Also known as odontotomy, wisdom molar extraction is a therapeutic maneuver commonly performed in dental practices.

Wisdom molars, four in number, are the last teeth to erupt from the dental arches. They are positioned posteriorly, behind the molars that have already erupted.

Sometimes the space on the arches may already be occupied by other teeth, so the wisdom molars may erupt in atypical positions or even remain embedded in the jawbone.

It is possible that this inclusion of the wisdom molar is asymptomatic, the patient not being alarmed by any signs. However, sometimes, if the covering mucosa is injured during feeding, a continuity solution is created which will be populated by bacteria and thus become infected, a pathology called pericoronitis, which is particularly painful for the patient.

When is extraction of wisdom teeth indicated?

Extraction of wisdom teeth should be performed in the following situations:

Perichondritis

Infection of the mucosal cap covering the crown of the wisdom molar.

In the case of pericoronitis, the treatment aims at loosening the covering mucosa but also antiseptic washes to reduce the bacterial gradient.

If episodes of pericoronitis recur and the removal of the mucosal cap does not result in a reduction of the dental eruption, odontotomy is recommended.

Injury to the adjacent tooth – the unerupted wisdom molar included in a deific position may affect the neighboring tooth, i.e. the 12th molar. A wisdom molar that is in contact with the root of the adjacent tooth can cause root resorption or carious lesions. Both types of phenomena cause weakening of dental strength. In this case, it is recommended to extract the tooth that is damaging the antagonists.

Some doctors recommend odontotomy even if the non-erupted tooth has not caused suffering to neighboring teeth and the patient does not present painful symptoms, as a preventive measure.

Carious lesions

If a wisdom molar shows massive coronal destruction or requires endodontic treatment, treatment is very difficult and made more difficult by the distal arch position.

Thus, if the tooth in question is not of prosthetic importance and has a reserved prognosis, extraction is suggested.

Postoperative care is intended to facilitate and speed up healing following tooth extraction. The patient must be aware of the importance of following the instructions given by the doctor.

These include:

Avoiding brushing and rinsing with mouthwash on the day of extraction, followed by resuming these habits the next day

Food should be semi-liquid in consistency and eaten at an appropriate temperature, neither too hot nor too cold.

It is possible that pain may occur following the intervention, especially if the intervention also involved the sacrifice of bone due to the deep position of the wisdom tooth.

To reduce pain, painkillers and sometimes antibiotics are prescribed if the operation was complicated or if the patient has associated general illnesses.

Following the extraction, the doctor applies a supra-alveolar dressing, which helps to absorb blood secretions but also promotes and protects clot formation. The patient must maintain the tamponade for at least 30 minutes after the end of the procedure.

If at the end of the extraction the doctor sutures the resultant suture, the patient will return after 7 days for thread suppression. The doctor will also assess tissue healing.

Wisdom molar extraction, also known as odontotomy, is a common procedure performed in dental offices. This procedure is necessary when the wisdom tooth has failed to erupt completely or its eruption in a limited space can cause problems and complications.

Wisdom molars, four in number, are the last teeth to erupt at the dental arch. Because they erupt posteriorly, behind molars that have already erupted, the space available on the arch can be limited, leading to them erupting in incorrect positions or remaining embedded in the jawbone.

Sometimes impacted wisdom molars may be asymptomatic and the patient may not be aware of their existence. But in other situations, when the mucosa covering them is injured during chewing, an infection called pericoronitis can develop, causing intense pain for the patient.

There are several situations in which wisdom tooth extraction is recommended:

Perichondritis: If the wisdom molar is partially impacted and the mucosal cap covering it is infected, treatment consists of cleaning the area and using antiseptics to reduce bacteria levels. If episodes of pericoronitis recur and removal of the mucosal cap does not facilitate normal tooth eruption, odontotomy may be recommended.

Injury to the adjacent tooth: A wisdom molar that has not fully erupted and is in an incorrect position can damage a neighboring tooth, such as a 12-year-old molar. This can lead to root resorption or the appearance of tooth decay. Both situations weaken the strength of the affected tooth. In this case, it is recommended to extract the wisdom molar that is causing problems for the other teeth.

Carious lesions: If the wisdom molar shows massive destruction at the crown or requires difficult endodontic treatment because of its distal position, extraction may be recommended. This is a viable solution if the tooth in question is not given prosthetic importance and has a reserved prognosis.

Postoperative care is essential to facilitate proper healing and recovery after wisdom molar extraction. Here are some important recommendations:

Avoid brushing and rinsing with mouthwash on the day of extraction and resume these habits the following day. This will protect the operated area and avoid dislodging the blood clot that forms at the extraction site and aids healing.

Choose foods with a semi-liquid consistency and eat them at a moderate temperature. Avoid hard, crunchy or spicy foods as these can irritate the operation site and cause discomfort.

You may experience pain and swelling after the procedure, especially if a significant amount of bone had to be removed. To reduce pain, your doctor may prescribe painkillers or anti-inflammatories. In some cases, antibiotics may also be needed to prevent infection or treat existing infections.

After the extraction, the doctor will apply a supra-alveolar dressing to absorb any bleeding and to help form and protect the blood clot. It is important to keep the dressing in place for at least 30 minutes after the procedure.

If your doctor used sutures to close the area, you will need to return after about 7 days to remove them. At this stage, the doctor will also assess the state of tissue healing.

It is essential that you strictly follow your doctor’s instructions and directions to ensure an effective recovery and avoid possible complications. Ignoring these instructions or self-medicating can lead to delays in the healing process and cause further problems.

It is important to discuss all aspects of wisdom tooth extraction with your doctor and clarify any concerns. An experienced dentist will give you personalized instructions and monitor your progress during the recovery period.

Wisdom molar extraction may be a necessary intervention to avoid complications and maintain optimal oral health. Adherence to post-operative care and communication with your doctor are key to a smooth and speedy recovery.