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Tooth Extractions

If a tooth has become damaged or has started to decay to the point that nothing can be done to save it, the only course of action left is to remove it. A tooth extraction is a routine surgical procedure that is performed daily in surgeries up and down the land, and is most commonly used to remove teeth that have decayed due to bad oral hygiene or high decay rate. However, this is not the only reason an extraction is performed, there are other cases where it may be necessary. 

Gum disease is another result of lax oral hygiene, without treatment it can cause the gums to become swollen and recede from the teeth. Because this type of disease will compromise the structure of the teeth and their roots, an extraction is usually needed.

Extra teeth (supernumeries) or a crowded mouth might require several extractions, particularly if the patient is undergoing further orthodontics to straighten their teeth. Sometimes teeth already present can block the growth of new teeth due to impactions, these have to be removed in order to allow the teeth to grow in and develop properly.

Fractured or broken teeth represent a real risk of infection, the inner pulp of the tooth houses the root and nerve tissue and this is susceptible to bacteria if left exposed. In some cases, a root canal can be performed to try and save the tooth, followed by a crown or cap to shield from further impact. However, this is not always a viable option and it’s up to the dentist to decide if the tooth is worth saving or if the patient will stand a better chance at a swift recovery if it is taken out.

A common form of extraction is that of the impacted third molars – or wisdom teeth. An impacted molar is a tooth that partially begun to break to the surface of the soft tissue in the mouth behind the other two molars that adults grow, but hasn’t got enough room to complete the movement. There is an ongoing argument in the dentistry world that there is no need to extract the molars just because they are impacted. The process is seen as unnecessarily traumatic for the patient and there can be some serious complications such as tongue/lip numbness. Most dentists would suggest that the teeth should not be removed unless there is evidence of an infection or they are causing ongoing pain for the patient. If they are causing no pain and don’t appear to be at risk of disease, they should be left alone.

There are two types of tooth extraction; simple and surgical. Simple tooth extractions are performed under local anaesthetic and the dentist will usually only have to use instruments such as forceps to loosen the tooth and remove it. This procedure is used for teeth that have already fully formed in the mouth, and should not take longer than a few minutes to complete following local anaesthesia. Surgical extractions are slightly more complicated and – as their name suggests – more invasive in nature, they involve removing teeth that are below the gum line, either because they have been completely broken or because they have not fully erupted – as in the case of impacted molars. IV sedation is occasionally administered in these surgical extraction procedures, and then a surgical instrument is used to cut away at the gum line allow access for the tooth extraction.

As scary as these treatments may sound, most reputable dentists won’t carry them out unless they are strictly necessary and with the minimum amount of discomfort for the patient. The Pearl Dental Clinic can provide you with a top level of service if you need to have a tooth extracted, with post-surgery check-ups to make sure everything is healing well and there are no complications that require on-going treatment.

After a tooth extraction, its recommended that patients refrain from smoking for 1 week if they do smoke and to use painkillers such as Ibuprofen for a few days to combat any toothache. Antibiotics are sometimes prescribed if the extraction was a difficult extraction and there is a risk of infection. Patients should spit out any blood that comes out of the extraction socket as swallowing blood can irritate the stomach. Gentle mouth rinses with salt water should only begin 24 hours post extraction in order to allow the socket clot to stabilise first.

Occasionally post extractions, dry socket can arise and this is where the blood clot is lost too early and the socket bone is left exposed. Dry socket can be extremely painful and is more common in more difficult tooth extractions and in cases where the patient has smoked post tooth extraction. If dry socket pain does arise, please see the emergency dentist for him to dress the socket with a soothing dressing that will reduce the dry socket pain significantly.