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TEETH EXTRACTION

If a tooth has been broken or damaged by decay, we will try to fix it with a filling, crown or other dental treatment. But when there’s too much damage for the tooth to be repaired, the tooth may need to be extracted or removed from its socket in the bone.

When the damage to the tooth is beyond repair, only then tooth removal is suggested.

1. Forceps extraction, intra alveolar extraction

2. Surgical extraction, trans alveolar extraction

Forceps or simple extraction, intra alveolar extraction

This procedure is on a tooth that can be seen in the mouth. For a simple extraction, the dentist loosens the tooth with an instrument called an elevator. Then the dentist uses forceps to remove the tooth.

Surgical extraction, trans alveolar extraction

This is a more complex procedure, which is used if a tooth may have broken off at the gum line or has not erupted in the mouth. The oral surgeon will make a small incision into your gum to surgically remove the broken tooth or impacted wisdom tooth. Take it easy for the rest of the day. Take as little exercise as you can, and rest as much as you can. Keep your head up to avoid any bleeding.

  • Expansion of bony sockets (by forceps)
  • The use of lever and fulcrum principles ( by elevators)
  • Wedging principal (by elevators)
  • Surgical extraction is also called as open method of extraction
  • This method involved the reflection of a muco periosteal flap, cutting of the bone obstructing the removal of the tooth and if required sectioning of the roots and then removal.

Here are some other common reasons for tooth extraction:

Some people are known to never develop wisdom teeth, while there are others who develop all four wisdom teeth – one in each corner of the mouth.

  • Some people have extra teeth that block other teeth from coming in.
  • A badly decayed and abscessed tooth that cannot be saved by conventional root canal.
  • Repeated failure and frequent complain of pain of long standing chronic root canal treated tooth
  • Cracked tooth - Vertical fracture of tooth
  • People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
  • People receiving cancer drugs may develop infected teeth because these drugs weaken the immune system. Infected teeth may need to be extracted.

Therapeutic Extractions

People getting braces may need teeth extracted to create room for the teeth that are being moved into place.

Wisdom teeth

Also called third molars, are often extracted either before or after they erupt in the mouth. They commonly come in during the late teens or early 20’s. They need to be removed if they are decayed, infected, or if there is not enough room in the mouth.

Understanding

There are two types of extractions:

A simple extraction

This is performed on a tooth that can be seen in the mouth. General dentists commonly do simple extractions. In a simple extraction, the dentist loosens the tooth with an instrument called an elevator. Then the dentist uses an instrument called forceps to remove the tooth.

A surgical extraction

This is a more complex procedure, which is used if a tooth may have broken off at the gum line or has not erupted in the mouth. Oral maxillofacial surgeons typically perform this procedure, though general dentists can also perform them. The doctor makes a small incision (cut) into your gum to surgically to remove the broken tooth or impacted wisdom tooth. It may be necessary to remove some of the bone around the tooth or to cut the tooth in half in order to extract it.

Most extractions can be done using just an injection (a local anesthetic). Some people such as patients with specific medical or behavioral conditions and young children — may need general anesthesia.

If you are receiving conscious sedation, you may be given steroids, as well as other medicines in your intravenous sedation line. The steroids help to reduce pain and swelling after the procedure.

During a tooth extraction, you can expect to feel pressure, but no pain. If you feel any pain or pinching, tell your dentist.

Planning

simple extractions

Having a tooth taken out is a surgical procedure. You can expect some mild discomfort even after simple extractions. Research has shown that taking drugs that include ibuprofen, such as Advil, Motrin and others, can greatly decrease pain after a tooth extraction. Take the dose your doctor recommends, 3 to 4 times a day. Take the first pills before the local anesthesia wears off, and continue taking the mediations for 3-4 days following or as your dentist has recommended.

Surgical extractions

Surgical extractions generally cause more pain after the procedure than simple extractions. The level of discomfort and how long it lasts will depend on how difficult it was to remove the tooth. Your dentist may prescribe pain medicine for a few days. Most pain disappears after a couple of days.

Tips to help minimize your discomfort and speed recovery:

  • Eat soft and cool foods for a few days. Usually for non-diabetic patients ice cream is advised.
  • Do not rinse vigorously or spit until 24 hours of tooth removal.
  • A gentle rinse with warm salt water, started 24 hours after the surgery, can help to keep the area clean. Use one-half teaspoon of salt in a cup of water. Most swelling and bleeding ends within a day or two after the surgery.

Cold compress

You can put ice packs on your face to reduce swelling. Typically, they are left on for 20 minutes at a time, done 4 -5 times a day until the swelling reduces. Complete healing takes at least two weeks.

Hot compress

After a few days if your jaw is sore and stiff after the swelling goes away, try warm compresses.

Suture (Stitches)

If you need stitches, your doctor may use the kind that dissolves on their own. This usually takes one to two weeks. If the sutures are removable ones, the dentist might call you a week later to check the site for healing and remove the stitches.

Call your dentist or oral surgeon if:

  • The swelling gets worse, instead of better.
  • You have fever, chills or redness.
  • You have trouble swallowing even after two weeks
  • You have uncontrolled bleeding in the area.
  • The area continues to ooze or bleed after the first 24 hours.
  • Your tongue, chin or lip feels numb more than 3 to 4 hours after the procedure.
  • The extraction site becomes very painful -- This may be a sign that you have developed a dry socket.
Antibiotics and painkillers (Analgesics) as prescribed by the dentist should be taken as per advice.

Precautions

Avoid hot food or drinks until the anesthetic wears off. This is important as you cannot feel pain properly and may burn or scald your mouth. Also, be careful not to chew your cheek. This is quite a common problem, which can happen when there is no feeling. Do not rinse the area for the first 24 hours. It is important to allow the socket to heal, and you must be careful not to damage the blood clot by eating on that side or letting your tongue disturb it. This can allow infection into the socket and affect healing. Avoid alcohol for at least 24 hours, as this can encourage bleeding and delay healing. Eat and drink lukewarm food as normal but avoid chewing on that area of your mouth. There will usually be some tenderness in the area for the first few days, and in most cases, some simple pain relief is enough to ease the discomfort.

If it has been a particularly difficult extraction, will give you a follow-up appointment. This could be to remove any stitches that were needed or simply to check the area is healing well.

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  • Kharmanghat | Dilsukhnagar | Kondapur | Kokapet | Tarnaka | Nallagandla
  • 9553-444-999
  • siridentalhospital@gmail.com
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