Extractions

Why should I get my tooth extracted?

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Sometimes teeth are so –as we say in Christchurch- “Munted” that the dentist will offer the choice of the tooth to be extracted.

Every tooth is different and after assessing several factors such as

• The extent of decay

• Condition of surrounding teeth and gums

• Medical factors

• Cost and likelihood of successful treatment

the dentist may offer you the option of having the tooth extracted, as an alternative to a root canal, large filling or crown.

 

How is my tooth extracted?

The majority of teeth will be extracted simply by injecting a local anaesthetic to numb the tooth. Various instruments are then used to help loosen up the tooth and finally it is extracted using forceps.

Unfortunately some teeth may not be able to be extracted this way due to

• The amount and location of decay

• Direction of the roots of the tooth

• Density of the surrounding bone

In these cases the dentist may elect to do a “surgical extraction”. The process is relatively straightforward.

1. An incision is made into the gum around the tooth

2. The gum is pulled back

3. The surrounding bone is removed until the tooth is removed

4. The site is stitched up.

5. The stitches will be removed a week later.

 

How do I look after myself after the extraction?

After an extraction, the socket fills up with blood, which then clots. This is the first stage in normal healing. The following instructions are designed to stop you from interfering with normal healing.

1) Eat and drink normally.

Do not rinse your mouth for 24 hours.

2) Bleeding

To control bleeding a large pad of gauze should be placed over the extraction socket and held firmly between the jaws for at least 30 minutes.

3) Pain

Take two paracetamol/ nurofen every four hours as required. Or you may take the prescribed medication given by your dentist.

If the bleeding or pain is not controlled by these procedures, or if there are other complications, please do not hesitate to contact us.

 

What problems can occur with an extraction?

 

1) Not all the tooth gets removed.

Often a root tip will fracture off during the course of an extraction or the dentist will decide to lessen the trauma and leave a piece of tooth root behind.  Providing the piece is small and not associated with an abscess the dentist may decide to leave the piece alone.

There are three possible outcomes when this occurs

1. Bone will form around the root tip and area can be left alone.

2. The piece of root will work its way to the surface and then can be easily removed at a later date.

3. The root tip will get infected and need to be surgically removed usually by a specialist.

 

2) Dry Socket or Alveolar Osteitis

This is the condition when there is severe inflammation (not bacterial infection) of the bone round the extraction site.

The condition is extremely painful and uncomfortable. It occurs usually when the blood clot is lost from where the tooth was extracted. It occurs more often

• After difficult extractions

• In people with very dense (unvascularised) bone

• In people who smoker

Treatment includes the placement of a oil of cloves dressing and appropriate pain relief. It may take up to three days for the site to settle down

 

3) Bone Fragments

Often after a back molar tooth is extracted the pieces of surrounding bone fail to be initially resorbed by the body. Often a sharp bone spike can make its way to the gum surface. The piece of bone is easily removed.

 

4) A hole through to the sinus

This is rare.

The roots of upper back molar and premolar teeth lie close to the maxillary sinus. Usually there is a thick layer of bone separating them. In rare occasions the layer of bone is very thin and in some cases missing all together.

In these cases when the tooth is removed a hole will open up to the sinus. The size and severity will determine the treatment. Often the extraction site will just be packed with special foam, however an Oral Surgeon may be needed to close the hole.

 

5) A root in the sinus

This is very rare.

Again due to the lack of bone between the bottom of an upper back tooth and air sinus a tip of a tooth may get accidentally pushed into the sinus. In this situation a referral to a Oral Surgeon is required.