Doubts about dental inclusions

What are dental inclusions or included teeth?

Dental inclusions or included teeth are those dental structures, usually normal in their shape, size, structure and composition, but that for various reasons, cannot be installed during their eruptive period, in the place that corresponds to them in the dental arch. This gives rise to different pathologies, such as inflammation, crowding, collateral damage to other teeth in their vicinity, cysts and tumors…

What causes them?

There are multiple factors that cause inclusions. Some phenomena, due to the frequency with which they occur, could even be considered within normality. This would be the case of included wisdom teeth, in which the cause, not always, is the lack of material space for their eruption and more often due to their exit disposition. It could be genetic or evolutionary aspects of the species or other, simpler ones, such as premature extractions, which close spaces. In this case, a tooth can no longer emerge and remains on the “waiting list”, perhaps for orthodontic procedures associated or not with surgery, since the place that would correspond to it has been reduced.

What does the treatment and surgery consist of?

The first step for the treatment of impacted teeth is to perform and evaluate the patient’s General and Specialized Clinical History.

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Then the local and / or regional radiology, usually panoramic or even more precise, for selected cases, Dentoscan, CT, without forgetting the traditional Radiology unprofiled, which can play an indispensable role. Through its use, the particularities of the relations and spaces of the included dental piece(s) are diagnosed. Each patient, once informed of the need for surgery, can be operated under local anesthesia, perhaps better, locoregional, sedation or general anesthesia.

Can the tooth be repositioned or is it necessary to resort to an implant?

If the positioning treatments of the included tooth are not recommended, its replacement by a dental implant could be indicated, to support the corresponding prosthetic crown, provided of course that there is the necessary space and volume of bone and saving and evaluating, of course, the air and dental canal structures, in the upper and/or lower jaw, respectively.

What care should the patient follow after the operation?

The usual recommendation is the positioning of the patient, liquid and/or soft diet, easy to eat and to maintain careful oral hygiene, by meticulous and soft brushing of the non-intervened areas and to perform, with more directionality and effectiveness, rinses especially of the treated areas, with physiological saline solution, bitter chamomile infusions and recently even green tea. Some specific mouthwashes could be considered in compromised situations, due to suspicious or unfavorable clinical manifestations. Depending on the particularities of the clinical case in question, antibiotics, analgesics or anti-inflammatory drugs may also be necessary.

Let’s see some radiographic images, so that the reader can get involved in the search for the dental inclusions that appear in them!

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Disclosure Article submitted to Top Doctors on August 17, 2014.

Dentary Inclusions

Professor Dr. Don Francisco Hernández Altemir