Surgical Treatments

Extractions

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What Is a tooth extraction?

This is the full removal of a tooth which is a routine procedure. This is normally the last resort after other options have already been explored.

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Why might I need a tooth extraction?
There are a number of reasons to have a tooth removed:

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• The tooth is abscessed and root canal treatment isn’t an option

• The tooth is broken beyond repair

• Gum disease

• The tooth is required to be removed in order to be able to have braces.

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What happens during the extraction procedure?

The tooth will normally be numbed with an injection of local anaesthetic. Taking a tooth out can either be really quick or it can sometimes take as long as 30 minutes. This all depends on what state the tooth is in prior to having it removed. Various instruments are used to rock the tooth forwards and backwards to loosen it and you will feel quite a lot of pressure. This process isn’t painful but it may feel strange and there may be some strange cracking noises which is all perfectly normal. Once the tooth has been removed a small piece of gauze will be placed over the socket and you will be asked to bite down hard on this to apply pressure in order to stop the bleeding so a clot can be formed.

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What are the risks?
Frequently occurring problems:

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• Bleeding

• Swelling

• Pain

• Failure of local anaesthetic

• Bruising

• Infection (dry socket)

• Breakage of the tooth or root

• Limited opening or stiffness of the jaw

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Other less common complications:

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• A hole into the sinus that may need surgical repair

• Displacement of the tooth into the sinus or fracture of the tuberosity (bone next to the top

  back tooth).

• Nerve damage leading to altered sensation or numbness of your lip, teeth, tongue or gums. You may feel some numbness over your face or within your mouth due to a bruised nerve. This usually goes away on its own, but it can take a few months.

• Retained root which, after discussion, may be best left in place.

What are the after effects of having a tooth out?

After a dental extraction patients will normally get some pain and discomfort, so you will be advised of appropriate painkillers. Some swelling and bruising may occur which is usually worse 48 hours after the procedure. Infection can occur after any extraction and if this occurs you may need some simple treatment with a dentist to relieve this.

Please note that smoking can affect the healing after an extraction and we would advise you that stopping smoking before and after an extraction can reduce the chances of infection.

Some teeth are more complicated than others and your dentist will advise you if you have any concerns about your extraction. This may be due to the unusual shape of the roots or the position in your mouth. In most cases the procedure is completely simple and successful, but on some occasions the process may be more complicated e.g., if the tooth breaks.

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Will my gum need to be cut?

Sometimes teeth can break because they are fragile, or the roots are quite thin, or they have large fillings in them. When this occurs, the gum may need to be cut and lifted so that we can see more clearly. Sometimes drilling a small amount of bone away, and perhaps even cutting the tooth into small pieces, is necessary. This procedure may take a little bit longer than expected and there may be more swelling afterwards. Usually, you will have some stitches in your mouth that normally dissolve, but can take a few weeks to do so.

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What will happen about missing tooth/teeth?

Not all extracted teeth need to be replaced. If you are already wearing dentures, then an addition to the existing denture may be possible. Other options may include bridges or implants. As every case is different, this discussion should take place with your dentist.