due to the main active ingredient. Kills germs, and fungi due to this does not allow the gums to become inflamed again. It is recommended to apply it before meals if painful sensations interfere with food intake.

After eating, the mouth should be rinsed to get rid of food debris. Cholisal is made on the basis of a gel, so it is quickly absorbed, and the active ingredients last much longer. The analgesic effect lasts from 2 to 8 hours, depending on the individual characteristics of the organism.

In the dry residue

Thus, with obvious signs of inflammation in the area of the wisdom tooth, it is imperative to consult a doctor to prevent the development of an inflammatory process in soft tissues. If the doctor prescribes excision of the hood as a treatment, his recommendations cannot be neglected.

In case of refusal to remove the gum, it may not recover on its own and with the help of local therapy, and the inflammatory process will take a lot of time and effort to heal it.

The operation under local anesthetic is painless. But after the anesthesia wears off, severe pain can occur. But they are removed with the help of painkillers, which are taken internally and topically.

Within 3 days, the wound should heal due to the high ability of the mucous membrane to regenerate tissues. On a second examination, the doctor will confirm the effectiveness of the recovery.