Extractions

"We can replace with dentures, bridges, or implants"

Tags: dentist, london dentist, nhs, whitening, inman aligner, cosmetic dentist, checkup, dental, anish, anish dentist, london hygienist, dental hygiene, root canal., crown, cap, onlay, veneer, wisdom tooth, extraction

by Mr Anish Patel
extraction

Overview

Extractions are normally performed after years of extensive treatment trying to save the tooth and the reasons we extract include, advanced decay and infection, gum disease leading to supporting bone loss(loose teeth), done voluntarily to make room for other teeth before braces, or when removing wisdom teeth.

There are two routine methods for removing teeth. The routine forceps extraction and the surgical extraction. Which one depends on how heavily decayed the tooth is and whether or not we could remove the crown and root intact. If we feel that much of the tooth is far below the gums and bone we may elect to perform a surgical extraction. We will always let you know if we plan on doing anything but a routine extraction.

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The Procedure

Routine Forceps Extraction
1.  
After checking your medical history we will place numbing gel where we plan to place the anaesthetic, this is so you are less likely to feel the small pinch from the needle. We then wait a minimum of 10 minutes for it to work.

2.  We will always wait until you are completely numb before we start. The area is tested so you no longer feel a sharp pinch, however you will feel some pressure. At this point if you do feel a sharp pinch, you need to tell us so we can either give you more anaesthetic or wait a little longer.

3.  At this point we will ask you to rinse out with an antiseptic mouthwash.

4.  Once you are ready we will proceed to gently tease the root of the tooth away from the gums. The is done by making small back and forth, rotating movements while we apply some gentle pressure. This will be enough most of the time to allow the tooth to come away freely.

5.  The tooth is checked to make sure we have removed all of it, and a pack of gauze is used to help stop the bleeding.

6.  Tailored post-operative instructions will be given and adherence to such advice is recommended so as to speed up healing and prevent infection.

Surgical extraction
1.  
After checking your medical history we will place numbing gel where we plan to place the anaesthetic, this is so you are less likely to feel the small pinch from the needle. We then wait a minimum of 10 minutes for it to work.

2.  We will always wait until you are completely numb before we start. The area is tested so you no longer feel a sharp pinch, however you will feel some pressure. At this point if you do feel a sharp pinch, you need to tell us so we can either give you more anaesthetic or wait a little longer.

3.  At this point we will ask you to rinse out with an antiseptic mouthwash.

4.  Once you are ready we will proceed to make a small incision in the numb gum area around the tooth.The gums will be temporarily reflected to give us better access to tooth. Sometimes a small cuff of bone is removed around the tooth to make room for our fine instruments.

5.  The next steps mimic a normal tooth extraction, where we gently tease the roots of the tooth away from the socket.

6.  Once removed, we cleaned out the socket with sterile solution, and proceed to place a few stitches. These will disappear within 2 weeks as the socket and gums heal. ( This may look overwhelming; however it is all done with you in complete control. You decide when you want to start and stop. We review all our patients 2 weeks after a surgical extraction to check healing and signs of infection.


What To Expect After A Surgery

After an extraction, your lips and gums may remain numb for a few hours until the anesthetic wears off. You may also experience some oozing of the socket which can be treated easily by biting down on a small clean cotton napkin for 20 mins. If it does not stop in that time you shoud come back into the surgery, as we may need to place a stich or two. Later you may have throbbing pain, which you can treat with pain medicines, such as ibuprofen, paracetamol, or a stronger prescription painkiller(prescribed by your medical professional for the specific problem) just before the anaesthetic wears off. The pain usually lasts only a day or two.

Risks Of Having And Not Having Treatment

Risks of leaving an infected tooth would only mean that the infection could progress to other parts of the body via the blood stream. This is especially important for those that have a hard time fighting infections such as diabetics, patients on immunosuppressants, and those with heart disorders.

Risks of having an extraction are site dependant but in general risks include prolong numbness, possible need for surgical extraction, prolonged bleeding, and an infected socket. These risks are infrequent, but are consented before any extraction.

Alternatives to extraction

The alternate to having an extraction and replacement, would be not to have one. The risk of doing so have been covered under the risk section.

What To Think About

Once a tooth has been removed the bone and the gums in the area start to shrink. This make future replacement more difficult as we need good quality and quantity bone to place an implant. To counter act shrinkage, we can place an immediate synthetic bone alloplast to help prevent bone loss and maintain the area for implant placement in the future.

We can extract a tooth and replace it immediately if desired-either with a denture, temporary bridge or an immediate implant.

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