Dentistry involves not only treatment procedures but also the prevention of and restoration of decayed or broken teeth. Caring for the teeth is important to prevent decay and other possible complications such as infection. If a tooth is damaged by decay, or broken, a dentist will try to remedy the condition through teeth filling. A crown may be placed on the decayed tooth after a root canal procedure. However, if the damage is extensive and that no other dental procedure can repair the tooth, it has to be removed or extracted from its socket in the jaw bone.
Why teeth extraction?
Dental extraction is a procedure done not only for removing decayed tooth. Tooth extraction is done to remove extra teeth that block other teeth from erupting or coming out. This is most commonly seen in baby teeth that don’t fall out to allow the permanent teeth to break out. Tooth extraction is called for to prepare the mouth for orthodontia in case the mouth is too crowded to move and align teeth.
If damage to the tooth extends to the pulp or the main part containing blood vessels and nerves, infection may set in due to the bacterium that can enter the pulp. In case a root canal is no longer feasible, tooth extraction is the only solution.
If there is risk of infection due to a compromised immune system, pulling the tooth out may be necessary. If there is an infection of the bones and tissues that support and surround the teeth, tooth extraction may be required.
Two Types of Tooth Extraction
There are two general types of tooth extraction done by a dentist or oral surgeon.
A simple extraction is done on a tooth that is visible when the mouth is open. This procedure is commonly done by general dental practitioners. An x-ray of the tooth may or may not be required. Using an instrument called an elevator, the dentist loosens the tooth, then removes it by using forceps. Local anesthesia is injected into the area surrounding the tooth to be extracted. Sometimes topical anesthesia is first applied to the gum to deaden the impact of the anesthetic injection.
A more complex procedure is a surgical extraction of teeth. This procedure is the most feasible option if a tooth is broken off the gum line or in the removal of an impacted (wisdom) tooth. A panoramic x-ray is commonly required for wisdom tooth extraction. Oral surgeons normally do this procedure, but general dentists do surgical extraction as well. A small incision is made into the gum. At times, it is necessary to cut the tooth in half or chip away some bones around the tooth for easy extraction. Local anesthesia or intravenous anesthesia may be used. In some cases, there are patients who chose general anesthesia or conscious sedation due to medical or behavioral conditions. General anesthesia is also preferred for small children. In cases like this, a qualified anesthesiologist is required.
What to Tell the dentist Before Tooth Extraction
Tooth extraction is generally very safe and should not cause any complication. However, the procedure can allow bacteria into the bloodstream. Infection of the gum is also a possibility more so in surgical extraction. Antibiotics may be prescribed if the patient is at risk of developing an infection, so it is necessary for the dentist to know if the patient has:
- Artificial or damaged heart valves
- Weakened immune system
- Congenital heart problem
- Cirrhosis or any other liver disease
- Artificial joint
- Previous bacterial endocarditis episodes
- Infection at the time of tooth extraction
- If taking medications
If a patient developed cough and cold a week or so before the procedure, his dentist should know about it. If a patient felt nauseous or vomited the night before the procedure, his dentist should be informed too, as the extraction might have to be rescheduled in reference to the anesthesia. Smoking must be deterred at least on the day of surgery as doing so will increase the tendency to develop a painful condition known as dry socket.
What to Do After the Tooth Extraction
Recovery at home usually takes a couple of days. Painkillers may be prescribed to help in speedy recovery. A gauze pad is placed over the socket to reduce bleeding and allow for a blood clot to form in the area. This gauze should be changed if it is already soaked in blood. This pad should be in place for at least 3 hours after the procedure. To keep the swelling down, an ice bag over the affected area will help.
Rinsing or spitting forcefully should be avoided for at least 24 hours to avoid dislodging the clot in the tooth socket. Drinking from a straw as well as smoking will greatly inhibit healing of the wound. Solid and complicated food should be avoided. It is best to eat soft food until the site of the extraction heals. Brushing and flossing teeth is permissible, but the extraction site avoided.
The patient must call his dentist if the following occurs:
- Nausea and vomiting
- Fever and chills
- Swelling, redness or excessive discharge from the extraction site
- Chest pain, shortness of breath,
Dental extraction is routine and complications are unlikely unless the patient’s history is not fully known to the attending dentist.