Tooth removal is an ancient practice done for several ages, The tooth removal was done without any anesthesia by the local barber in the medieval age.in those ages, exodontia was done not only for dental pain but also to cure a few diseases.
In recent times tooth removal is done under local anesthesia and it’s completely pain-free. Two types of local anesthesia are used in dentistry that is lignocaine and articaine, these are amino amide class of local anesthesia.
People are referred for tooth extraction for several reasons and most common reasons are:
- Tooth decay
- Wisdom teeth impaction
- Orthodontic teeth removal
- Gum infection
- Trauma to the teeth and jaw
- The child’s teeth are not falling properly.
- Supernumerary teeth removal
- Removal of teeth for placing prosthetic teeth.
Pre-dental extractions protocols:
When you visit a dentist for tooth removal, we will ask a few questions about your previous medical and dental history, then we will check your soft and hard oral tissues completely. If needed we recommend dental radiographs such as RVG/IOPA, OPG, or CBCT.
On complete examination and if there are no alternatives(remember saving a tooth is always better than removing it) then the teeth will be recommended for removal.
If there is any medical history like:
You must consider and get an opinion from your medical officer.
If your pregnant or nursing mother please inform your dentist before tooth removal. Pregnant women must not be exposed to radiographs and can perform tooth extraction only after getting an opinion from your gynecologist.
The medication will be changed post-extraction for nursing mothers.
Types of exodontics:
The type of tooth-pulling can be classified generally with their size, shape, location, and position in the jaw.
We classify it into simple and surgical extraction.
Simple tooth extraction:
When full teeth are intact without any damage to the teeth and the teeth can be pulled out without any complication.
This is mentioned as simple because the procedure is so easy for the dentist and we do not need any special instruments other than our elevators and forceps. Most of the simple cases do not require any sutures for healing.
The procedure is risk-free as there is no bone coverage involved and no nerve or blood vessels hinder the removal of teeth.
Surgical tooth extraction:
As mentioned in the name, it involves the surgical procedure for the removal of the teeth. The teeth may be positioned in such a way we have to remove gum tissues, bone, or both.
Sometimes there may be sinus, nerves, or blood vessels involved hindering tooth removal making it a complicated procedure.
Special instruments are necessary for these types of extraction and lots of skills in performing the surgery without complication.
Additional materials like bone graft, membranes may be required to cover the bone removed site, in few severe cases, nerve reposition is required.
Surgical tooth removal does require sutures, sutures help in:
Guards the bone graft and membrane,
Do not allow foreign material or food substances.
Nerve or blood vessel repositioning is required during surgical tooth removal. This alters the position of nerves or blood vessels in different directions after the removal of teeth.
Wisdom tooth removal is mostly a surgical extraction as the tooth is surrounded with maximum bone coverage and nerves passing below it. The wisdom is the last tooth to erupt and its first teeth to be removed if not erupted in the desired direction.
This change in position of the tooth and hitting the adjacent bone or teeth is known as tooth impaction, the impaction is very difficult to be corrected and involves lots and lots of time.
Wisdom teeth and canines are frequently impacted by teeth in humans.
What to do after tooth removal?
- After removal of the tooth, your dentist will pack the extracted site with cotton gauze, this is done to stop bleeding. The gauze pack must be removed with clean hands and discarded after ten minutes.
- Apply ice pack over the wound, this will stop further bleeding because when you apply an ice pack over the wound the blood vessels shrink and the bleeding will be arrested. Applying an ice pack is really very difficult inside the mouth hence we give good news! Have ice cream….
Because ice cream acts as an ice pack and has the ice cream over the wound, don’t have cone ice cream or popsicles, it must be ice cream.
- You can also have fresh cold fruit juices. Strictly no aerated drinks are allowed
- Do not use a straw for drinking as it may create negative pressure, the negative pressure will remove the blood clot which is sealed on the wound. Blood clot helps in wound healing.
- Don’t eat hot or spicy for the next 3 days, as it may irritate the wound.
6. Do not meddle the extracted site with a finger or toothpick.
- Smoking and drinking are prohibited because it will delay wound healing.
8.swallow your saliva, do not spit, gargle, or rinse your mouth for the next 3 days.
9.you can brush, but be careful not to brush too hard on the extracted site.
10.last but not least take your medication properly do not skip any course, if pain persists visit your dentist to seek advice on further medication.
In general, Wisdom teeth removal will take more time to heal than a simple extraction.
Bleeding after extraction is normal for the next 2-3 hours they are called primary bleeding and reactionary bleeding. If there is prolonged bleeding even after 3 days you must visit your dentist as soon as possible because this is secondary bleeding. Secondary bleeding is caused by the microbes which affect the blood clot and new blood vessels.
The Other major complication after tooth removal is Dry socket. This condition is caused by excess bone exposure, The exposure of bone may be due to lack of blood clot formation on the wound site or the clot has been dislodged from the wound. symptoms of dry sockets are severe pain 2 to 3 days after the procedure, the pain will be radiating and there will be e bad breath.
In this situation, you should visit your dentist to manage the complication. The dentist will apply zinc oxide eugenol paste over the Dry socket.
How to manage pain with normal tooth removal?
take medication that is prescribed by your dentist after extraction of teeth, you have to follow the instructions given by your dentist and you should not miss any instruction.
The pain may be mild to moderate after removal of the teeth but if you take medications properly you can avoid pain.
how to manage pain with wisdom tooth removal?
Pain after wisdom tooth removal is common this is because the tooth is removed along with some part of the bone which was surrounding the tooth. Sometimes there may be pain near years this is because opening your mouth for a long time during the surgery. The long-term stress on the temporomandibular joint will cause pain near your ears.
Other systemic cause may be due to:
If you have any previous medical or dental history do inform your dentist for a safe tooth removal.
The cost of simple and surgical tooth removal will vary according to the complication and additional materials like graft, membrane, and suture materials.
Tooth removal in Chennai, India will be charged from $20 to $200.
In this wisdom teeth, removal can cost from $100 to $200.
Always remember the teeth removed by a dentist are trained and use special instruments for each tooth. Do Not attempt tooth removal at home as it may increase furthermore compilation.