Tooth extraction is a procedure where you have a tooth pulled out by a dentist. Once the tooth is pulled out, you have to seek some other treatment to fill the space. If you don’t fill the extracted space, the gum in that space will start to shrink. Later on, this will create problems in that area as well as to the adjacent and opposing teeth.
What are the causes for Dental Extractions?
1. Hole in the tooth : When you have decay, it usually starts as a pinpoint hole. Generally, you won’t be able to see small cavities. If left untreated, cavities will become large and eventually reach the nerve or pulp. Once the pulp or nerve becomes infected, you will have a toothache. Toothache can be a mild pain, a dull pain or a throbbing pain. The severity of the infection will determine the type of pain.
2. Advanced Gum disease : In later stages of gum disease, teeth will lose their bone support. In these cases, teeth will become very wobbly, and you may also have very sore teeth or gums. Sometimes you may get a gum abscess. This will cause severe pain in the gum area. If the dentist can’t save the tooth they will need to pull it out.
3. Very loose tooth : Accidents and sports-related injuries are the most common cause. The dental professional will splint the teeth using wires or use some filling material. Sometimes the infection under the root will cause the teeth to become loose.
4. Baby teeth : When permanent teeth come through, the baby teeth will become loose, but at times will not fall out. This can cause a lot of pain.
5. Badly broken down tooth : This is usually due to decay. You can save it by doing root canal treatment, otherwise, extraction is the best option.
6. Extra teeth : This can create crowding which leads to gum disease and decay in the mouth.
7. Braces or orthodontic treatment : Some children may get crowding of teeth in the mouth. The dentist will extract some teeth if there is not enough space for the other teeth.
8. Broken tooth or fractured teeth roots : If the fractured tooth or root surface is below the gum margin, and unrestorable, the dentist may need to remove it. Severe night time grinding may also be the cause of a fractured tooth.
9. Resorbed roots : Teeth roots may become resorbed or lost as a result of accidents or trauma, extensive dental infections, or any other dental lesions. We might not be able to save the tooth.
10. Impacted tooth : Impacted wisdom teeth are the most common cause of infection, pain and swelling. In some instances, patients are unable to open their mouth.
11. Radiation therapy : If the radiation involves the jaw area, the dentist may need to extract teeth in this section of the jaw before the radiation therapy starts. This will depend on the severity and duration of the radiation therapy
If you have a toothache, our gentle Bendigo dentist will assess your teeth and take a small digital dental x-ray. This will show the infection or problem underneath the gum and severity of the disease. The dental x-ray will also show the shape and size of the roots.
Types of extraction:
If we can’t save the tooth, our dentists will then decide whether you need a standard extraction or surgical extraction.
1. Standard dental extractions: The dental professional will extract the tooth while you are in the dental chair. They use local anaesthesia to make sure the extraction area is numb and there is no discomfort.
2. Surgical extractions: Where the dentist makes a small cut to the gum, removes a little bit of bone or cuts the tooth into sections to remove it. The gum is stitched after the procedure.
Reasons for surgical extractions:
- If the crown of the tooth is severly broken down and the dental professional can’t get a good grip to pull it out.
- Curved, bulged or long roots.
- The tooth is impacted and buried deep in the bone – gum and bone are cut out while we do the extraction.
- If teeth are too close together and crowded and there is not enough room to fit the extraction tools.
- If the bone is thick and dense.
Dentists can do both types of extraction while you’re seated in the dental chair and awake or under general anaesthesia at the hospital. If it is at the hospital, it will be a day surgery procedure. The anaesthetist will put you to sleep while the dentist removes the tooth. After you wake up, you leave the hospital on the same day.
In some instances, the dentist won’t be able to take out the tooth. In this situation, they will refer you to the oral and maxilla facial surgeon.
Many patients are nervous or worried about extractions. If you are very nervous, we have “happy gas” available at our practice to keep you calm and happy. If you would like to have your dental extractions under happy gas, please call our Bendigo dentist on 5442 2012.
What are problems after dental extractions?
In most cases, there won’t be any complications and the gum area from where the tooth was extracted will heal. In some instances the following may occur:
Bone infection or dry socket — after the extraction, blood will clot in the socket as part of the natural healing process. If the blood clot gets removed by vigorous rinsing of the mouth or infection, bacteria will enter into the exposed bone. This will cause infection under the bone area. The technical name for this is “dry socket”. Dry socket is more painful than a regular toothache. Smokers are more prone to get dry socket.
Infection after extraction — Usually, after the tooth is taken out, your defence mechanism will remove the infection. If the infection is large, the extracted socket area may become very sore. If an infection is the cause of your pain, we need to treat it.
Severe infection — in most cases the infection will drain from the extracted socket. Sometimes the infection may flare up, and you may need a course of medication.
Delayed healing — smoking and infection will delay the wound healing process.
Bleeding excessively after extraction — our gentle and caring dentist will give you instructions on how to prevent excessive bleeding. We recommend following the instructions carefully.
Bruising — If you have a bruised cheek or chin don’t panic. It will heal and disappear after 3-6 weeks.
Nerve damage in the lower jaw and sinus exposure in the upper jaw — The dentist will take dental x-rays before the procedure. This will show them the nerve and sinus in relation to the roots. If the tooth is close to the nerve or sinus, they will refer you to an Oral Surgeon.
Unable to open the mouth or trismus — The dental term for unable to open the mouth or limited opening of the mouth is called trismus. Due to swelling of the tissue or infection, you may have to take some medication.
When a tooth cannot be taken out:
- Some medications will prevent clotting of blood. If you take a high concentration of blood thinning medication or anticoagulants, see your GP or specialist for advice before the extraction.
- If you are on Bisphosphonate medication, healing might not take place. You’ll need to see your specialist and get advice before extractions.
- After high doses of radiation therapy in the jaws, healing may not take place.
- Pregnancy – it is better to avoid extractions during early and later stages of pregnancy. If you require an extraction, our staff will take extra measures.
- Some medical conditions – you will not be able to have an extraction if you have certain medical conditions. Your GP or specialist will be able to advise you.
- If you have certain heart or valve conditions, you may have to take antibiotics before the extraction.
- If we can’t take out the tooth, the only option is nerve filling or root canal filling.
A gap will form after dental extractions. Options to fill the empty space are:
1. Partial or Full Denture— A partial denture can be either plastic (acrylic) or metal. We make a complete denture using a special plastic.
2. Dental Bridge— Attachments and porcelain crowns are joined together in the dental lab to make a bridge unit. Then the dentist glues the attachments on the adjacent teeth next to the gap area.
3. Dental Implant– An implant is a titanium screw fixed in the bone, and a porcelain crown is then placed on top.