Definition
Tooth extraction is the non-surgical removal of a tooth from the oral cavity, which means that the dentist does not have to make an incision in the mucous membrane with a scalpel. Colloquially, the whole thing is also called tooth extraction.
Causes – An overview
Tooth extractions are the last resort when everything else has already been tried. So the dentist will always try to save the tooth in question first and only when all other means of treatment have been exhausted will he resort to forceps. Reasons for a tooth extraction can be
- Deep caries with extensive destruction of the tooth structure (cannot be filled and cannot be crowned)
- Heavily broken teeth
- Broken root
- Severe inflammation of the tooth root, where all other treatment attempts failed
- Lack of space in the jaw (jaw tightness)
- Very high degree of loosening (tooth can already be moved with tongue contact)
Causes in detail
Tooth extraction is always absolutely necessary when the tooth has been so badly destroyed by caries that neither fillings nor crowns can be anchored. In order to be able to fix a crown securely on a tooth, you need enough remaining tooth and also the caries must not reach too deep into the gums. In case of deep caries, it cannot be ensured that no bacteria are trapped under the crown when fixing the crown.
These can destroy the tooth unnoticed from the outside to the inside. Even if the root of the tooth is broken apart or has a longitudinal crack, this tooth can only be removed. The root holds the tooth in the jawbone and ensures that you can chew normally.
The whole system becomes very unstable once the root wall is damaged. Broken teeth, or broken crowns, can sometimes not be reattached. The remaining root in the oral cavity is often removed to prevent infection or to make room for an implant.
The remaining root can also be root canal treated if it does not have a longitudinal fracture. In this case, the remaining nerve, blood vessels and invading bacteria are removed and an antibacterial filling material is placed in the cleaned canal instead. The remaining root canal treated in this way can now be used as an anchorage for a crown with post build-up.
A post is cemented into the root and a custom-made crown is placed on this post. This is not always possible. The dentist must decide on site whether this treatment is a possibility or not.
Decisive factors are, among others, x-ray image, fracture location and periodontal conditions. Crowns and also root canal treatment are very expensive and the costs are rarely completely covered by both statutory and private health insurance. Not every patient is able to pay for the required crown or root canal treatment.
In this case, the tooth in question is removed by the dentist. If the tooth is simply left in the oral cavity, an inflammation develops and the resulting pus leads to blood poisoning. If a tooth has already become so inflamed that a very severe apical periodontitis has developed, which cannot be eliminated even with a root canal treatment, a tooth extraction is considered.
Apical periodontitis refers to an inflammation of the tooth root at the root tip. A large amount of pus usually forms, which then exerts pressure on the tooth nerve, causing massive pain. If the inflammation is still in its early stages, an attempt is made to remove the focus of the inflammation with a root canal treatment.
If the periodontitis has already spread too far, sometimes an attempt is made to save the tooth by a root tip resection. An oral surgeon removes a small bone window over the diseased tooth and cuts the inflamed root tip. Sometimes the chances of success are small compared to the risk of the operation.
Patients with heart problems can often not be sufficiently anesthetized or wound healing is hindered in some cases. In these cases, tooth extraction is more appropriate than surgery. Weighing up the risks against the probability of success of the operation decides on the further therapy.If the decision is made in favor of apicoectomy, the oral surgeon will perform it in a specially equipped practice.
In some patients, especially children, it is found that the jaw is too small for all 16 teeth. In this case, the orthodontist orders the strategic removal of one tooth to make room for all the other teeth. If this does not happen, the teeth in the jaws will slide over each other and the result will be crooked and crooked teeth.
Of course, tooth extraction is the last resort in this case as well. The orthodontist first has to make sure that even with braces there is not enough space for all teeth. Only when this has been determined, a tooth is removed and the braces are used to move the remaining teeth to the right place.
In the context of orthodontic treatment, sometimes the term “compensatory extraction” is used. This means that a tooth in the opposite row of teeth is also removed to ensure that the patient can bite properly. The occlusion is restored.
This becomes necessary, for example, if somewhere a tooth is not attached or had to be extracted to make room, or if it would shift the center line between the incisors from the center of the face. If the periodontitis has already spread too far, sometimes an attempt is made to save the tooth by a root tip resection. An oral surgeon removes a small bone window over the diseased tooth and cuts the inflamed root tip.
Sometimes the chances of success are small compared to the risk of the operation. Patients with heart problems can often not be sufficiently anesthetized or wound healing is hindered in some cases. In these cases, tooth extraction is more appropriate than surgery.
Weighing up the risks against the probability of success of the operation decides on the further therapy. If the decision is made in favor of apicoectomy, the oral surgeon will perform it in a specially equipped practice. In some patients, especially children, it is found that the jaw is too small for all 16 teeth.
In this case, the orthodontist orders the strategic removal of one tooth to make room for all the other teeth. If this does not happen, the teeth in the jaws will slide over each other and the result will be crooked and crooked teeth. Of course, tooth extraction is the last resort in this case as well.
The orthodontist first has to make sure that even with braces there is not enough space for all teeth. Only when this has been determined, a tooth is removed and the braces are used to move the remaining teeth to the right place. In the context of orthodontic treatment, sometimes the term “compensatory extraction” is used.
This means that a tooth in the opposite row of teeth is also removed to ensure that the patient can bite properly. The occlusion is restored. This becomes necessary, for example, if somewhere a tooth is not attached or had to be extracted to make room, or if it would shift the center line between the incisors from the center of the face.
