Dentists around the world routinely remove diseased or damaged teeth every day. While some extractions require surgery, many don't: Your family dentist can perform these simple extractions, usually with little complication.
The term simple doesn't necessarily mean easy—as we'll note in a moment, it takes a deft and experienced hand to perform this type of extraction. The term in this case refers more to the type and condition of the tooth: The tooth roots are relatively straight and reside in the bone at an accessible angle. There are otherwise no meaningful impediments to removing it straight out.
The idea of “pulling a tooth” out of the jaw isn't the most accurate way to describe the procedure. A tooth is actually held in place within its bony socket by the periodontal ligament, a tough, elastic tissue between the tooth root and the bone that attaches to both through tiny fibrous extensions. The best method is to first loosen the tooth from the ligament's tiny attachments, for which experienced dentists can develop a certain feel. Once released from the ligament, the tooth will usually come free easily from its socket.
Not all teeth, though, can be removed in this manner. Teeth with multiple roots like back molars, and without a straight trajectory out of the socket, can have a complicated removal. Other dental conditions could also prove problematic for simple extraction, such as brittle roots that might fragment during removal.
For these and other complications, your general dentist may refer you to an oral surgeon for the tooth extraction. But even with the surgical component, these more complicated extractions are relatively minor and routine—millions of wisdom teeth, for example, are removed every year in this manner.
If you have a tooth that needs to be removed due to disease or injury, your dentist will first determine the best way to remove it and will refer you, if necessary, for surgical extraction. And whatever kind of extraction you undergo, the dentist performing it will make sure you remain pain-free during the procedure.
While tooth preservation is usually the best course for long-term dental health, it's sometimes best to remove a tooth. If that should happen, your dentist will make sure it's done with as little discomfort to you as possible.
If you would like more information on dental extraction methods, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Simple Tooth Extraction?”
Surgical tooth extraction is a fairly routine procedure with few complications. But one rare complication called dry socket does affect a small number of patients. Dry socket, which derives its name from its appearance, can be quite painful. Fortunately, though, it doesn't pose a danger to oral health.
Normally after a surgical extraction, a blood clot forms in the empty socket. This is nature's way of protecting the underlying bone and nerves from various stimuli in the mouth as well as protecting the area. Sometimes, though, the clot fails to form or only forms partially (almost exclusively in lower wisdom teeth), exposing the sensitive tissues beneath the socket.
Patients begin to notice the painful effects from a dry socket about three or four days after surgery, which then can persist for one to three more days. Besides dull or throbbing pain, people may also experience a foul odor or taste in their mouth.
People who smoke, women taking oral contraceptives or those performing any activity that puts pressure on the surgical site are more likely to develop dry socket. Of the latter, one of the most common ways to develop dry socket is vigorous brushing of the site too soon after surgery, which can damage a forming blood clot.
Surgeons do take steps to reduce the likelihood of a dry socket by minimizing trauma to the site during surgery, avoiding bacterial contamination and suturing the area. You can also decrease your chances of developing a dry socket by avoiding the following for the first day or so after surgery:
- brushing the surgical area (if advised by your surgeon);
- rinsing too aggressively;
- drinking through a straw or consuming hot liquid;
If a dry socket does develop, see your dentist as soon as possible. Dentists can treat the site with a medicated dressing and relieve the pain substantially. The dressing will need to be changed every few days until the pain has decreased significantly, and then left in place to facilitate faster healing.
While dry sockets do heal and won't permanently damage the area, it can be quite uncomfortable while it lasts. Taking precautions can prevent it—and seeing a dentist promptly if it occurs can greatly reduce your discomfort.
If you would like more information on oral surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dry Socket: A Painful but Not Dangerous Complication of Oral Surgery.”
Routine Check of Teeth and Bone
A full set of x-rays will be recommended every 3-5 years to get a full picture of your mouth and check to make sure all your teeth are healthy as well as your bone levels, the health of your jaw and other structures are all in good condition. The full set of x-rays may consist of something called a “full mouth series,” which is 12-18 small x-rays of your teeth and teeth roots, or a “panoramic” x-ray, which is a large x-ray that shows your entire mouth on one film.
In addition to the panoramic x-ray, a couple of small checkup x-rays will still need to be taken to check for cavities between the teeth that the panoramic x-ray doesn’t show clearly. Also, every 1-3 years, a set of 2-4 checkup x-rays will be taken to check for cavities between the teeth. These checkup x-rays will be recommended more frequently for patients who are prone to cavities and less regularly for patients who are not prone to cavities.
Benefits of Routine X-rays
Catching cavities in their early stages before growing larger, assessing the health of past restorative work, catching bone loss in its early stages, catching cysts and any other abnormalities in the jaw and bone.
To Detect Issues or Problems
An x-ray will likely need to be taken if you come into the dental office and are experiencing pain or sensitivity with a tooth. There is only so much that can be seen visually and detected clinically without being able to see the underlying tooth and bone structure with an x-ray. The type and number of x-rays that may be recommended will be based on the problem and what needs to be assessed.
Digital Vs. Film X-Rays
Dental offices are moving over from film x-rays to digital x-rays. The benefit of digital x-rays is that it produces about 70% less radiation than film x-rays. It is instantaneous, therefore eliminating the processing time. As well, the digital image can be enhanced and enlarged, unlike a film x-ray and digital x-rays are more eco-friendly for the environment.
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