怎么处理智齿感染

智齿（第三磨牙）之所以叫这个名字，是因为智齿长得最晚，常常要到青春期后期才长出来。 ^[1] （也有部分人根本就不长智齿。）^[2] 智齿发炎是件令人十分痛苦的事情，通常需要立即采取措施。看牙医前，你也可以通过几个步骤来缓解痛苦。

步骤

家中护理

1. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/c\/c7\/Deal-with-an-Infected-Wisdom-Tooth-Step-1-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-1-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/c\/c7\/Deal-with-an-Infected-Wisdom-Tooth-Step-1-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-1-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 1 确认征兆。冠周炎（智齿周围发炎）是指智齿周围组织感染，红肿发炎。可因牙齿部分萌出所致，也可因智齿周围过度拥挤，不易进行牙齿清洁所致。^[3] 为明确智齿是否发炎，需仔细查看以下征兆及症状：^[4]
   • 牙龈鲜红或牙龈发红有白点。牙齿周围的牙龈会红肿发炎。
   • 下颌有中度至重度疼痛，并伴有咀嚼困难。可看到脸颊肿胀，鼓出一块。肿胀部位摸上去会感觉发烫。^[5]
   • 嘴里有令人难受的金属味。金属味是由感染部位的血和脓引起。还会感觉有口臭。^[6]
   • 张嘴或吞咽困难。可能感染已由牙龈转移到周围肌肉。^[7]
   • 发热。体温超过100华氏度（37.8摄氏度）表明你正在发热，身体正在抵御感染。如感染严重，可伴有肌肉无力。如有这种情况，应立即联系牙医或医生。
   • 某些情况下，牙根也会感染。如牙根感染，牙医很可能会把牙齿拔掉。^[8]
2. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/5\/58\/Deal-with-an-Infected-Wisdom-Tooth-Step-2-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-2-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/5\/58\/Deal-with-an-Infected-Wisdom-Tooth-Step-2-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-2-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 2 用盐水漱口。盐水有天然抗菌作用。用盐水漱口可杀灭口腔细菌。^{[9] [10]} 将半勺至一勺盐加入8盎司（约227毫升）温水中充分混匀。^[11]
   • 倒一口盐水在嘴里含漱30秒，含漱时要充分漱洗感染部位，杀灭细菌。
   • 30秒后吐出盐水——别喝下去。每天用盐水漱口三至四次。
   • 该方法可与牙医开的抗生素同时使用。
3. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/d\/de\/Deal-with-an-Infected-Wisdom-Tooth-Step-3-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-3-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/d\/de\/Deal-with-an-Infected-Wisdom-Tooth-Step-3-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-3-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 3 用牙用凝胶缓解疼痛和炎症。当地药店可能会有牙用抗菌凝胶出售，主要要看你居住何处。凝胶可以控制感染并缓解疼痛或炎症。^[12]
   • 使用凝胶前，先彻底漱口，然后用棉签取一两滴凝胶直接涂抹于发炎部位。
   • 不要直接用手指涂抹凝胶，这样可能会沾染到更多细菌。
   • 每天涂凝胶三到四次，以达到最佳效果。
4. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/b\/b6\/Deal-with-an-Infected-Wisdom-Tooth-Step-4-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-4-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/b\/b6\/Deal-with-an-Infected-Wisdom-Tooth-Step-4-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-4-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 4 缓解疼痛。如果因智齿感染感觉疼痛严重，可服用同时有缓解炎症作用的镇痛片。非类固醇类抗炎药（NSAIDs）通常在药店药房都可以买到。^[13]
   • 布洛芬（艾德维尔或摩特灵）、甲氧萘丙酸（萘普生）和阿司匹林是最常见的非类固醇类抗炎药。不得给18岁以下儿童服用阿司匹林，因为阿司匹林会引发雷氏综合症，造成肝脑损伤。^[14]
   • 对乙酰氨基酚（扑热息痛）不是非类固醇类抗炎药，没有消炎的作用，但可以缓解疼痛。^[15]
   • 按包装说明的剂量服用或遵照医嘱，不得超剂量服用。
   • 切记是药三分毒，服药前必须仔细阅读包装说明。如需要，可咨询药剂师或医生。
5. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/c\/cd\/Deal-with-an-Infected-Wisdom-Tooth-Step-5-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-5-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/c\/cd\/Deal-with-an-Infected-Wisdom-Tooth-Step-5-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-5-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 5 用冰袋。如果不想服药或不能服药，可在感染部位敷上冰袋。就医前，冰袋可以缓解疼痛和炎症。^[16] 如肿胀得厉害，要紧急治疗。
   • 将冰块倒入塑料袋或者裹在毛巾里，然后将冰袋敷在疼痛部位至少十分钟。
   • 也可用袋装冷冻蔬菜，如冻豌豆或冻玉米。（请勿食用解冻后再冷冻的袋装蔬菜。）
6. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/c\/c2\/Deal-with-an-Infected-Wisdom-Tooth-Step-6-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-6-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/c\/c2\/Deal-with-an-Infected-Wisdom-Tooth-Step-6-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-6-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 6 联系牙医。一定要尽快和牙医预约就诊时间。如果感染得不到适当的治疗，会扩散到口腔及身体其他部位。^[17]
   • 冠周炎还会导致牙龈病、龋齿、囊肿等并发症。更为严重的并发症还有淋巴结肿大、败血症、全身感染，甚至可以导致死亡。
   • 如果牙医太忙没有时间立即给你治疗，可以到急诊诊所或医院。很多急诊诊所或医院都有急诊牙医。

牙医诊治

1. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/1\/17\/Deal-with-an-Infected-Wisdom-Tooth-Step-7-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-7-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/1\/17\/Deal-with-an-Infected-Wisdom-Tooth-Step-7-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-7-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 1 和牙医沟通治疗事宜。牙医会检查感染部位并拍X射线查明感染情况是否严重，以确定最佳的治疗方案。^[18]
   • 牙医会检查牙齿位置，确定牙齿是否已从牙龈完整或部分地萌出。牙医也会注意周围牙龈的状况。
   • 如果智齿尚未萌出，牙医可能需要拍X射线来确定牙齿的部位及其位置。这些因素会影响到牙齿是否需要拔除。
   • 不要忘记告知既往病史。牙医需要了解你是否对药物过敏。
2. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/7\/77\/Deal-with-an-Infected-Wisdom-Tooth-Step-8-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-8-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/7\/77\/Deal-with-an-Infected-Wisdom-Tooth-Step-8-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-8-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 2 询问治疗的费用、风险及好处。咨询牙医治疗需要多少开销。还要询问治疗的一切风险和好处，以及是否还有其他治疗方法可供选择。
   • 不要怕问问题。你有权了解自己的医疗情况。
3. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/f\/f8\/Deal-with-an-Infected-Wisdom-Tooth-Step-9-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-9-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/f\/f8\/Deal-with-an-Infected-Wisdom-Tooth-Step-9-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-9-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 3 让牙医清洁感染部位。如智齿即将从牙龈中顺利萌出，且感染情况也不算严重，牙医只需用抗菌溶液简单地清洁感染部位就可以了。
   • 牙医会除掉发炎部位受感染的组织、脓液、食物残渣或菌斑。如牙龈出现脓肿，有时需要切开小口排出脓液。
   • 清洁后，牙医会建议接下来几天如何在家中护理。可用口腔凝胶消炎，用抗生素全面清除感染，以及用止疼药缓解疼痛。^[19] 通常开的抗生素包括阿莫西林、克林霉素和青霉素。^[20]
4. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/5\/58\/Deal-with-an-Infected-Wisdom-Tooth-Step-10-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-10-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/5\/58\/Deal-with-an-Infected-Wisdom-Tooth-Step-10-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-10-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 4 做好动小手术的准备。智齿感染的主要原因之一是，包裹智齿的牙龈部位（即牙龈瓣）因细菌、菌斑和塞在牙缝下的食物残渣而感染。如智齿仍包裹在牙龈中（但萌出位置正常），去掉感染的牙龈瓣往往比拔除智齿本身要容易得多。^{[21] [22]}
   • 牙医可能会安排一次小型外科手术，称为“龈盖切除术”，术中会切除遮盖智齿的牙龈软组织。^[23]
   • 切除后，发炎部位就容易保持卫生，不会有菌斑和细菌，大大减少智齿再次感染的几率。
   • 术前，牙医会局部麻醉手术部位。然后使用手术刀、激光或采用电烙术将感染的组织瓣切除。^[24]
5. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/1\/19\/Deal-with-an-Infected-Wisdom-Tooth-Step-11-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-11-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/1\/19\/Deal-with-an-Infected-Wisdom-Tooth-Step-11-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-11-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 5 考虑将智齿拔除。如出现多重感染，且智齿也没有主动萌出的迹象，就需要将智齿拔除。感染非常严重的情况下也需要将智齿拔除。^[25]
   • 根据智齿的位置，由牙医或口腔外科医生来拔除智齿。^[26]
   • 牙医会进行局部麻醉，然后拔除智齿。^[27]
   • 可能会开抗生素、止疼片来防止进一步感染并缓解疼痛。一定要按牙医的要求保持好口腔卫生。
   • 和牙医预约术后随访时间，让牙医检查牙龈，确保牙龈正常愈合。牙医会检查另一侧智齿的位置，以防另一侧智齿也需要拔除。

保持口腔卫生

1. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/2\/2c\/Deal-with-an-Infected-Wisdom-Tooth-Step-12-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-12-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/2\/2c\/Deal-with-an-Infected-Wisdom-Tooth-Step-12-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-12-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 1 每天刷牙两次。为避免日后感染，一定要保持好口腔卫生。保持好口腔卫生的第一步就是用软毛牙刷每天刷牙两次。硬毛牙刷太粗糙，会磨损娇弱的牙齿釉质。^[28]
   • 将牙刷与牙龈线形成45度角。^[29]
   • 以打小圈的方式刷牙，而不是来回刷（会伤害牙釉质）。
   • 每天刷牙两次，每次至少刷两分钟。确保刷到牙龈线，也不要忘记刷牙齿的背面。
2. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/0\/09\/Deal-with-an-Infected-Wisdom-Tooth-Step-13-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-13-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/0\/09\/Deal-with-an-Infected-Wisdom-Tooth-Step-13-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-13-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 2 每天使用牙线清洁牙齿。用牙线清洁牙齿和刷牙一样重要，因为牙线可以去除在齿缝间堆积的，牙刷无法刷到的菌斑和细菌。如果不清理菌斑，就会导致龋齿、感染和牙龈疾病。每天至少用牙线清洁一次牙齿。^{[30] [31]}
   • 两手将牙线抓好，在牙齿间轻柔地来回移动。不要用力弹在牙龈上，这样会刺激牙龈，导致出血。
   • 将牙线贴在牙齿上弯曲成C形。将牙线轻柔地在牙齿和牙龈上滑动。
   • 抓好牙线，轻柔地来回摩擦牙齿。
   • 要用牙线清洁好每个牙缝，以及后磨牙的背面。一定要在使用牙线后漱口，吐掉脱落的菌斑和细菌。
3. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/4\/40\/Deal-with-an-Infected-Wisdom-Tooth-Step-14-Version-2.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-14-Version-2.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/4\/40\/Deal-with-an-Infected-Wisdom-Tooth-Step-14-Version-2.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-14-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 3 用抗菌漱口水杀菌。使用抗菌漱口水有助于控制口腔细菌，同时也能保持口气清新。选择有美国牙医协会认证的漱口水，美国牙医协会认证的产品效果好。^{[32] [33]}
   • 可在刷牙前后使用漱口水。将一小满盖漱口水倒入嘴里，漱齿约30秒后吐出。
   • 可用商业品牌抗菌漱口水，或用未经稀释的洗必泰，大部分药房均有售。^[34]
   • 如果感觉漱口水刺激性太强，可用无酒精漱口水。
4. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/3\/34\/Deal-with-an-Infected-Wisdom-Tooth-Step-15.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-15.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/3\/34\/Deal-with-an-Infected-Wisdom-Tooth-Step-15.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-15.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 4 和牙医预约检查时间。和牙医预约定期检查牙齿的时间，这是预防智齿感染及其他牙齿问题的最佳措施。^[35]
   • 每六个月要看一次牙医，尤其在智齿尚未萌出时要看牙医。牙医会建议在出现某些健康问题时增加来访频率。
5. {"smallUrl":"https:\/\/www.zenmeban.com\/images_en\/thumb\/2\/22\/Deal-with-an-Infected-Wisdom-Tooth-Step-16.jpg\/v4-460px-Deal-with-an-Infected-Wisdom-Tooth-Step-16.jpg","bigUrl":"https:\/\/www.zenmeban.com\/images\/thumb\/2\/22\/Deal-with-an-Infected-Wisdom-Tooth-Step-16.jpg\/v4-728px-Deal-with-an-Infected-Wisdom-Tooth-Step-16.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"<div class=\"mw-parser-output\"><\/div>"} 5 不要吸烟。智齿感染时不要吸烟或使用烟草制品，会刺激牙龈并导致感染恶化。^[36]
   • 吸烟对健康有害，对口腔健康也一样有害。尽早向医生咨询戒烟方法。^[37]
   • 吸烟会污染牙齿和舌头，减缓身体的愈合能力，导致牙龈疾病和口腔癌。^[38]

小提示

• 如果智齿没有引发问题，也不一定都要拔除。牙医能帮你确定是否需要拔除。^[39] 出现智齿问题的人通常在15到25岁之间。

^[40]

警告

• 家中自行治疗和护理大多无法治愈感染。如有感染，应尽快让牙医检查，并及早进行治疗。