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Tooth Extraction A tooth that is severely damaged may need to be removed. Dr. Muruga who specializes in surgeries of the mouth (oral and maxillofacial surgeon) can remove a tooth.Before removing your tooth, Dr. Muruga will give you a local anesthetic to numb the area where the tooth will be removed. A stronger, general anesthetic may be used, especially if several or all of your teeth need to be removed.General anesthetic prevents pain in the whole body and will make you groggy or make you sleep through the procedure |
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After the tooth is removed, you may need stitches. You can gently bite down on a cotton gauze pad placed over the wound to help stop the bleeding. The removed tooth can be replaced with an implant, a denture, or a bridge is a replacement for one or more (but not all) of the teeth and may be permanent or removable. The Types of Extractions : 1. Simple Extractions. A simple extraction is one in which Dr. Muruga can remove the tooth simply by loosening the gums around it, grasping the crown above the gum line with a plier-like forceps and then moving it side to side until it loosens from the bone. Teeth are normally held into the bone by a thin sheathe of soft tissue that separates it from the bone like a sock separates a foot from a shoe. This sheathe is called the periodontal ligament, and it is this structure which ultimately enables the dentist to remove the tooth. The key to simple extractions is to rock the tooth side to side slowly enlarging the socket in the bone while at the same time breaking the ligament which binds the tooth in the socket. 2. Complex (surgical) Extractions. Unfortunately, not all extractions can be done by simply grasping the tooth with forceps and rocking it out. What if there is nothing left above the gum line to grasp? O r what if the crown breaks off leaving the roots still in the bone? These things can and do happen, and any dentist that extacts teeth will have to deal with them routinely. In these cases, it becomes necessary to surgically remove the tooth. This is frequently accomplished by prying the root out using a sharp instrument that can be forced between the root and the bone surrounding it. This technique is called "luxation". In the case of multiple rooted teeth, the roots are first separated so they can be removed individually. Unfortunately, not all root fragments may be removed in this fashion. This means that the dentist must make an incision into the gums around the tooth and raise a flap of tissue exposing the tooth and its surrounding bone. Sometimes, after the flap is raised, there is enough tooth exposed to grab and remove it as in a simple extraction (#1 above). Sometimes, the technique described above as luxation may successfully remove the tooth. If luxation fails, Dr. Muruga will take a handpiece (drill) and cut away some of the surrounding bone in order to gain a purchase on the tooth. After the tooth has been pried out of the artificially enlarge socket, Dr. Muruga then sutures (sews) the flap of tissue back in place so that healing can proceed normally. 3. Impacted Teeth. When a tooth does not fully erupt into the mouth, but remains below the gums, it is said to be impacted. Impacted teeth can present special health problems for most patients, and they are generally removed to prevent difficulties. The extraction of such teeth proceeds like the surgical extraction explained above with a few modifications. Sometimes, the only surgical procedure is the raising of the soft tissue flap. If after raising the flap, the extraction can proceed as a simple extraction, the tooth is said to be a "tissue impaction" because there was enough of the crown left above the bone to grab and extract with forceps. But many times the crown is submerged below the level of the bone. The tooth may even be lying on its side under the bone which complicates the extraction further. In these cases, not only must Dr. Muruga remove surrounding bone in order to expose the tooth, but he must cut and break the tooth itself into sections so that each section can be removed separately. Teeth in this condition are said to be "bony impactions" and are further classified as vertical, horizontal or angular depending on the angle of the tooth uinder the bone. What To Expect After Surgery ? 1. Take painkillers as prescribed by Dr. Muruga 2. Rinse your mouth with warm salt water several times a day to reduce swelling and relieve pain. Make your own salt by mixing 1tsp (5g) of salt in a medium-sized glass (8fl oz) of warm water. 3. Change gauze pads before they become soaked with blood. 4. Relax after surgery. Physical activity may increase bleeding. 5. Eat soft foods, such as gelatin, pudding, or a thin soup. Gradually add solid foods to your diet as healing progresses. 6. Do not lie flat. This may prolong bleeding. Prop up your head with pillows. 7. Avoid rubbing the area with your tongue. 8. Continue to carefully brush your teeth and tongue. Why It Is Done ? Removing a tooth is necessary when decay or an abscessed tooth is so severe that no other treatment will cure the infection. How Well It Works ? Removing the tooth can help keep infection from spreading to other areas of your mouth. Can I Pull My Own Tooth ? Don't laugh. People really do try! In general, the answer to this question is NO! there are two situation when it is even possible for a person to extract his/her own tooth. 1. The first situation is a loose baby tooth, and even then it is usually a good idea to check on the general age when that particular baby tooth is supposed to get loose (this coincides with the general time when the adult tooth will erupt). If you try to pull a "loose" baby tooth and it turns out that it is only abscessed, then you could have a real disaster on your hands to include a very sick and unhappy child. 2. The second situation is when an older patient has had severe gum disease for a long time (most of these people are well over the age of 45), and the tooth is extremely loose (very wobbly) because the gum disease has caused the loss of almost all of the bone that used to surround the tooth. In the latter case, even touching the tooth can be extremely painful and attempting to yank on it will be much worse (not to mention bloody). Even then, if you misjudge the amount of bone remaining around the tip of the root, you may only succeed in breaking the top off the tooth. |