Wisdom teeth Wait instead of remove the same

Wisdom teeth always have to be removed?

09/11/2014

One person usually has four wisdom teeth, but some have fewer and some never show themselves. In the past, it was common to pull the wisdom teeth as early as possible, but now has „a rethinking took place“. For the decision what to do, above all, it is important to have a dentist who gives good advice.

Wisdom teeth can cause severe toothache
Most people have four wisdom teeth, others less. In some people, they break through in adolescence, with some, they never show up. Although they are no longer needed while chewing, but can lead to a variety of problems. For example, they cause massive toothache in some patients. In addition, follicular cysts, a special form of the dental cyst, can often be observed on the lower wisdom teeth. The course is usually free of symptoms for a long time, but can occur as a long-term consequence of misaligned teeth. Wisdom teeth can sometimes even take up space if they never break through.

A rethinking has taken place
As Kai Fortelka of the Dentistry Association (KZBV) explained, according to a message from the dpa news agency, until some time ago it had been customary to pull the wisdom teeth as early as possible because of possible problems. „In recent years, however, a rethinking has taken place in this area.“ For example, dentists would now be guided by "an updated guideline for surgical wisdom tooth removal". Who wants to get rid of the tooth, must be operated on. If the procedure is medically necessary, the health insurance will cover the costs.

For acute problems wisdom tooth usually needs to get out
In this context, the maxillofacial surgeon Wilfried Wagner, who works at the University of Mainz, speaks of a risk assessment. If a wisdom tooth causes acute problems, he usually has to get out. The board member of the German Society of Oral and Maxillofacial Surgery also refers to the scientific guideline, which states: If a patient with pain in connection with a wisdom tooth should be removed, this should be removed. This applies, for example, to jaw pain, such as pressure pain on the jaw, or when the surrounding tissue is inflamed. If the back molar hurts, but is healthy in itself, removing the adjacent wisdom tooth can also provide relief. But even with more general symptoms, the guideline recommends an intervention: For example, if there are indications that a wisdom tooth is a cause of tooth or facial pain.

Prophylactic removal of wisdom teeth
However, wisdom teeth are not only pulled to treat pain, but in some cases, to prevent them. This is because prophylactic extraction of wisdom teeth is easier and less risky. The dentist has to estimate how the external tooth will develop. There are risks in keeping him in the jaw. Often, wisdom teeth would break through piece by piece and could cause new inflammation with every little push. In addition, they led to pressure in the jaw and in patients with tight pines they could push the incisors over each other. In addition, this pressure could damage the jaw or molars.

Financially lucrative business
If such a development is foreseeable, a prophylactic operation may be useful. However, this always depends on the patient. According to Wagner, adolescents and young adults are the best at removing the procedure according to experience: „In patients between 14 and 25 years, the least complications are to be expected.“ There is also massive criticism of the prophylactic removal of wisdom teeth. This is how the book author and dentist Lars Hendrickson i.R. for years, that this is a financially lucrative business. The health of patients is frivolously put at risk. „After all, there are the most serious risks with every tooth removal, such as facial paralysis when the nerve is injured. A frivolous indication endangers patients completely unnecessary.“

Complaints after surgery
In surgery, patients usually get a rubber drainage that stays in the wound for one day. As Wagner explained, these fluids dissipate, preventing swelling and inflammation. For two to three days would have to expect operators with impairments. During this time, swelling, dysphagia, pain or opening mouth problems may occur. Wagner advises patients in whom the complaints stop, to visit their dentist. In addition to infection of the wound, possible consequences may also be damage to nerves or to the jaw.

In case of doubt, obtain a second opinion
Klaus Koch of the Institute for Quality and Efficiency in Health Care (IQWiG) says that there is a lack of comparative studies that track the course of disease in operated and non-operated patients. Due to a lack of scientific data, dentists can not always make reliable statements. „After all, you need a dentist who will advise you well“, so cook. The patient does not have to decide on the examination chair immediately if the dentist suggests surgery. „Normally, this decision is in no hurry“, says the expert. In addition, patients could consult a second physician "if they do not feel convinced by the arguments of their dentist." (Ad)