The term “germectomy” refers to the removal of the eighth teeth at the rudimentary stage or early calcification in children aged 7-11, long before they appear in the mouth.
In Chekhov’s “Surgery,” all the horrors of removing these “problematic” wisdom teeth are mentioned: swollen cheeks, puffy eyes, mouths that cannot be opened, broken tooth roots, and damaged facial nerves. Many believe this only happens to those who do not maintain proper dental hygiene. Unfortunately, this is not the case.
Let’s consider an important aspect:
Wisdom teeth, or third molars, often do not erupt at all or do not fully emerge.
(picture #1 from personal practice)
Let’s question everything and look into our own mouths: there are three large chewing teeth with cusps on each side of the jaw: the sixth, seventh, and eighth molars (ideally, all of which should form a straight dental arch in the mouth after the age of twenty-five).
By ceasing to actively chew tough food, our prehistoric ancestors inherited, along with wisdom, a lack of space for sufficiently large chewing teeth. The teeth that come last in line are particularly unlucky: the sixth and seventh can position themselves relatively comfortably, while the wisdom teeth have to push in various “incorrect” directions.
(picture #2 * from the Web)
Sometimes they peek out into the mouth with just one bump
(picture #3 from personal practice)
Other times, like a ghost, they only appear on an X-ray, lying deep in the bone or pressing against the roots of neighboring teeth.
(picture #4 from personal practice)
How to predict problems with wisdom teeth?
Let’s figure out whether it is worth removing wisdom teeth. Many hope that the eighths may never erupt or that they will emerge well and properly occupy their place in the dental row. However, Dr. Ricketts dedicated several decades of his professional life to studying the likelihood of third molars erupting and the bite pathologies they cause.
He found a reliable method that allows for a high degree of accuracy in predicting the behavior and fate of eighth teeth more than ten years in advance by examining X-rays and computed tomography for the ideal relationship between bones, growth points of the jaws, and the position of tooth buds. Nowadays, orthodontists can use his method to determine whether wisdom teeth will remain retained (in the bone) or will erupt, pushing aside anything that obstructs them.
Dr. Turley validated the reliability of this method over ten years: 90% of predictions matched actual outcomes.
The rationality for early removal of wisdom teeth:
Undoubtedly, the operation to remove an eighth tooth is one of the most unpredictable and complex in dentistry. Nevertheless, we can assist you and your children at a stage when surgical intervention is least dangerous and labor-intensive. Germectomy, in this sense, is the simplest and most elegant solution.
There is a misconception that it is better to wait until the tooth erupts on its own, making it easier to remove later. Unfortunately, this is not true. In germectomy, a small rounded bud is removed using a curette, which makes the complexity and duration of the operation relatively low. Moreover, germectomy cannot be compared to removing eighth molars with a fully formed dental system. After eleven years, the roots of these teeth may spread in different directions,
(picture #5 * from the Web)
twist and bend in various ways,
(picture #6 *from the Web)
wrap around the jawbone,
(picture #7 from the Web)
be very thin, numerous, and extremely fragile.
(picture #8 *from the Web)
Even without these complex roots, accessing the depths of the mouth with instruments is quite challenging. Now imagine that the wisdom tooth has partially erupted, and food begins to get trapped under the soft mucous membrane around this area, making it extremely difficult to clean. Even if caries develops, leading to pulpitis, simple inflammation of the mucosal flap over the eighth tooth can be agonizing.
(picture #9 *from the Web)
Imagine that swelling sets in, making it difficult to open your mouth, the inflammation spreads to the throat, and swallowing becomes painful. How can you remove this complicated tooth if you can’t even lick a teaspoon? In 11.6% of cases, the pericoronitis can progress and lead to an abscess (a localized purulent focus) or phlegmon (diffuse inflammation of the soft tissues of the face and neck).
What if you brush your teeth very well?
This may help prevent inflammation, abscesses, and other complications, but it does not guarantee a 100% success rate. At the moment your immune system is weakened, the wisdom tooth may become problematic and cause significant issues even after proper oral hygiene care.
Potential problems associated with wisdom teeth:
What threats do wisdom teeth pose to modern children, aside from all the aforementioned issues? From the perspective of future smile aesthetics:
- Wisdom teeth, when erupting, “push and shift” all the other teeth, including the incisors. Your child may have perfectly healthy and beautiful teeth, but as soon as the wisdom teeth start to come in, everything else will begin to shift in different directions.
- The wisdom tooth stimulates the growth of the lower jaw, causing it to protrude unattractively.
- The eighth molar can erupt and alter the bite: in such cases, certain areas of teeth may stop occluding altogether, while others become overloaded.
Local complications from wisdom teeth:
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A poorly erupting wisdom tooth can damage a healthy and important neighboring molar: it can resorb the roots of the seventh molar, cause caries leading to pulpitis, result in cyst formation, and lead to bone loss around the seventh tooth, which will ultimately cause it to become loose.
(picture #10 from personal practice /11,12 *from the Web)
- A wisdom tooth that erupts in the wrong direction can cause chronic trauma: you may constantly bite your cheek or tongue, which over time could result in malignant neoplasms.
Early removal of wisdom teeth can prevent the formation of an improper bite and is also a necessary part of preparation for orthodontic treatment.