Sometimes tooth extraction takes a minute, sometimes it takes much more time, but you shouldn't be afraid of it in any case. The advances in modern dentistry make tooth extraction fearless and delicate - even for young patients.
Modern dentistry is not what it used to be. Today’s techniques are not only effective, but also as comfortable as possible for the patient – even when it comes to tooth extraction. Surgical dentistry becomes less traumatic, does not require brute force and is not limited to tooth extraction “with one movement”.
The price of tooth extraction is formed from the cost of equipment, materials and the work of a doctor.
When is a tooth not worth saving?
IInflammation, dental injury, gum disease, poor hygiene, crowding or improper positioning all cause the teeth to be removed at some stage. The main reason for tooth extraction is tooth decay. Carious destruction, which began in the tooth, passes into the nerve, then into the periodontium, bone and soft tissues. If the tooth decay goes deep under the gum, then, unfortunately, it must be removed.
When a tooth is the cause of inflammation and does not respond to conservative treatment, it is urgently removed. The rest of the cases of tooth extraction are planned, allowing you to plan the subsequent implantation and prosthetics before extraction.
The physician, in deciding whether or not to remove a tooth, is guided by the individual characteristics of the patient and the objective state of the tooth. The degree of tooth damage, the depth of the cariasis cavity, its position relative to the pulp – vascular nerve beam, presence of cracks, hygiene of the oral cavity influence the decision-making.
Before the procedure, the dentist will conduct a diagnosis and survey, collect information about the medications taken, past and chronic diseases. Extraction of teeth is a surgical operation, so the doctor should be aware of conditions that make them vulnerable to infection:
- Cardiovascular disease;
- Liver disease;
- Blood diseases;
- A weakened immune system;
- Recently transferred operations;
Find out the details
- Stages of tooth extraction
- Sparing or atraumatic tooth extraction
- Extraction of wisdom teeth
- Removal of milk teeth
Stages of tooth extraction
Before surgery, the dentist must clean it. If the oral cavity is not sanitized before the operation, there is a risk of infection.
At the next stage, the patient is given anesthesia. The doctor preliminarily treats the oral cavity using application anesthesia so that the patient does not feel or fear the injection for pain relief.
Further, injection infiltration or conduction anesthesia is applied. When using infiltration anesthesia, the doctor injects an anesthetic solution into the surgical site – only a specific area is anesthetized. The second, conductor, is inserted into the area of the nerve associated with the site of surgery. At the same time, the patient feels numbness of the entire jaw fragment. Such anesthesia is used during complex surgical intervention.
Typical tooth extraction is loosening of the tooth and extraction of the root using special tools – an elevator, a luxator and forceps. The duration of tooth extraction directly depends on the complexity of the operation. For typical removal, the duration of the operation is 30 minutes, including pre- and post-test preparation.
The removal itself, not burdened by complications, will take only a few minutes. Difficult, or atypical, tooth extraction can take several hours. And a special technique of sparing, or atraumatic, removal – even for several days.
After tooth extraction, the surgeon conducts a thorough revision of the hole: a blood clot should form in it, which will ensure successful wound healing. If necessary, sutures are applied to this place.
The dentist then determines when the patient should come for the next check-up. Depending on the complexity of removal, there may be several subsequent examinations;
The doctor prescribes pain relievers and antiseptics, gives recommendations for care. For two days, you will have to refrain from hot food and rinsing your mouth. In addition, it is recommended not to warm the place of tooth extraction, including by hand. The next meal after removal is two hours later.
Having removed the tooth, you can safely go home. For a while, you will have to walk around with a tampon in your mouth, which will stop bleeding, and your lips and cheeks will be temporarily numb – that’s all the inconvenience that removal brings.
It must be remembered that after removing a tooth, leaving an empty gap in its place is fraught with consequences. At the site of the extracted tooth, the bone tissue becomes thinner, the adjacent teeth lean into the empty space, the rest gradually change their position. The chewing load is unevenly distributed, and in particularly difficult cases, the facial skeleton is deformed.
Therefore, when planning a tooth extraction, the dentist thinks over its subsequent restoration, including implantation and prosthetics. In some cases, they resort to temporary prosthetics.
Sparing or atraumatic tooth extraction
In family dentistry “Your Dentist” in Odessa, surgical procedures of any complexity are performed. Including atraumatic tooth extraction.
Habitual removal “in one motion” puts pressure on the bone, can lead to malnutrition of bone and soft tissues, as a result – to bone atrophy. Meanwhile, for the subsequent restoration of the tooth, it is important that the bone around the hole is preserved in the maximum volume.
When the surgeon separates all the roots, carefully saws the tooth and removes it step by step, the operation is less traumatic, the bone tissue is preserved, and the wound always heals faster. Such extraction of teeth takes more time, but it creates optimal conditions for subsequent implantation and prosthetics.
Extraction of wisdom teeth
No matter how masterly a tooth is treated, there are situations when it is not worth fighting for it. Often this applies to wisdom teeth, in another way – third molars or eights. If they are located incorrectly, harm the adjacent teeth and soft tissues, provoke the accumulation of plaque, then, most likely, they must be removed.
An interesting fact is that one in ten people do not have wisdom teeth at all. And this does not in any way determine the level of knowledge and experience of a person: just wisdom teeth are a rudimentary organ. Initially, they were intended so that a person could chew solid food in large quantities.
Historically, it turns out that from generation to generation, people’s food becomes softer. Without stimulation, the size of the jawbone and the muscle mass of the masticatory apparatus gradually decreased during evolution. Therefore, the volume of the jaw of a modern person does not allow full placement of wisdom teeth. Hence their peculiarity – pathological eruption, which complicates the life of their owners.
Wisdom teeth erupt arbitrarily in different directions, and they can partially come out or not come out at all.
Incorrect eruption of wisdom teeth occurs due to the fact that there is not enough space in the dental arch for their development, they are often interfered with by adjacent teeth, and therefore the wisdom teeth cannot take a normal, vertical position.
A deformed tooth can cause various inflammatory processes in the entire oral cavity, harming adjacent teeth, and forming an incorrect bite.
The main reasons for the removal of wisdom teeth are their topographically incorrect location, retention and semi-retention. Most often, wisdom teeth begin to bother because of semi-retention – incomplete eruption. Semi-retention becomes the cause of many dental diseases: caries, pulpitis, periodontitis and others.
Retention is a complete non-eruption of a wisdom tooth. Such a tooth is not visible in the mouth, however, it causes severe pain.
Wisdom teeth are often removed before their root system is fully formed: a tooth with a formed root is more difficult to remove. However, it is necessary to remove them or not – the doctor decides on an individual basis.
Direct indications for the removal of wisdom teeth:
- Deep caries of the wisdom tooth that does not respond to treatment
The process of appearance of wisdom teeth takes a long time, and often they are affected by caries even before they completely erupt. Treatment of these teeth is problematic: access to them is difficult, the need to keep the mouth wide open during the treatment procedure causes discomfort and even a gag reflex in many patients.
Therefore, if the doctor sees that the tooth has deep damage as a result of caries, treatment in a particular case is difficult and as a result, a relapse of the disease will still occur – a decision is made to remove the wisdom tooth.
- The wisdom tooth is the cause of poor oral hygiene
There are situations when a tooth partially erupted and stops. Such a tooth is covered from above with soft tissues – in medical slang, a “hood”, which is a flap of mucous membrane not attached to the bone. Saliva, a soft plaque constantly accumulates under the hood. This stagnant mixture cannot be completely washed, cleaned or rinsed out – then inflammation of the “hood” develops – pericoronaritis (the so-called inflammation of the gum tissue surrounding the wisdom teeth).
In this situation, the doctor needs to make a correct prognosis and choose a treatment method. Sometimes with pericoronaritis they resort to excision of soft tissues (“hood”). However, if the wisdom tooth is initially located incorrectly and does not participate in the act of chewing, then in the future there will be more problems than benefits from it, and it is better to remove it immediately.
It happens that a periodontal pocket (a gap between the gum tissue and the tooth) forms between the wisdom tooth and the adjacent tooth, which cannot be cleaned with high quality, food constantly accumulates there, which causes bad breath. Periodic inflammation of the periodontal pocket around the wisdom tooth is also the reason for its removal.
- The wisdom tooth is the cause of odontogenic inflammation (i.e. inflammation due to the tooth)
The specific location of the wisdom teeth (in particular, the upper ones) is that their roots are close to the bottom of the maxillary sinuses. Therefore, unilateral sinusitis often develops over the inflamed tooth, which can quickly spread to the adjacent sinus.
If, due to inflammation of the upper wisdom tooth, the so-called odontogenic sinusitis occurs – in such cases, a decision is also made to remove the tooth. But the inflammatory process in the lower wisdom teeth, which are located in close proximity to the 3rd branch of the trigeminal nerve, can cause neuritis.
- The wisdom tooth disturbs and causes malocclusion
Special problems with a wisdom tooth are associated with the fact that if it is not properly positioned, it can deform the bite. When the wisdom tooth begins to erupt, all teeth are already formed, and are a part of permanent bite. A wisdom tooth located horizontally or at an angle (incorrect orientation of the tooth in the bone) is called “dystopia”) presses on the adjacent teeth and causes them to shift. In this case, you need to see a doctor who determines the future prognosis and the fate of the wisdom tooth.
Sometimes the wisdom teeth come out on the side of the gums – in this case, while eating, the patient will bite his cheek or the tooth will rub his cheek. The daily hygiene of such a tooth becomes more complicated: it is difficult to clean it from food debris, and therefore it is highly susceptible to caries. As a rule, if not removed in a planned manner, such a tooth is removed when pulpitis develops in it.
Factors that ensure a stable position of the tooth: firstly, a fully formed, attached mucous membrane around the tooth provides it with a stable position. The second point is that the tooth must be a full-fledged functional unit, that is, it must participate in the process of chewing food. And thirdly, the area around the wisdom tooth should be cleaned efficiently. If these factors are absent, the wisdom tooth is recommended for removal.
Simple and complex wisdom tooth extraction
There are differences in the method of tooth extraction at different stages, when the wisdom tooth has not erupted, the tooth has erupted partially and the tooth has erupted completely.
The method of removing a wisdom tooth, like any other tooth, is selected individually for a particular patient. When talking about a fully erupted wisdom tooth, it can be a simple, simple extraction. First, the tooth is gently loosened and then removed. Special care must be taken, as the wisdom tooth usually lacks space in the jawbone and its roots can be bent in different directions. Therefore, there is a possibility of breaking the roots and thus complicating the removal task.
Complicated wisdom tooth extraction is foreseen if the tooth has not erupted or has not erupted completely. First of all, the doctor determines the cause of the pathology. One of the options: the tooth does not have enough space in the jawbone – the tooth grows relatively evenly, but is covered with a “hood”. In this case, the doctor cuts through the soft tissues (makes a hood cut), gently exfoliates the gum, removes the tooth, cleans the hole and sutures. This happens in the case of a planned removal of the lower and upper wisdom teeth without an inflammatory background.
If the tooth has not erupted at all, the doctor determines its location based on the data of an X-ray or tomograph. Then the mucous membrane is cut, the tooth is carefully sawn into pieces and removed piece by piece. It is important not to damage the jawbone and the adjacent tooth.
Sometimes, when a tooth is located in the bone, and it cannot be cut into pieces, a small fragment of the bone is cut out and the tooth is removed through the resulting bone window. After such extractions, the hole is usually filled with an osteoplastic tongue and sutured.
Removal of milk teeth
Milk teeth should not be pulled out at home – just like permanent teeth, they should be removed in the dentist’s office. The indications for tooth extraction in children can be carious destruction, dental injuries, acute inflammation. In addition, milk teeth must be removed when they cannot fall out on their own, interfere with the eruption of permanent teeth and cause discomfort in the child.
The formation of bite and the health of molars depend on milk teeth, therefore, the pathology of such teeth cannot be ignored. In addition, dental diseases develop faster in children than in adults.
Milk teeth are rarely removed. Nevertheless, sometimes removal is still required, so the specialists of «Your Dentist» family dentistry are constantly working to ensure that the little patients in the dentist’s chair are not afraid.
Frequently asked questions
You probably care about questions that other patients have already asked. Look through the answers to them, but if you still have doubts –
just contact us!
- Can teeth be removed during pregnancy?
Dental treatment during pregnancy raises many questions and misconceptions. It is certainly good if a woman visits the dentist at the stage of pregnancy planning. But very often the need for dental treatment occurs during pregnancy. All the same injuries and inflammations require an immediate visit to the dentist, and therefore – treatment or tooth extraction.
At the same time, you should not be afraid of anesthesia – modern methods can be used during pregnancy.
The optimal time for dental care in such cases is the second trimester, from 14 to 25 weeks. At this time, the treatment is as safe as possible and is carried out on an outpatient basis, in the usual conditions. And if it is possible and necessary to have oral hygiene during pregnancy, there are reservations for treatment and removal. In the early stages of pregnancy, treatment is not recommended, in the later stages it is carried out only in emergency cases and, if necessary, in a hospital.
- What are the complications of tooth extraction?
If a tooth is extracted in a typical way, bone tissue can be injured. After pulling out teeth, the mucous membrane may suffer, and the hole will heal for a long time and painfully.
Another option for complications is a tooth that is not completely removed. To avoid such complications, it is important to carefully choose a clinic: be guided by reviews, the experience of specialists, give preference to the one where they will not save on materials and equipment.
A common complication after tooth extraction is alveolitis, infection and inflammation of the tooth socket. Alveolitis develops due to improper oral care after surgery. After removal, a blood clot forms in the socket, which contributes to normal healing. If the clot has not formed or the patient is actively rinsing the oral cavity, washes out the clot, violates oral hygiene, then the wound becomes infected, and alveolitis begins. In this case, it is imperative that you contact your dentist to sanitize the hole.
Any surgical operation, including tooth extraction, has risks of complications. However, delaying the removal, asking the dentist to put a filling is not the best solution. Refusal to remove teeth can lead to more serious consequences, both local and general, while competent tooth extraction ends with restoration with the help of prosthetics.
- What complications are possible after a wisdom tooth extraction?
Postoperative events include: cheek edema, which usually subsides on the third day; pain when opening the mouth is normal after the removal of a wisdom tooth in the lower jaw and should not be feared. The upper wisdom tooth, removed without any complications, does not give edema.
After the operation, it is recommended: take food no earlier than 2 hours later, avoid hot meals, avoid physical activity for a week, take medications prescribed by your doctor, including antibiotics, if necessary.
Complete healing takes from 1-2 weeks and longer – when the lower wisdom tooth is removed, up to 1 week – when the upper wisdom tooth is removed.
- Is it painful to remove wisdom teeth?
Extraction of a wisdom tooth usually takes place with the use of local anesthesia. Modern drugs make it painless for the patient. If there is a difficult and long-term removal of patients who are allergic to standard drugs for anesthesia, anesthesia can be applied when removing a wisdom tooth – sedation or general anesthesia. In the first case, the patient is immersed in medication sleep, in the other, the patient’s consciousness is completely turned off.
- What kind of diagnostic and pre-preparation is done before removing wisdom teeth?
A panoramic image of the teeth is taken (orthopantomogram). In case of incorrect tooth location and a complicated situation (in particular, the presence of pathological formations, the proximity of the wisdom tooth to the mandibular canal, in which the trigeminal nerve is used, and so on), assign a CT scan of this segment.
- Are there any contraindications for wisdom teeth extraction?
Contraindications of the following:
- The location of the tooth in the tumor area;
- Diseases of the blood;
- General somatic diseases (severe forms of diabetes mellitus, exhaustion of the body, immunopathological conditions).
Extraction of teeth in patients with such diagnoses takes place only in a hospital or in special medical institutions.
The patient’s age is not a limitation for wisdom tooth extraction. In this case, it is just necessary to take into account whether it is too early to remove wisdom teeth. Because the removal of a located wisdom tooth germ (follicles) can be more traumatic than the planned removal of an already formed wisdom tooth.
- What is the cost of removing a wisdom tooth?
The price of the wisdom tooth extraction service is determined individually and depends on several factors: the method of anesthesia, the method of removal, the complexity of the operation, the need to use additional materials and drugs. The average cost is considered from 700 UAH.
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