Root Canal and Gum Problems Dentistry

Tooth Extraction

woman who is having her tooth extracted by a dentist

Tooth extraction is the latest plan for the treatment of various oral and dental problems. Dentists and orthodontists always attempt to preserve the patient’s natural teeth. All treatments are initially based on avoiding teeth extraction and preserving the patient’s natural teeth.

The right time for tooth extraction

Formerly, tooth extraction was the first plan for the treatment of tooth infections and sore teeth. However following significant advancements in public health, science, and culture, this way of treatment was substituted by advanced modalities of tooth restoration and maintenance. According to dental reference books, conditions leading to tooth extraction are as follows:

Acute tooth cavity: This refers to the condition in which the tooth cavity is so severe that the tooth can no longer be repaired and even the root of the tooth is lost. In these conditions, the specialist and the dentist conclude that the tooth shall be extracted; otherwise, it may pose a threat to the adjacent teeth.

Tooth Extraction

A cracked (broken) tooth and jaw injury: It refers to cases where the jawbone is damaged along with a cracked tooth and there is no possibility to restore the lost tooth. The dentist advises extracting a broken tooth to prevent any potential tooth infection.

Dental pulp necrosis: It refers to teeth with irreversible necrosis due to infection of nervous tissue or irreversible pulpitis or those with dead nervous tissue or necrotic pulp. There is no possibility of applying root canal treatment for these types of teeth and thereby extraction is the only suggestion.

Chronic gum disease: Gum disease is prevalent in areas with poor health conditions. People in these areas suffer from severe gum damage so the tooth can no longer be repaired and the dentist has no other choice than extraction.

Orthodontics purposes: Patients with shrinking jaws and large teeth oftentimes face crowded and irregular teeth. Some patients also have extra teeth. An orthodontist prescribes tooth extraction for this group of patients.

Impacted teeth: It refers to less-grown teeth and those that have not fully emerged. If it is difficult to see them or there is no necessity for this, they will be extracted at the advice of an orthodontist. An example is the impacted wisdom tooth.

Post-extraction care

Since bleeding is normal upon tooth extraction, your dentist will put a piece of gauze bandage on your tooth for 45 minutes to quicken coagulation. There may also be gingivitis and pain in the extraction area.

Cold compresses or ice packs can aid in diminishing swelling. You can use a warm water compress when the jaw is injured upon deswelling or when it is so stiff. When sleeping, keep your head up to lessen the pressure on your jaw. Holding your head up with an extra pillow can further be helpful. Your dentist may prescribe OTC painkillers such as ibuprofen (Motrin or Aspirin) for a few days. During a surgical extraction, which is generally more painful, your dentist may prescribe an analgesic.

Advice following tooth extraction and surgery

Hold the bandage tightly on the gum for 30 minutes. Avoid frequent saliva gulping or spitting. Eat soft foods on the first day and avoid drinking hot liquids. It is not advised to smoke and try to drink liquids through a straw for several days. Do not brush for one night after extraction.

From the second day, you can wash your mouth with a diluted saline solution, but avoid spitting and filling and emptying your mouth. Bleeding is normal for up to two days after tooth extraction. In the event of severe bleeding, use a sterile gauze pad and cold compress to stop it. Under severe and uncontrollable bleeding, refer to a clinic and avoid putting various medications and substances on the site.

If you feel pain, you can use an anti-inflammatory painkiller such as Gelofen. Avoid consuming anticoagulation drugs such as aspirin. Contact your physician if you notice uncontrollable bleeding, infection, or severe pain. Dental anesthesia usually lasts up to 4 hours. Be careful not to bite the wall inside the mouth and tongue. If you feel a severe dry cavity resulting from a blood clot removal, see your physician for more considerations. It is normal to feel a bitter taste in the mouth and an unpleasant odor for a few days following tooth extraction.

Applying hot and cold compresses following tooth extraction

To accelerate recovery following a tooth extraction, the application of hot and cold compresses aids remarkably. For this, use a cold compress on the first day after tooth extraction and surgery. On the second day, there is no need to use compresses. From the third day onwards, you can apply a warm compress to diminish pain and inflammation.

a woman using water compress after tooth extraction

To prepare a cold compress, pour the crushed ice into a plastic bag and wrap it in a clean, dry cloth. Direct contact of ice with the skin may damage the skin. Apply this compress on the operated area every 20 minutes. Rest for another 20 minutes, and repeat the procedure.

Hot compresses and even warm mouthwashes are applied to improve swelling and relieve the surgical area. You can prepare a hot compress using a bag or a bottle containing hot water. A warm compress is also applied to the face every 20 minutes. Be cautious not to burn the skin of the face.

Which teeth are usually extracted

Wisdom teeth are one of the most typical teeth that many dentists advise them to extract. Many dentists advise extracting wisdom teeth (third molars) before they are fully developed. These teeth normally grow during adolescence and are extracted to help eliminate potential dental problems. One of the most frequent problems with wisdom teeth is that they can grow impacted without any space for their growth in the mouth, causing problems such as tooth infection, adjacent teeth decay, interfered canine teeth, and gum disease

Tooth extraction complications

Several complications may appear following a tooth extraction, including the following:

Incidental damage to adjacent teeth: It can be one of the complications of tooth extraction.

Alignment problems during chewing and jaw joint function: Deviated teeth may cause pain, cracks, or snarl. Besides, deviated teeth can trap food and make it harder to clean teeth, thereby increasing the risk of cavities and gum disease.

An incomplete extraction with residual tooth root in the jaw: Your dentist will normally extract the root of the tooth to prevent infection, but in some cases, this is less risky on smaller root tips.

Jaw teeth may break during extraction: It often happens in older people with osteoporosis.

Upon extracting upper teeth, a hole may appear in one of your sinuses: It usually heals on its own quickly; otherwise, you may need to visit your dentist.

Infection: It occurs rarely. If you are at risk for infection, your dentist may prescribe antibiotics before and after extraction.

Nerve damage: It may occur while extracting any other tooth. However, it is mostly related to wisdom teeth. Nerve damage is usually caused by surgery and is rare and usually temporary.

Bisphosphonates: These are drugs consumed to treat osteoporosis, multiple myeloma, bone cancer, and bone metastases resulting from other cancers, and may cause osteoporosis for patients who aim to extract their teeth and put them at risk. If you are taking osteoporosis medications (e.g., Fosamax), try to keep prevention instead of tooth extraction whenever possible to prevent extraction.

Dry cavity: Dry cavity, a prevalent complication following a tooth extraction, occurs when a blood clot is removed from its place in the cavity and exposes the underlying bones and nerves to air and food. It is often painful, can smell and taste bad, and usually occurs 2 to 5 days after the extraction.

Extraction of wisdom teeth

Dentists and experts believe that teeth should not be extracted for no reason. If your wisdom teeth contribute to certain oral and dental problems, you should visit the dentist for extraction in time as it is not rational to keep them longer. These problems include:

  • Pain and discomfort
  • Infection
  • Cyst or gland formation
  • Damage to the adjacent teeth
  • Gum disease
  • In the case of the cavity in wisdom teeth

Tooth extraction costs

The standard common tooth extraction cost is directly correlated with the difficulty of the extraction operation. Higher costs correlated with harder extraction settings. Depending on where you live, the majority of dental insurance plans cover up to 80% of the cost of tooth extraction if it is medically necessary.

Dr Abdolreza Jamilian Orthodontist

About Dr Abdolreza Jamilian Orthodontist

Dr. Jamilian, an orthodontist, has a specialized fellowship in orthodontic surgery and maxillofacial abnormalities and is a professor in the orthodontics department of the Dentistry School of the Islamic Azad University. He is member of Iranian and European Board of Orthodontics (EBO) and is a member of the Iranian, American and European Orthodontists Association.

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