This is a 24-year old girl who has come with severe pain in the Right lower third molar region. She had got similar trouble about two years ago after which there has been no problem.
Partially erupted Lower Third Molar
You can see in this picture that the gum tissue above the partially erupted wisdom tooth is swollen. Immediate remedy for this is frequent warm saline rinses and painkiller-cum-anti-swelling tablet like Iburpofen and Paracetamol Tablet to be taken twice or thrice a day.
Sometimes such patients also complain of painful swallowing also when they are also required to take Amoxycillin 250 mg Capsules every 8-hourly for three days. In this patient, by the way, antibiotic is not required.
You can see that in this patient, the upper third molar is missing – it never erupted, she says. So, in a way there is any usefulness of the lower partially erupted wisdom tooth. But I have seen that patients seldom get ready to get such wisdom teeth removed in spite of being told that these have only nuisance value.
Tilted Upper Third Molar
Now, just look at her other side of mouth. You can see the upper third molar is lying in a malposed position – means it is lying tilted. It would never come to its normal position. Again, it has got just the nuisance value as the lower third molar is missing and the tilted upper wisdom being not in proper alignment is encouraging food impaction. It is not uncommon to find such third molars getting decayed with time to the extent that these have to be extracted. But it is very unfortunate in many cases when we find that due to perpetual food impaction between tilted tooth and a normal tooth lying just in front of this, the previously normal tooth has became extensively decayed and the tilted tooth is unaffected, though it is good for nothing.
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