What is tooth extraction?
Tooth extraction is an ancient method of treatment. There are already records of tooth extraction from the first century of our era.
A distinction is made between simple tooth extraction and surgical tooth removal. The latter is performed only in complicated cases, for example, removal of wisdom teeth. The cost of tooth extraction is covered by health insurance.
When do you have to pull a tooth?
In principle, the so-called preservation principle applies to tooth extraction: a tooth should only be extracted if it can no longer be preserved with all other methods (such as root canal treatment or root apex resection) or if preservation would not be sensible or would be harmful.
There are various reasons (indications) for tooth extraction:
Loose or damaged tooth
Lack of space
Congenital malocclusions of the jaw can cause crowding of the teeth. In this case, the extraction of healthy teeth can create space for the remaining teeth. Usually the so-called “extraction therapy according to Hotz” is applied.
Prevention
Under certain circumstances, teeth are extracted as a preventive measure – to prevent these teeth from becoming infected and aggravating an existing disease or making treatment more difficult. This applies, for example, to the following cases:
- Organ transplants: Tooth germs can cause rejection of the transplant here.
- Chemotherapy or radiation therapy: protection against radiation-induced tooth damage (osteoradionecrosis)
- Heart valve replacement: tooth extraction prevents endocarditis, which is often caused by tooth germs.
Tooth extraction is usually not possible for patients who are not allowed to undergo surgery due to a medical condition. These include, for example, the following clinical pictures:
- suppressed immune system (immunosuppression)
- bleeding tendency
- acute inflammations or tumors in the surgical area
- allergy or intolerance to the anesthetic used (local anesthetic)
How does tooth extraction work?
Your dentist will first explain the procedure to you. He will inform you about possible alternatives, the procedure of the tooth extraction, possible complications and the subsequent treatment. In addition, the dentist will ask you about your age, underlying diseases, medication or possible allergies.
He will then thoroughly examine the affected tooth and the condition of the rest of your dentition. An x-ray of your dentition will also be taken. For anxious patients, the dentist may give a sedative for further treatment.
Anesthesia for tooth extraction
Tooth extraction procedure
To extract a tooth, the dentist uses various levers and forceps – depending on whether the tooth is already loose or still firmly anchored. If the dentist uses a scalpel, the oral cavity should be thoroughly disinfected beforehand and the surrounding area covered with sterile cloths.
Once the tooth has been removed, the wound is closed. In most cases, tightly squeezing the gap between the teeth with a swab is sufficient. Suturing of the wound is usually only necessary after surgical tooth extraction.
What are the risks of tooth extraction?
Tooth extraction is in most cases without complications – 90 percent of the procedures are successfully completed within five minutes. Despite all this, complications can occur. These include:
- accidental injection of the anesthetic into a blood vessel (risk of severe side effects)
- fracture of the tooth crown or root
- swelling or bruising
- Opening of the maxillary sinus
- Inhalation or swallowing of tooth parts
- Infection or bleeding
Endocarditis (inflammation of the inner lining of the heart)
Procedures in the oral cavity can cause inflammation of the inner lining of the heart. This is especially true for people with congenital heart defects or patients with heart valve replacements. These “risk patients” are therefore given so-called endocarditis prophylaxis as a preventive measure – antibiotics administered before the dental procedure to reduce the risk of infection.
What do I have to pay attention to after tooth extraction?
- After tooth extraction, you should take it easy and avoid physical exertion.
- You can eat and drink again as soon as the anesthesia has worn off. However, be careful of the affected tooth area (for example, chew your food in your left cheek if a tooth has been extracted from your right cheek).
- You should refrain from smoking, coffee and alcohol until the day after the tooth extraction.
If the pain still persists a few days after the tooth extraction, the swelling does not decrease and/or increased post-operative bleeding occurs, you should visit your dentist again.
