We all have two sets of teeth, baby teeth designed to stay till early teens and permanent teeth that can last a lifetime.
Occasionally, if a tooth become damaged or decayed it may need to be removed or extracted.
What are the indications for teeth extractions?
Indications for tooth extraction includes:
- Heavily decayed or broken teeth where bacteria extended too deep into the pulp (nerve) causing infection and abscess. If infection is so severe that antibiotics or root canal treatment do not cure it, extraction may be needed to prevent the spread of infection.
- Gum disease can extend to a degree leading to the loss of the supporting bone and gum surrounding teeth making them loose.
- Extraction can be the only solution in advance gum disease
- A crowded mouth. Sometimes dentists extract teeth to prepare the mouth for orthodontics and create the needed space to realign teeth.
- Wisdom teeth sometimes has no space in the jaw to erupt and with repeated infection, tooth extraction can be the only option.
- Extra teeth or baby teeth that do not fall and prevent the eruption of permanent teeth
- Risk of infection. If your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant) even the risk of infection in a particular tooth may be reason to remove the tooth.
There are two types of extractions:
A simple extraction – this procedure is on a tooth that can be seen in the mouth or in case of extracting baby teeth or loose teeth.
A surgical extraction – this is a more complex procedure, which is used if a tooth may have broken off at the gum line or has not erupted in the mouth.
For extraction to take place, the dentist will administer local anesthesia to numb the area. Then, the dentist loosens the tooth with an instrument called an elevator. Forceps used to to remove the tooth.
In cases of surgical extractions, the dentist will make a small incision into your gum to surgically remove the broken tooth or impacted wisdom tooth. Stitches may be needed to help with blood clot formation and promote healing.
With anxious patients or difficult extractions, sedation can be used to ease your concern and make tooth extraction stress free procedure.
Tooth extraction aftercare:
It is recommended that you take it easy for the rest of the day and avoid physical activities for the rest of the day to avoid bleeding.
The area may feel uncomfortable so simple painkillers can be helpful. However, it is important to avoid Aspirin as it encourage bleeding.
You need to remember that sign of slight bleeding is not unexpected for the first day or so.
If you do notice bleeding, do not rinse out and apply pressure for 15 minutes to the area using the sterile gauze supplied by London Smile Care.
If the bleeding has not stopped after an hour or two, either contact our Clinic or go the nearest A&E.
At night time, it is a good idea to use an old pillowcase, or put a towel on the pillow, in case you bleed a little.
Applying an ice bag to the affected area immediately after the procedure can keep down swelling. Apply ice for 10 minutes at a time and 10minutes off. But please follow Dr Daoudi, specialist dentist, instructions
In relation to brushing, it is crucial to keep the mouth clean. However, careful clean around the extraction site will be needed for the first few day.
What to avoid after tooth extraction?
- Avoid physical activities and excerscise for two days.
- Consuming hot food or drink can easily burn your mouth without noticing while still under the influence of anesthesia. In addition, be careful not to bite your tongue, lips or cheek while still numb
- Do not be tempted to rinse the area for the first 24 hours. It is important to allow the socket to heal, and you must be careful not to damage the blood clot by eating on that side or letting your tongue disturb it. This can allow infection into the socket and affect healing.
- Avoid alcohol for at least 24 hours as alcohol encourages bleeding.
- Smoking raises blood pressure and can lead to bleeding. It is better to stop smoking all together.
What’s are the possible tooth extraction complications
Most extractions are provided with no adverse effect. However, there are a number of potential complications to teeth extractions including:
- Potential nerve damage
- Accidental damage to adjacent teeth, dental crowns or fillings or TMJ/TMD
- Incomplete extractions where part of the tooth remains in the jawbone. In some occasions it is less risky to leave a small part of the root rather than trying to remove it.
- Encroaching on the maxillary sinus
Dry socket is one of the most common complication after wisdom tooth extraction or traumatic / difficult extractions.
It occurs when a blood clot fails to develop in the tooth socket, or if the blood clot becomes dislodged or disappears. This can happen three to five days after surgery.
This leaves the underlying bone and nerves exposed to air and food. Dry socket is quite painful and can cause a bad breath or bad taste.
Dry socket occurs more often with people over the age of 25, smokers, those with poor oral hygiene habits and women (particularly those taking oral contraceptives). Unless there is an emergency, experts recommend that women using oral contraceptives schedule their extractions during the last week of their menstrual cycle, when estrogen levels are lower.
How to treat Dry Socket?
Contact Dr Daoudi as soon as possible to clean the extraction socket and to place a medicated dressing into the socket to soothe the pain and encourage healing. The dressing is replaced every 24 hours until the symptoms of dry socket lessen (about five to seven days).
Bisphosphonates users — this kind of medications is used to prevent/treat a number of conditions including osteoporosis, multiple myeloma, bone cancer and bone metastasis from other cancers — may put patients who undergo tooth extractions at risk for developing osteonecrosis of the jaw (a rotting of the jaw bones). If you are taking an osteoporosis medication such as Fosamax, try to avoid extraction whenever possible, rather than opt for removal of the tooth/teeth. Please inform Dr Daoudi about the medications you are using to avoid such complications
What is socket / ridge preservation procedure ?
Socket preservation or alveolar ridge preservation (ARP) is a procedure to reduce bone loss after tooth extraction allowing preserving the jawbone. Once the tooth is extracted the jaw bone shrink. It is estimated that 30-60% loss in bone volume take place in six months after tooth extraction and this process continuous over time.
Bone loss can complicate your option of having tooth implant or causing adverse effect to your smile and the the possibility of having a cosmetic dental bridge of cosmetic denture.
Socket preservation technique is used to stimulate bone growth in a tooth socket immediately or soon after tooth removal, thus allowing an esthetic pontic to be placed in areas of esthetic concern
It is an easy and predictable procedure whereby bone graft material is used to maintain the shape and size of the ridge through special surgical procedure. Please contact Dr Daoudi for further information.
How can I replace the extracted tooth / teeth?
Dr Daoudi, specialist dentist will advise you on replacing any extracted tooth to avoid possible complications, such as affect to smile and function shifting of the teeth, TMJ and bite problems, gum recession and bone loss. Dental implants are the ideal tooth replacement; dental bridges and cosmetic dentures are other options. Nowadays, you can have immediate dental implants to replace the extracted tooth/teeth using instant dental implants or all on 4 dental implants with a fixed cosmetic bridge to replace the missing teeth.
Please contact us for further details.