Extractions
Extractions are often
categorized as "simple" or "surgical".
Simple
extractions are performed on teeth that are visible in the
mouth, usually under local anesthetic, and require only the use
of instruments to elevate and/or grasp the visible portion of
the tooth. Typically the tooth is lifted using an elevator, and
using dental forceps, rocked back and forth until the
Periodontal ligament has been sufficiently broken and the
supporting alveolar bone has been adequately widened to make the
tooth loose enough to remove. Typically, when teeth are removed
with forceps, slow, steady pressure is applied with controlled
force.
Surgical extractions
involve the removal of teeth that cannot be easily accessed,
either because they have broken under the gum line or because
they have not erupted fully. Surgical extractions almost always
require an incision. In a surgical extraction the doctor may
elevate the soft tissues covering the tooth and bone and may
also remove some of the overlying and/or surrounding jawbone
tissue with a drill or osteotome. Frequently, the tooth may be
split into multiple pieces to facilitate its removal. Surgical
extractions are usually performed under a general anaesthetic.
Reasons for tooth
extraction
The most common reason for
extraction is tooth damage due to breakage or decay. There are
additional reasons for tooth extraction:
- Severe tooth decay or infection. Despite the reduction in worldwide prevalence of dental caries, still it is the most common reason for extraction of (non-third molar) teeth with up to two thirds of extractions.
-
Extra teeth which are blocking other teeth
from coming in.
-
Severe gum disease which may affect the
supporting tissues and bone structures of teeth.
-
In preparation for orthodontic treatment
(braces)
-
Teeth in the fracture line
-
Fractured teeth
- Insufficient space for wisdom teeth (impacted third molars). Although many dentists remove asymptomatic impacted third molars, American as well as British Health Authorities recommended against this routine procedure, unless there are evidences for disease in the impacted tooth or the near environment. The American Public Health Association, for example, adopted a policy, Opposition to Prophylactic Removal of Third Molars (Wisdom Teeth) because of the large number of injuries resulting from unnecessary extractions.
-
Receiving radiation to the head and neck may
require extraction of teeth in the field of radiation.
-
Deliberate, medically unnecessary,
extraction as a particularly dreadful form of physical
torture.
Post-extraction healing
Following extraction of a
tooth, a blood clot forms in the socket, usually within an hour.
Bleeding is common in this first hour, but its likelihood
decreases quickly as time passes, and is unusual after 24 hours.
The raw open wound overlying the dental socket takes about 1
week to heal. Thereafter, the socket will gradually fill in with
soft gum tissue over a period of about one to two months. Final
closure of the socket with bony remodeling can take six months
or more.
Notes: Information retrieved from source, 2011; Photo used from Beatgoddes with permission.