Extractions
This means a surgical procedure to remove the entire tooth (including the root) from its bony jaw housing.
If a tooth cannot be saved (gross decay or severe bone loss) and a large filling or crown not possible an extraction may become necessary. Extraction may also be required to:
- Stop spread of infection
- Reduce further bone loss
- Reduce pain
- Allow for healing to allow for future planned replacement
- Allow for normal eruption if extra teeth are present
- Create space as part of orthodontic treatment
- Elimination of diseased, impacted and unrestorable Third molars or Wisdom teeth
Procedure
After careful consideration with x rays and clinical examination, if a tooth is decided to be removed – anaesthetic is given. In most cases a local anaesthetic is given which is more than enough to make the entire experience acceptable. The injections are at the most, a little uncomfortable. Ask for a surface (or topical) anaesthetic gel before the actual injection which makes the procedure much better.
Local anaesthetic takes about 5-10 minute to have effect. You are totally awake throughout and you may drive after.We may give more than one cartridge of anaesthetic to ensure you are fully numb.
During an extraction you may feel “back and forth” pushing and pressure. You should not feel anything sharp or painful.
Occasionally, if a tooth / root is so decayed that it can’t be seen in the mouth and needs removing, a gum flap may be created to visualise and access the tooth to enable its removal.
After removal, we wait till you have stopped bleeding. We often ask you to bite firmly on a sterile gauze to help with this.
After the extraction we give you a post-extraction advice sheet telling you some common sense DO’s and DON’T’S.
Some common complications after an extraction include pain, swelling, bleeding. With our advice sheet and good home care, these may be easily managed and avoided.
Dry-socket
Sometimes a local infection of the bony tooth socket happens in 5% of cases. This occurs because a blood clot fails to initially form or is destroyed early. This leaves bone exposed to food and air which is very painful, causes swelling and may leave a bad taste. Management includes dressing the bony exposure, pain relief, good home care, Chlorhexidine / salt water mouth rinsing, possibly with antibiotics.
Replacement options for a tooth include the following which need to be discussed:
- Denture
- Bridge
- Implant
- Space closure with orthodontics if possible
- Leaving the gap
