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Extraction of a permanent tooth is the most extreme measure that dentists resort to only when it is impossible to solve the problem in any other way. But before you pull out a permanent tooth, you need to find out the root cause, because of which you have to perform a serious surgical intervention.
Reasons for removing permanent teeth
A permanent tooth is removed in the case when it can cause complications after a long inflammatory process. Doctors are trying in every possible way to preserve the incisors and fangs, using all sorts of techniques: they heal caries, they treat the inflammatory process.
Factors due to which you have to “get rid” of the teeth: their excessive mobility, obstruction of the root canals, incorrect location of the “eights” (lying, not fully formed), chronic exacerbated periodontitis.
When the “eights” cannot erupt, there is a possibility of phlegmon, so doctors recommend surgery. If the tooth is not treatable and the inflammatory process is running, you should dare and make the right decision. If you do not pull out a diseased tooth, phlegmon, sinusitis of the maxillary sinuses, purulent lymphadenitis, maxillary abscesses, odontogenic purulent periostitis may occur.
Interfering “fours” break out when a bracket system or denture is placed. Extraction of a tooth is recommended if it cuts and pricks the tongue, injures the buccal mucosa or interferes with normal bite (if this defect cannot be eliminated by mechanical grinding).
When there is an inflammatory process in the bones and periodontium, then removal is mandatory, other cases are discussed with a specialist and a compromise is sought in the form of an alternative (non-surgical) dental treatment.
Easy Removal Features
Tooth extraction (simple) is a dental operation to remove it from the alveoli. It is prescribed if the patient has the following indications: jaw swelling, mechanical damage to the tooth, incorrect position of the canines, incisors and molars (they interfere with eating, talking, injure the oral mucosa), periodontitis, impassable root canals.
Simple surgery is performed only on teeth with well-visualized roots or crowns that can be securely fixed with forceps. Removal is carried out with an elevator or forceps. With tools, the doctor swings the diseased canine in different directions until the periodontal ligament collapses. Along with the destruction of the ligament, the expansion of the alveolar bone occurs. After such manipulations, the tooth will stagger, and its removal will become less painful.
Forceps for labor-intensive manipulation consist of cheeks, a lock and a handle. In private clinics, doctors use tools designed to remove certain groups of teeth and separately the roots. Canines located on the upper jaw should be torn with straight forceps, premolars and molars should be pulled out by the dentist with forceps in the shape of the letter “S”. The incisors, which are located on the lower jaw, are removed with special tools, curved ninety degrees, with narrow cheeks. Lower molars should be pulled out with spiked forceps.
An obligatory procedure before the operation is the direction of the x-ray. The resulting image will show the topography of the roots, the structure and parameters of the diseased tooth.
Simple removal procedure
The patient sits on a chair, finds a comfortable position. If it is necessary to pull out the upper tooth, the doctor will stand on the right and approach the patient. The patient’s head is slightly thrown back on the chair so that the patient’s oral cavity is at the level of the specialist’s shoulder.
If a lower molar or incisor is to be removed, the patient’s head should be tilted slightly forward. The lower jaw should be near the doctor’s elbow. For conventional removal, the doctor does local anesthesia.
Stages of surgical intervention:
- the doctor separates the gum from the neck of the tooth with tools;
- forceps are adjusted to the tooth and fix it with cheeks;
- the tooth dislocates under slight pressure from the doctor;
- after it begins to move in different directions, it is removed from the alveolus.
The patient should sit and rest for a while so that he does not become ill. After 5-10 minutes, the bleeding will stop. The doctor or medical staff will look after the patient after the operation to avoid adverse reactions and any complications. After the procedure, it is advisable to eat at least 2 hours later.
Features of complex removal
Pulling out canines, incisors and premolars most often does not cause any difficulties and problems. Removal of molars, including “eights”, can take longer and cause a lot of difficulties.
Complicated removal is carried out when special medical instruments and medications are used. Signs that indicate the complexity of the removal: the tooth does not grow correctly or has not completely erupted, the fusion of bone tissue with the tooth, a crooked root.
Not only the patient, but also the doctor needs to prepare for the operation. Only a highly qualified specialist can carry out the surgical procedure. He prepares special tools and materials: suture material, needles, scalpel, cotton swabs, scissors, forceps, elevator, burs. All instruments must be sterile. All this is monitored by a nurse and helps the dentist prepare for the operation.
The patient should take a panoramic x-ray so that the doctor can see the condition of the tooth and its roots. Before the procedure, you need to eat so as not to faint. 2-3 days before the manipulation, the patient should drink antibacterial drugs.
Sometimes the patient is recommended to take an allergy test for pain medications that will inject him during the operation. Preliminary testing will help the dentist select safe drugs and determine the dosage.
Painkillers are selected by the doctor according to the following parameters: the age of the person, current illnesses (are there any diseases in the oral cavity), the duration of the planned procedure.
Complicated tooth extraction procedure
Complicated removal differs only in the additional opening of the mucous membrane and bone tissue. The same actions are performed as with a simple removal method, only the wound does not remain open, but sutures and other materials are applied to it to completely restore bone tissue, for example, resorbable membranes.
Also, medications are often used that contribute to the full healing of the hole.
The duration of a complex operation varies from 30 minutes to 1,5-2 hours, depending on the number of roots. The doctor draws the patient’s attention to the recovery period after surgery and gives recommendations.
Dentist’s advice after a complex procedure: you can not drink hot and cold drinks, smoke, eat food (especially solid), play sports or physically overload yourself, visit a sauna or bath, swim in the pool for 3-4 hours after the manipulation. If the patient neglects the recommendations, bleeding may begin, then you will have to seek medical help.