Tooth Extractions Explained

//Tooth Extractions Explained

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    You know that dreaded feeling, the anxiety that most of us have experienced, at one time or another. It has been several days now and that annoying pain in your tooth just will not go away. In fact, the discomfort that you are experiencing is getting worse, not better. It has become virtually impossible to chew any food on that side of your mouth. Even soft foods like yogurt are an effort to get down.

    Whenever you put too much pressure on the tooth that is bothering you, the searing pain sends shock waves through your body. You simply cannot focus on anything else. You have been putting off the inevitable for as long as you possibly can, hoping that the pain would vanish, but it has not. The time has come to put a call in to your neighborhood dentist and find out what is really going on. There is nothing to be afraid of. A visit to your dentist can only bring relief and serenity to your situation.

    It is now twenty-four hours later. You are sitting in the dental chair and have just been examined. Frowning, the dentist speaks the words that we all dread hearing,” I have looked at the tooth and it is in worse shape than I thought.  We cannot save it. I am afraid that I am going to have to pull that tooth.” Sure, it is not the best news, but there is also no need to panic. The dentist knows exactly what he or she is doing.  Modern dentistry has come a long way from those 19th century Victorian caricatures that show a patient in agony, getting their tooth pulled, without anesthesia. Relax, your dental professional has got your back.


    If you have a toothache, right now, as you are reading this article, there is no need to let your imagination run wild and resign yourself to having a tooth extracted. Having a tooth pulled is usually a last resort. Your dentist will always attempt to save a tooth, if that option is medically feasible. Very often, a toothache may not necessarily mean that the damage is so bad that the tooth must be pulled. There can be other, less serious reasons why your tooth hurts. Simple toothaches can often be relieved by rinsing the mouth to clear it of debris, according to Dr. Rotsos from New York. ” A piece of food could have become lodged between two teeth, causing some major discomfort and pain. Once the patient has flushed the debris out, by rinsing, the pain subsides and there may be no need to visit the dentist. However, let’s be clear,” added Dr. Rotsos, “every situation is different”. “Should you have a toothache, avoid placing an aspirin between your tooth and gum to relieve the pain. It will do more harm than good by hurting the gum tissue” warns the doctor.

    For a fractured tooth, if the damage is minor, then the tooth can be sanded or restored by your dentist. No extraction is necessary. The dentist can also use fillings or a crown to rectify the damage. During your consultation, Dr. Rotsos said that it is imperative that you inform your dentist about any medications and supplements that you are taking. He listed several conditions that you should make your dentist aware of, congenital heart defects, cirrhosis of the liver, damaged or man-made heart valves, or any artificial joints that were placed in your body such as a hip or knee replacement. He will also want to know if the patient has a history of bacterial endocarditis. “Your natural adult teeth were meant to last a lifetime, but unfortunately that is not always the case.  A very common reason why a tooth has to be extracted is if the tooth is damaged beyond repair, from decay or trauma”, stated Dr. Rotsos.

    Now, you do not have to be an NHL Hockey player or a UFC Fighter to suffer traumatic damage to your teeth. Accidents can happen to anyone, no matter how careful we are. You could have an accident at home or on the street, fall and chip a tooth so severely that it cannot be saved. Should your tooth be knocked out, try to put it back in its socket while waiting to see your dentist. Ibuprofen may be used to help keep the swelling down for a fractured tooth.

    Sometimes the teeth in a person’s mouth can bunch up and become too crowded. Think of a packed subway car, where everyone is squeezed in so tight, that the train cannot accommodate even one more commuter. If a particular tooth cannot erupt, or break through the gum, because there is no room in your mouth for it to “grow”, then your dentist very likely will recommend that you consider having it extracted. These extra teeth are supernumerary.

    If you are considering getting braces for yourself or your child, then you may be facing the possibility of having a tooth extracted, somewhere down the road. Orthodontists seek to properly align your teeth. However, that may not be possible if certain teeth are too big for your mouth. The teeth that may cause problems are known as canines (fangs or eye-teeth), In this instance a dental professional will pull the problem teeth to prepare the patient for orthodontic treatment.

    Infection, or the imminent threat of same, may be yet another reason for tooth extraction.  Dr. Rotsos explains that this can happen when tooth decay extends into the pulp, which is the center of the tooth that contains nerves and blood vessels. Bacteria in the mouth can easily enter the pulp area causing major problems. Root canal therapy is sometimes utilized to combat the raging infection, along with antibiotics. But, if these treatments do not work, then he cautions that, extraction may be the only remaining alternative.

    People who are receiving chemotherapy may have a compromised immune system and are at greater risk of infection, so a troublesome tooth may have to be pulled as a precaution. Doctor Rotsos explained to that there are two types of extractions. The most commonplace is called a simple extraction. This means that the tooth is removed from its socket in the bone. The dentist loosens the tooth with an instrument called an elevator. This instrument is wedged between the tooth and the surrounding bone. The elevator places pressure on the tooth, thereby, expanding its socket. The elevator is also used to separate the ligaments. A Luxator is a surgical cutting instrument that fits between the tooth and your gum. It also assists the dentist in making the extraction as easy as possible. Then, using forceps, your dentist will grasp hold of the tooth and gently rock it back and forth and pull it. If your tooth is resistant to conventional methods, it may have to be taken out, piece by piece.

    The other procedure is a surgical extraction. Wisdom teeth are almost always removed by surgery. Wisdom teeth, also known as third molars, usually come in during your teenage years or during the early twenties. Wisdoms need to be removed if the teeth have become decayed, infected or there is a cyst present. Impacted wisdom teeth can become stuck in the jaw. This can cause severe pain and swelling. The surgeon will make a small incision in the gum to extract the tooth. Extractions can be performed by both your primary care dentist and an oral surgeon. Depending on the specific issue at hand, as well as on how many teeth are designated for extraction, your dentist will either give you an injection of local anesthetic to numb the area surrounding the tooth, or put you to sleep with a strong general anesthetic. But no need to worry, you will not feel a thing.

    Once the procedure is done, the aftercare and follow-up is of vital importance. Having a tooth pulled is considered to be a relatively safe procedure. But Dr. Rotsos warned me that complications can occur. Excessive bleeding as a result of the extraction is not uncommon. After the tooth is removed, a blood clot forms in the socket. Your dentist will pack a gauze pad into the socket and ask you to bite down on it, in an effort to stop the bleeding. Self-dissolving stitches are also used to close the gum up, around the extraction site. Depending on what type of stitches are used, they can take up to a week to dissolve. Sometimes your dentist will have to remove the stitches. A cut in the mouth tends to bleed more than a paper cut or scrape on the surface of the skin, because of your saliva, it cannot dry out and form a scab.

    Another issue that may need to be addressed is socket preservation. This is a procedure that oral surgeons use to reduce bone loss after a tooth extraction. In order to preserve the socket at the time of extraction, a platelet rich fibrin, or PRF, membrane containing bone growth enhancing elements is placed in the wound or on the socket of the extracted tooth. The socket is then closed with stitches or covered with a resorbable membrane and sutured. Dry socket is a painful condition that occurs when the blood clot in the socket breaks loose, exposing the bone. It is not likely to happen, but if it does, your dentist is ready with the appropriate dressings to protect the socket as new clots form.

    After your tooth has been pulled, many dentists advise that the patient stay off his or her feet for twenty-four hours after the surgery. Bed-rest or lying down on your couch is recommended. Do not engage in any strenuous activities after oral surgery. When the healing process begins, you may have to skip a couple of workouts at the gym. But, it is all for a good cause. Once the tooth has been pulled, swelling may occur. This is normal. Most dentists will recommend that you apply a cold pack or ice bag to the cheek that is adjacent to the area of your mouth where the extraction was performed. You should always keep your mouth clean with saltwater rinses, two to three times per day. The average dose is 1 tablespoon of salt with 8oz. of water. Try to avoid over the counter mouthwashes as they may be too harsh.

    In the aftermath of surgery, pain will occur. Painkillers will most likely be prescribed by your dentist. NSAIDS are non-steroidal anti-inflammatory meds. Also, if you smoke, please avoid doing so for at least a couple of days after the procedure, as it can interfere with the healing process. Do not drink from a straw for twenty-four hours. This may seem like a little thing but it is so very important. If persistent bleeding is a problem, then remember to keep your head propped up when lying down. Lying flat can prolong the bleeding. When you brush your teeth, do keep the brush as far away from the site of the extraction as possible. You do not want to irritate the wound, which will be sensitive for a while.

    We hope that this overview of having a tooth extracted has cleared up a few common misconceptions and answered some, if not all, of your questions. As always, it is best to consult a dental professional, who will address the concerns that you have regarding your specific case. Do not ignore pain in your mouth and just hope that it will go away. If you feel something, then say something.


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