Normally, dentists do everything to keep a tooth as long as possible. But sometimes it is necessary to extract teeth for various reasons.
What is extraction?
Extraction refers to the mechanical pulling of a tooth out of the jaw without any other surgical procedures. The medical term extraction comes from the Latin word “extrahere” meaning to pull out. Extraction is one of the most common surgical procedures in dentistry. Extraction means the mechanical pulling out of a tooth from the jaw without further surgical procedures. However, the tooth is not pulled out directly, but after local anesthesia, it is first loosened in the gums with the help of various dental instruments, then carefully moved back and forth several times, and only after sufficient mobilization is it grasped with special forceps and removed from the jaw. One of the most common extractions in a dental office is the removal of wisdom teeth. Due to special circumstances, it may sometimes be necessary to surgically remove teeth under general anesthesia.
Function, effect and goals
There are several factors why a tooth can no longer be retained and must be extracted, such as to make room for other teeth, as is often the case with orthodontic procedures. The most common reasons why teeth need to be extracted are.
- Severely loosened teeth (e.g., due to periodontitis).
- Inflammation in the root of the tooth or in the periodontium in periodontitis.
- Longitudinal or transverse fractures in tooth crowns or roots.
- Teeth displaced in the jaw, causing discomfort and possibly interfering with other teeth
- Space reasons for orthodontic treatment
- Too many teeth in the jaw
- Root canal treatment does not eliminate the discomfort
- Caries at the root of the tooth with possible cyst formation.
- Extreme destruction of the hard substance of a tooth
- Compensation for missing teeth in the opposing jaw to avoid a malocclusion.
Before an extraction, if not already done, an x-ray is taken in the dental office and the patient is informed about the risks and behavior during a tooth extraction. In many cases, patients take an antibiotic a few days before and after the procedure to prevent infections. Before the tooth is extracted, the patient is given a local anesthetic. For teeth in the upper jaw, this is done by infiltration anesthesia in several places in the area of the tooth in question. For teeth in the lower jaw, a conduction anesthesia is performed, in which the anesthetic is injected into a conduction pathway of the mandibular nerve. This numbs the half where the tooth to be extracted is located. Once the tooth is sufficiently anesthetized, it must first be mobilized before it can be removed from the jaw. To do this, the dentist uses levers and forceps to slowly release the tooth. Through the movement, he notices on which side the tooth gives way. After sufficient loosening, the tooth is removed from the jaw with forceps. Because extraction injures blood vessels in the gums, the wound bleeds after the procedure and the patient must bite down on a sterile swab for 10 to 30 minutes to stop the bleeding. If necessary, he may be prescribed a painkiller if he does not have one at home. In the days following the procedure, the wound healing is checked again. In case of unfavorable conditions, teeth sometimes have to be operated out and the wound sutured afterwards. Wisdom teeth that have not yet erupted are often operated on in this way.
Risks, side effects and dangers
In most cases, tooth extraction proceeds without problems and the wound heals after a few days. Patients can do a few things to help prevent complications. After the extraction, the cheek should be cooled regularly with cold packs or washcloths for the first 24 hours to prevent swelling. Eating should be delayed until the anesthesia wears off. As long as the wound has not healed properly, soft food is better, preferably no grains. Teeth can be brushed normally except for the wound. If you use an oral irrigator, do not rinse in the wound area, otherwise a wound plug cannot form.Dairy products should be restricted during the wound healing period because lactic acid bacteria can prevent the wound plug, which is important for healing. Due to increased bleeding tendencies and the possibility of secondary bleeding, coffee, alcohol and cigarette consumption should be limited on the day of extraction and, if possible, the day after. Sports and strenuous physical work should also be avoided. If there is major post-extraction bleeding, the dentist should be consulted. Pain approximately 3 days after extraction may be a sign of alveolitis sicca. The most common complications that can occur include breaking of decayed teeth during the procedure, associated with the risk of injury from the tooth chips. If tooth chips are missed, purulent infections can form. If the jawbone is injured, inflammation of the jawbone may occur. If blood thinners are taken, there is a risk of bleeding. Injury to the jawbone due to extraction can cause instability of the denture in denture wearers. In difficult conditions, adjacent teeth may be injured. Complaints should have improved no later than 3 to 5 days after tooth extraction.
