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Extractions

Tooth eruption is nothing but the process in which the tooth travels from beneath the jaws to enter the mouth and become visible to us. A tooth is called “impacted” if its path is obstructed by any other tooth, bone or soft tissue.

Depending upon the position of the impacted tooth inside the jawbone, there are four types of impaction:

  • Mesial Impaction
  • Vertical Impaction
  • Horizontal Impaction
  • Distal Impaction

An impacted wisdom tooth may cause gum swelling in the back of your mouth, difficulty or pain in opening your jaw, bad breath, bad taste in the mouth, and pain while chewing or biting.

X-rays of the wisdom teeth are taken to assess the positions, shapes and sizes of the tooth, the covering bone and the nerve. X-rays also locate cysts or tumours that may be associated with the tooth and to assist the surgeon to plan the surgical procedure.

In cases where there is sufficient space for the teeth to erupt such as with soft-tissue impaction, then a pericoronal flap excision is done. The second option is surgical removal of impacted third molars between ages 16-20 if it is found that there is no space for them to erupt.

  • Antibiotics and anti-inflammatory drugs are given to eliminate infection in the area
  • It is a minor surgical procedure lasting 20-45 minutes
  • The procedure is done under local anaesthesia
  • An incision is made to open up the flap
  • The bone covering the tooth is cut to expose the tooth crown
  • The tooth is removed either in whole or by cutting it into pieces and removing the pieces out
  • Surgical wound is sutured
  • Removal of the stitch after a week

Risks and Complications

Complications or risks associated with surgical removal include pain, swelling, infection, and bleeding.

Post-operative Instructions

  • Use ice pack covered in a towel and place it on operated area from the outside (on the cheek) to reduce swelling
  • Bite down onto a clean gauze piece with pressure to stop bleeding
  • Eat soft food and drink lots of liquids
  • Brush your teeth gently in the area during the first few days after the surgery
  • Take prescribed medications and follow all instructions given from your surgeon

Routine Extractions

Routine extractions may be needed for resolving various dental problems that require one or more teeth to be extracted as a part of the treatment. Teeth may need to be extracted when it becomes difficult to restore or maintain them in the mouth. Your dentist may suggest extracting the tooth to improve the overall health of your oral cavity. Various issues that may need routine teeth extractions include:

  • Severe tooth decay that affects the underlying nerve
  • Periodontal disease causing loss of bone and tissue supporting the tooth
  • Tooth trauma causing irreparable damage
  • Improperly positioned or overcrowding of teeth in the mouth

During the procedure, your dentist will numb the tooth and surrounding area, loosen it and extract it from the mouth with dental tools. Sometimes, the surrounding bone may have to be removed for making the process of tooth extraction easier. You may experience some minimal bleeding which will be controlled before you leave the dentist’s office.

Following the procedure, you may experience soreness, pain and inflammation. Your dentist will prescribe medications to relieve your discomfort. You should avoid disturbing the blood clot within the socket. If it is disturbed, it may cause a painful condition called a ‘dry socket’. The site of the tooth extraction heals overtime within a few weeks.

Seriously Decayed Teeth

Dental caries is the most common disease or disorder occurring in the oral cavity. The microorganisms along with food particles present in the mouth lead to dental caries. It is also known as “Tooth Decay” or “Cavities”. This disease can lead to pain, infection, and tooth loss.

The problem of tooth decay can be corrected with root canal therapy (RCT). But, a severely infected tooth not responding to antibiotics or RCT may require tooth extraction to avoid the spread of infection. Loss of a tooth may affect the function of the surrounding teeth, thus your dentist will replace the extracted tooth with a dental bridge, implant or partial denture to maintain the function of surrounding teeth.

Teeth with Bone Loss due to Periodontal Disease

Periodontal disease or gum disease is a bacterial infection affecting the gums, the surrounding bone and other tissues supporting the teeth. This leads to formation of a pocket around the tooth. Initial stages of gum disease is called gingivitis in which the gums swell, bleed and redden. If not treated in time, gingivitis may progress to periodontitis. The tooth pocket resulting from periodontal disease destroys the underlying bone and tissues surrounding the tooth, thereby loosening the tooth structure. This condition needs extraction of the infected tooth in order to prevent spread of infection to the surrounding structures.

Your dentist will extract the tooth under the effect of local anaesthesia. If several infected teeth need to be removed at the same time, a general anaesthesia may be required. After the tooth is removed, your dentist may suture and place a gauzepad to stop bleeding. A dental bridge or an implant is placed after the tooth is extracted. Do not delay tooth extraction if gum disease is present, as it may lead to loss of more teeth due to the spread of the infection.

Serious Malocclusion

Malocclusion is the technical term for teeth that don’t fit together correctly. Malocclusions not only affect the teeth, but also the appearance of the face. Most malocclusions are inherited; however some are due to acquired habits such as thumb sucking and tongue thrusting. The spacing left from an adult tooth being extracted or an early loss of a baby tooth can also contribute to a malocclusion.

Among various treatment options for malocclusion, tooth extraction is one useful option for treating crowding of teeth in adults and children. Your dentist extracts the teeth so that more space is created for the incoming teeth to help improper teeth alignment. In children, either baby teeth or permanent teeth are extracted to make room for the teeth that are erupting. Tooth extraction can also help improve alignment of the upper and lower jaws in adults.

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