“About 6 months ago, my wisdom tooth finally broke through, but every now and then, it would cause me excruciating pain. A month ago, I couldn’t stand it any longer, so I went to the dentist, had X-rays taken, and finally decided to kill it all. After I had my wisdom teeth removed, I was so refreshed that I could eat like a baby. This has happened to me many times, and even to myself. Today, we are going to talk about the so-called “wisdom teeth survival”. Which wisdom teeth should be extracted? Wisdom teeth are also known as “third molars. 1. “Obstructed Wisdom Teeth” During the evolution of human beings, as food became more and more refined, coupled with the use of fire, food became softer and softer, drastically reducing the intensity of chewing food. Without enough stimulation, the upper and lower jaws of humans became shorter and shorter, but the number of teeth did not decrease. As a result, there was often not enough room for the third molar. Therefore, wisdom teeth (third molars) often do not erupt properly and upright. This is the most common cause of retained wisdom teeth. It is generally recognized that “blocked wisdom teeth” should be removed. 2. Do you have retained wisdom teeth? The easiest and most effective way to determine if a wisdom tooth is blocked is to take a panoramic X-ray. A panoramic radiograph is a film like the one pictured in the title of this article, but it is completely black and white. On the panoramic X-ray, we can see how the wisdom teeth are erupting. If they are lying horizontally, diagonally, or even upside down, then sorry, it is very likely that the wisdom teeth will not erupt properly and completely, and extraction may be the best option. 3. Why should wisdom teeth be removed? Because, incomplete eruption in the wrong position often leads to the formation of a difficult-to-clean area between it and the front teeth, where localized bacterial buildup can lead to severe caries, endodontics, and acute peri-coronitis, which produces unbearable pain! What’s more, it can lead to maxillofacial gap infections and osteomyelitis of the jaws. 4. What other wisdom teeth should be removed? Wisdom teeth are not recommended to be retained when they have developed severe caries that is difficult to treat, apical periapical inflammation, or advanced periodontal disease. This is because the treatment is very difficult and the results are poor. Wisdom teeth should also be removed when they are involved in cysts or tumors, or when they are needed for orthodontic treatment. Which wisdom teeth should be retained? In short, healthy wisdom teeth do not need to be removed. If a wisdom tooth erupts in the “right position” and there is no serious disease in the tooth itself, it is worth retaining. This is because, in addition to continuing to perform its function as a molar, it can serve as a potential “abutment” for a denture (also known as a false tooth) to hang on to in the future, should the tooth that preceded the wisdom tooth become missing for any reason. Although temporary pain due to gingivitis can occur during wisdom tooth eruption, proper use of toothbrush, floss, mouthwash, and maintenance of oral hygiene can usually ease the process until the wisdom teeth have fully erupted. Contraindications to extraction Not all wisdom teeth recommended for extraction can be extracted, and some contraindications to extraction should be ruled out before extraction. Severe heart disease (cardiac class III or IV), severe hypertension (systolic blood pressure > 180 mmHg or diastolic blood pressure > 100 mmHg), certain blood disorders (e.g. anemia, hemophilia, leukemia, etc.), and diabetes mellitus should be controlled and then extractions should be performed under supervised conditions. In pregnant women, extraction is safer in the 4th, 5th and 6th months of pregnancy. No medical procedure is risk-free, and tooth extraction is no exception. This is especially true for the extraction of retained wisdom teeth. 1. After the operation, pain, swelling and difficulty in opening the mouth may occur; 2. Wisdom teeth in the upper jaw are close to the maxillary sinus, and sometimes, perforation of the maxillary sinus may occur, causing maxillary sinusitis; 3. Wisdom teeth in the lower jaw are close to the mandibular neural tube, and sometimes, it may provoke the mandibular nerve, resulting in numbness of the lower lip, which can last from a few days to a few months; 4. Some of the retained wisdom teeth are pressed up against the molar teeth in front of them and may irritate the periodontal membranes of the front teeth, leading to a periodontium of the front teeth, which may cause a numbness of the lower lips. teeth’s periodontal membrane, resulting in a period of sensitivity and soreness. In addition, there are some other postoperative adverse reactions. However, most of them can be recovered through continued treatment. Patients should not be afraid to extract the teeth that should be extracted for these reasons, as the loss will outweigh the gain. Post-extraction precautions During the extraction process, the patient will be more anxious. For example, even a dentist like me, lying in the dental chair, will have the fear of “a man is an altar for a sword, and I am a fish for a meat”, which is completely dependent on the dentist’s ability to calm down the emotions and the skillfulness of the movements to form enough comfort. After the extraction, the dentist will also give you some precautions: 1. Bite the cotton ball tightly for half an hour and then spit it out, there is no need to replace it with more cotton balls; 2. You can eat and drink water after two hours, and try not to eat too hot and hard food on the day of the extraction, and try to use the half of the tooth that has not been extracted for chewing; 3. Don’t brush and rinse the mouth for 24 hours after the extraction; 4. It is normal to see a small amount of blood seeping out from the wound or blood in the water in the mouth in the period of 24 to 48 hours after the extraction. If there is a large amount of bright red blood, it should be treated promptly. If there is a large amount of bright red blood, consult a doctor; 5. avoid strenuous exercise for 1 to 2 days after tooth extraction; 6. remove stitches, if any, 7 to 10 days after surgery. Observing these precautions can greatly minimize the occurrence of postoperative complications or reduce the severity of complications, which is conducive to rapid recovery.