Dentoalveolar surgery or Wisdom Teeth Removal is one of the important aspects of Oral and Maxillofacial Surgery that concentrates on routine issues such as simple extractions, exposure of impacted teeth for orthodontic treatment, surgery to remove third molars (commonly knows as wisdom teeth) or canines, bone contouring, and minor soft tissue repairs. It actually represents nearly 50% of all minor surgeries completed in our office setting. Anyone who has ever experienced a toothache will appreciate the importance of every day Dentoalveolar Surgery. Recently, placement of dental implants was added to the rehabilitative and reconstructive options for the maxillofacial region, replacing the more traditional procedures. One of the most common procedures that come under Wisdom Teeth Removal or Dentoalveolar Surgery is the extraction of a third molar tooth (or wisdom tooth).

WHY DO THE THIRD MOLARS NEED TO BE REMOVED?

• Many members of most civilized races exhibit a disproportion between jaws size and tooth size in that they possess jaws which are too small to accommodate their teeth.
• The Wisdom tooth or third molar is the last tooth to erupt and so it may readily become either impacted or displaced if it is insufficient for it within a dental arch.
• Thus the removal of the wisdom tooth or third molar is one of the most frequently performed oral surgical procedures with pain and painless.

IF NOT, WHAT IT MIGHT LEAD TO:

• Recurrent pericoronitis (infection of the gum over the tooth).
• Caries or tooth decay.
• Periodontal disease
• Obscure Facial pain
• Exposed under the denture.

1. Recurrent pericoronitis: Commonest indication for the removal of impacted third molars. Paradoxically it is also the commonest contraindications to surgery, for the extraction must be deferred until the acute inflammation is controlled if a predominantly soft–tissue infection is not to be converted into agony infection.
2. Caries (Tooth Decay): The impaction of partially erupted wisdom teeth often cause a food trap which the patient finds impossible to keep clean. The resulting retention of food debris is first accompanied by an unpleasant taste and odor, but sooner or later caries occur in either the occlusal surface of the third molar or the adjacent distal surface of the second molar or in both teeth.
3. Periodontal disease: Residual pocketing of the gum may occur around the partially erupted and impacted third molar. The Removal of the tooth is often the only effective way of act eliminating the pocketing in such circumstances.
4. Obscure facial pain: Completely embedded or partially erupted wisdom teeth or third molars may be the cause of obscure facial pain.
5. Previous Extraction: If a previous unsuccessful attempt has been made to extract impacted wisdom teeth or third molar a careful preoperative investigation is to be into the causes of failure, followed by extraction of the wisdom teeth.
6. Prosthetic Considerations – At times, impacted molars & canines have to be removed before giving a prosthesis to the patient.
7. The Presence of Pathological Lesion: If an impacted third molar is relative to a pathological lesion this relationship may be either an indication or a contraindication to extraction. If the tooth is related to a cyst or is in a fracture line, it is usually better removed.

IS IT REMOVED DUE TO ANY REASON AS WELL?

At times removal of the wisdom teeth might be needed during orthodontic treatment (treatment with wires for alignment of teeth). Other than third molars, premolars can also be removed for this treatment. Canine if quite abnormally placed in the jaw, might need (surgical) removal as well.

IS THE PROCEDURE DONE UNDER ANESTHESIA?

Yes, the procedure is done under local anesthesia. In very rare situations it can be done under conscious sedation or general anesthesia if needed.

ARE THERE ANY POST-OPERATIVE INSTRUCTIONS TO BE FOLLOWED?

Yes, post-operative instructions will be given to you by your doctor after the wisdom teeth removal or extraction, which includes taking medications & certain other instructions to be followed by you. Dentoalveolar surgeries or Wisdom Teeth Removal are done after proper oral checkups which involve physical & radiographic examination following which correct diagnosis is to be made. The patient is explained about the entire treatment plan.

In COMHTS, it is made sure by Dr. Aseema that the treatment provided to the patient is painless & traumatic during & after the procedure is completed, which makes the clinic one of the best for all kinds of Dentoalveolar surgeries.