Wisdom teeth (third molars) are commonly impacted and prone to decay due to their position, making them difficult to clean. When infection, decay, or pain occurs, surgical extraction becomes the most effective treatment. This case highlights the management of a symptomatic, decayed, and impacted lower left third molar.
Patient Information
- Age/Gender: Not specified
- Medical History: No significant medical history reported
- Chief Complaint: Patient complained of pain in the lower left back tooth region.
Clinical Examination
- Tooth involved: Lower left third molar (tooth 38).
- Findings: The tooth was partially impacted and decayed, with pain reported by the patient.
- IOPA X-ray was taken, confirming impaction and caries.
Diagnosis
- Decayed and impacted mandibular third molar (38).
Treatment Plan
The patient was informed about the poor prognosis of the tooth and advised to undergo surgical extraction. After explaining the procedure and obtaining consent, surgical extraction was planned under local anaesthesia.
Surgical Procedure
The surgical extraction was carried out step by step as follows:
- Anaesthesia
- Incision and Flap Reflection
- Bone Removal (Osteotomy)
- Tooth Sectioning (if required)
- Tooth Removal
- Irrigation and Debridement
- Flap Repositioning and Suturing
- Hemostasis
Post-Operative Instructions
The patient was advised to:
- Keep the gauze in place for 30–45 minutes.
- Avoid spitting, rinsing, smoking, or using a straw for the first 24 hours.
- Apply cold compresses externally to minimise swelling.
- Take prescribed antibiotics and analgesics.
- Maintain a soft diet and avoid chewing on the extraction side.
- Keep the area clean with gentle brushing and follow up for suture removal/healing check.
Outcome
- The surgical procedure was successful and uneventful.
- The patient experienced relief from pain after the healing phase.
- Proper bone and soft tissue healing were observed in the follow-up.
Conclusion
Impacted wisdom teeth often cause pain, food lodgment, and decay. Surgical extraction is the treatment of choice to eliminate pain, prevent infection, and restore oral health. With precise surgical steps incision, bone removal, sectioning, and suturing, the procedure ensures safe removal and faster recovery.