Core tip: What should I do if my wisdom teeth hurt? Don’t tell me to pull them out! I won’t tell you about pulling them out. Let’s take a look at the following case and decide for yourself according to your impacted teeth: Acute wisdom tooth pericoronitis Erupted or impacted wisdom teeth, the surrounding soft tissue inflammatory lesions called wisdom teeth pericoronitis. The age of onset of the disease is 18-35 years old.
Insufficient eruption position of the mandibular wisdom teeth in the mandible leads to obstruction of the eruption of the lower wisdom teeth, and a blind pocket is formed between some of the erupted wisdom teeth and the surrounding teeth, impacting food and bacteria. Acute pericoronitis is often induced. Pericoronitis of maxillary wisdom teeth is rare. [clinical manifestations]
1. In the early stage, there is swelling and discomfort in the posterior molar area of the affected side, followed by pain, which is aggravated when chewing and swallowing. In the early stage, it is mostly dull pain. When the infection spreads to the masticatory muscle fascia, there may be limited mouth opening, or swelling of the face (mainly the cheeks, submandibular area, and parotid masseter muscle area). When local infection worsens, fever and fatigue may occur. Systemic symptoms such as headache.
2. Intraoral examination revealed impacted wisdom teeth, surrounding soft tissue congestion, edema, erosion, tenderness, and food residues or purulent exudates in the blind bag. In advanced stages, abscesses can form around the wisdom teeth, and in some cases, the abscess can be located on the buccal side or cheek of the second molar as the infection spreads down the mandible. Swollen and tender lymph nodes on the affected side. [diagnosis]
1. Based on history and clinical presentation.
2. X-ray examination can understand the position, growth direction and root shape of impacted wisdom teeth, and can also find the distal cervical caries of the second molars that are not easy to detect in the mouth.
3. Laboratory examination: the total number of self-cells in the blood routine increased, the neutrophils increased, and the nucleus shifted to the right.
4. In addition, it should be differentiated from pulpitis caused by distal caries of the second molar. (1) The pain performance is different. (1) Pulp vitality test: hot and cold stimulation hurts. (3) X-ray performance is different. [treat]
1. topical treatment
(1) Blind bag rinsing; 3% hydrogen peroxide and 1% Refnol can be used. After rinsing, put glycerin or concentrated Tyrode’s solution in the blind bag. Blind bag rinsing and drug application are very important for the subsidence of local inflammation, and should be done once a day if conditions permit.
(2) Gargle with mouthwash: such as Dobell’s solution, you can also gargle with light salt water.
(3) If the face is swollen, Ruyi Jinhuang Powder can be applied externally.
(4) The abscess has been formed, incision and drainage should be performed. The incision should be parallel to the gums and reach the bone surface.
(5) Tooth extraction in the acute stage: when the patient’s general condition is good and the inflammation is relatively limited, if it is estimated that the operation is not difficult, extraction of the affected tooth can be considered.
2. Systemic treatment: In mild cases, oral antibiotics such as Zengxiaolian Levosulfan, tetracycline, and erythromycin can be used. In severe cases, intramuscular injection or intravenous infusion of penicillin and streptomycin can be used.
3. If there is enough space between the jaws, the wisdom teeth are in the right position without bone impaction, and there is a fetal relationship, gingivectomy can be considered to preserve the teeth, otherwise, they should be removed as soon as possible. [Prevention and Recuperation] Early treatment or extraction of diseased teeth can effectively prevent the spread of inflammation to adjacent tissues.
Reminder: For more knowledge about crooked teeth, tooth deformities, wisdom teeth, etc., please pay attention to: padmel.com, to provide you with comprehensive professional tooth extraction, wisdom teeth extraction, dental implants and other dental maintenance knowledge.
