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Should wisdom teeth be removed before orthodontic treatment? The relationship between wisdom teeth and tooth alignment [Dentist Explains].
This article contains the following information Reference.
When to remove wisdom teeth?
When is wisdom tooth extraction used in orthodontics?
Cautions after wisdom tooth extraction
Cost of wisdom tooth extraction
Utilization of extracted wisdom teeth
I believe that many Japanese people have an image of wisdom teeth as something troublesome when they hear the word "wisdom.
When beginning orthodontic treatment, the condition of wisdom teeth isShould be confirmed.One of the key pointsIt is.
Depending on the condition, wisdom teeth removal (extraction) may be recommended.
What are wisdom teeth?
Wisdom teeth erupt behind the second molars (12-year-old molars) in the teens and 20s.
It is difficult to clean the tooth by oneself because it is located quite far back.
Therefore, dirt tends to accumulate between the wisdom teeth and the gums, which can lead to periodontal disease if the gum tissue becomes inflamed, and tooth decay if the bacteria in the dirt produce acid and dissolve the teeth.
Regardless of orthodontic treatment, wisdom teeth are the teeth that are more likely than others to be painful and swollen. Usually four are present at the top, bottom, left, and right sides, but people vary from person to person, some having all four, some having only two, and some having none.
The condition and growth of these wisdom teeth is an issue when beginning orthodontic treatment.
When do you remove wisdom teeth?
Extraction of wisdom teeth due to ingrowth
The first issue is how the wisdom teeth grow.
In general, Japanese people have small jaws, so wisdom teeth often grow in at an angle or sideways.
If the tooth grows at an angle or sideways and may push the adjacent second molar, or if it is prone to staining and will affect orthodontic treatment, extraction is required prior to orthodontic treatment.
If the wisdom teeth are completely embedded in the bone and do not affect orthodontic treatment, they are often left in place.
In some cases, it may break through the gum and not grow back, remaining embedded in the bone for the rest of its life.
If the wisdom teeth are well erupted and are firmly engaged with the teeth in the opposite jaw, they may be incorporated into orthodontic treatment without extraction.
Wisdom teeth extraction for posterior migration
In orthodontic treatment, space must be created to move the teeth into the desired position or to obtain the ideal dentition.
To create space
... enlarge the dental arch to create more space.
Disking to create space for the extraction of teeth.
Slightly sharpen both ends of the teeth.
Move molars backward.
These four methods are used to create space.
If wisdom teeth are in the way when moving molars backward, they may be extracted even if they are well erupted. Especially in Invisalign orthodontics, posterior movement of molars is often performed.
Diagnosis of wisdom tooth extraction prior to orthodontic treatment
How to determine if wisdom teeth are indicated for extraction before orthodontic treatment,Visual examination and routine radiographs may not be sufficient.
To accurately determineA dental CT should be taken.
Unlike conventional radiographs, a dental CT can capture the position of wisdom teeth in three dimensions.
This allows for a highly accurate diagnosis of whether or not teeth should be extracted prior to orthodontic treatment, and if extraction is necessary, an evaluation of the degree of difficulty can be made.
Dental CT is not available in every facility, so we recommend that you check if the clinic you plan to visit is equipped with a CT before you visit.
Cautions for removing wisdom teeth before orthodontic treatment
If wisdom teeth need to be extracted prior to orthodontic treatment, a little caution should be exercised.
In the case of wisdom teeth in the mandible, if they grow sideways or at an angle, the gum must be incised or the tooth must be split and extracted.
The root tips of wisdom teeth in the mandible may also be in close proximity to nerves and blood vessels.
Wisdom teeth in the maxilla may be in close proximity to one of the sinuses called the maxillary sinus, so there is a possibility of puncturing the maxillary sinus during extraction.
because ofDifficult wisdom teeth are difficult to extract in that clinic unless the dentist has experience.It is. Especially when orthodontists specialize in orthodontics, they are almost always referred to an oral surgeon at a clinic or hospital that specializes in 100% extractions.
Cautions after wisdom tooth extraction
Pain and swelling
The first important thing to keep in mind after wisdom teeth removal is,Pain and swelling may occur.This is to say.
Simple wisdom tooth extractions are unlikely to cause pain and swelling, but difficult extractions are more likely to cause pain and swelling.
Naturally, pain and swelling medications will be prescribed, but even if you take them, you should expect the pain and swelling to continue for about a week.
Hole after tooth extraction
The next important thing isHoles that form after extractionIt is.
When wisdom teeth are extracted, a hole is naturally left where the teeth used to grow.
The hole will remain open for at least a month or so, although the gingiva will rise with the month.
This makes it easy for food debris and dirt to get in there and cause infection.
It is also important to rinse lightly when food debris gets into the toothpaste.
Wisdom teeth extraction cost
When wisdom teeth are removed, theDepending on the purpose, it may or may not be covered by health insurance.
If a tooth is extracted for orthodontic treatment, it is not covered by health insurance as well as the usual convenience extractions, and the full amount is to be paid by the patient.
The cost for self-pay is about 5,000 yen to 20,000 yen.
In contrast, if there is severe tooth decay or gum disease and wisdom teeth are removed, it is covered by health insurance.
The cost is 2 to 3 thousand yen at 30% of the cost.
How to utilize wisdom teeth
The tooth that grows one forward of the wisdom tooth is called the second molar.
Second molars are particularly prone to decay, and because they are hard to see, cavities often grow without the patient's knowledge.
If the second molar has a large cavity and is difficult to save, the second molar may be extracted and the already erupted wisdom tooth may be pulled over and incorporated into the dentition, or the wisdom tooth buried in the gum may be pulled over and incorporated into the dentition.
summary
The condition of wisdom teeth is always a good thing.It is recommended to check before orthodontic treatmentThe following is a list of the most common problems with the
In some cases, wisdom teeth may need to be extracted prior to orthodontic treatment, and in others, wisdom teeth may be incorporated into the ideal dentition after orthodontic treatment.
If you would like to talk to someone experienced about wisdom teeth, please come visit our open chat ?.
Written by dentist/issy
After graduating from the National School of Dentistry, he trained at the Tokyo Medical and Dental University Dental Hospital, and is currently working in general and orthodontic dentistry.
Member of the Japanese Society of Oral Implantology
Japanese 
English