QUESTION Pedro Ivo Nogueira Silva, Rio de Janeiro, RJ
– (Márcio L. Castro/)
1) Wisdoms are four teeth of type third molar. Extraction is recommended around age 18, when mouth tissues are still softer. However, if they don’t sprout by 30, it’s because they haven’t found space. You have to pull them out – or they could cause pain, inflammation, cavities, chewing problems or crooked teeth.
two) One x-ray of the arch helps the surgeon assess the position and shape of wisdom and study the best technique to get it out. The lower ones are usually more work: they are larger than the upper ones and fixed on the mandible, which is shorter and more rigid than the maxilla. Then the operation can be scheduled, which lasts about 30 minutes.
– (Márcio L. Castro/)
3) A anesthesia it is composed of articaine or bupivacaine, vasoconstrictor drugs that make tissues lose sensitivity for about 50 minutes. It is applied to the inner and outer sides of the gum. In the case of upper wisdom teeth, also in the corner of roof of the mouth next to tooth. And, in the inferior ones, in the lingual nerve, at the bottom of the mouth.
– (Márcio L. Castro/)
4a) If wisdom is not apparent, you need to remove part of bone that covers it. There, the tooth It is broken and pinched in pieces, with what’s left of bone in the cavity.
4b) In most cases, however, the wisdom already «born». just make a gum incision, close to toothwith the cutter (a kind of scalpel) to expose it.
– (Márcio L. Castro/)
5) The surgeon finds a point between the tooth and the bone to fit the levers, that resemble screwdrivers. He moves them to soften and suspend the wisdom.
6) Dental forceps, an instrument in the shape of pliers, is used to «embrace» the crown of tooth and remove it. Finally, two to three points are given at the site.
CONSULTANCY Marcelo Trivelato, dental surgeon at the philanthropic association Centro de Estudos e Pesquisas Dr. João Amorim (SP)