Dental Extraction is a removal of a tooth from the mouth. It is performed for a wide variety of reasons:
Tooth decay – If the decay is severely advanced and the nerves and blood vessels in the tooth have been infected, and are unsuitable for root canal treatment.
Impacted wisdom teeth – Sometimes our mouths are simply not big enough to accommodate these teeth. The teeth become impacted (stuck), this can cause infection and pain.
Orthodontics (braces) – Teeth can erupt in many different positions, if this happens you may have to have teeth extracted so your other teeth can be brought into line.
Periodontal disease - Bacterial infection under the gum damages the tissue which connects the tooth to the gum; as the disease progresses, the bone anchoring the tooth to the jaw begins to dissolve, resulting in the tooth becoming loose.
Teeth that have been damaged by trauma.
Certain medical conditions may require teeth to be extracted.
Your dentist will examine your tooth and explain the reasons why your tooth needs to be extracted, an x-ray will be taken to help plan the best way to remove the tooth and to see if an abscess is present.
If an abscess is present your dentist may give you a course of antibiotics before your tooth is extracted.
Your dentist will ask you about your medical history. You must list every medication you are taking even if you have purchased it from over the counter, as some medications can complicate an extraction.
Please inform your dentist if you are anxious about the procedure as sedation is available. If your dentist does not carry out sedation he will refer you to a practice that does.
How the Extraction is Carried Out
There are two types of extractions:
1. A simple extraction is performed when the tooth can easily be seen in the mouth. The dentist will give you a local anaesthetic to numb the area around the tooth. When the anaesthetic has taken affect and the area around the tooth is numb the dentist will grasp the tooth using a pair of forceps, you will feel pressure but NO pain. The dentist will move the forceps back and forth to loosen the tooth in order to extract the tooth.
2. A Surgical Extraction – This is carried out on teeth which
Cannot be seen in the mouth but are present below the gum.
Partially showing through the gum
Broken off at gum level.
A local anaesthetic will be administered to numb the area before a small incision is made in the gum. The gum is pulled back to expose the whole of the tooth or the root. The dentist then uses the same procedure as a simple extraction to remove the tooth, in some cases the tooth or root may have to be cut into pieces to be removed.
When the tooth has been removed a swab will be placed at the extraction site and you will be asked to bite on this until the bleeding has stopped and a blood clot has formed.
Extraction After Care
After the extraction, a blood clot will form in the socket were the tooth used to be, this is NOT to be disturbed by vigorous rinsing or poking the site with your tongue or finger as it is a very important part of the healing process.
If the socket does start to bleed after you have left the dental practice, place a clean tissue or handkerchief over the extraction site and apply pressure by biting down, the bleeding will normally stop within a few minutes. Again do NOT disturb the blood clot. If the bleeding does persist please contact your dentist for further advice.
Your mouth will still be numb for an hour or so after the local anaesthetic, please take care not to bite your cheek or tongue or burn your mouth when drinking hot liquids.
Avoid Smoking and Alcohol for 24 hours as these can have an effect on the healing process
You may be in discomfort after the anaesthetic has worn off, take a household painkiller (headache tablet) following the manufacture's instructions. Do NOT take Aspirin as this may cause the socket to bleed.
Adults have up to 32 teeth, of which four are wisdom teeth and these are the last to come through the gum. They are the one's right at the back of the mouth and usually appear between the ages of 17 and 25 although sometimes they can appear in later years.
If there is enough room in the mouth the wisdom teeth will come through (erupt) in a useful position and there will only be minor discomfort as they erupt. However, wisdom teeth can cause problems if there is not enough room in the mouth, as the wisdom tooth erupts at an angle and gets stuck against the tooth in front; the dentist will describe this as 'Impacted'.
The dentist will be able to assess whether there is sufficient room for the teeth to come through by taking an x- ray which will show the position of the root. Once the x-rays have been taken, the dentist will be able to tell how easy or difficult it will be to remove the tooth. The dentist will then determine whether the tooth should be taken out at the Dental Practice or by a Specialist Oral Surgeon.
The dentist will only recommend taking out wisdom teeth if -
The teeth are not able to fully erupt through the gum and are causing an infection in the surrounding tissue; this is known as peri-coronitis.
There is decay present - wisdom teeth will often decay as it is very difficult to clean them as thoroughly as your other teeth.
Following the removal of wisdom teeth, there is likely to be some discomfort. However, this will vary depending on how difficult it was to remove the tooth; it is not uncommon to experience some swelling for a few days. The dentist will advise on how best to reduce this discomfort and may recommend pain killers such as Paracetamol or Ibuprofen. A further dental appointment will be necessary for the dentist to check the healing process and remove any stitches.
Dentures are a removable appliance used to replace missing teeth, They are fabricated using either acrylic or cobalt chrome to which false teeth are added. They help with speech, chewing, add support to your lips and chin as well as improving the appearance of your smile.
There are two types of dentures:
Partial denture which replaces one tooth or several teeth.
Full denture which replaces the whole set of teeth, on the upper or lower.
Dentures are kept in place by either using clasps which anchor around neighbouring teeth or by the dentures’ natural suction. On occasions a denture fixative or glue is recommended to aid in keeping the denture in place.
All dentures are designed by the dentist or our dental technician to suit each patient’s individual needs.
If you have a fear of dentists or of dental treatment sedation is an option for you. It enables dental treatment to be carried out whilst you are relaxed and makes your visit much more pleasant. It is commonly used on patients who have a fear or phobia of dental treatment. This fear can be for a number of reasons including:
Fear of pain
Extremely sensitive teeth
History of traumatic dental experiences
Complex dental problems
The underlying issue is that whatever phobia patients may have, they will often choose to neglect dental treatment because of this phobia and thus create more damage to the teeth. Sedation not only helps the patient but also greatly assists the dentists as they are able to carry out the procedure with greater cooperation from a relaxed patient.
What is dental sedation?
It is the use of sedative medications in order to make the patient more relaxed and to allow the dentist to perform the necessary dental procedures. These medications range from tranquilizers to anxiolytics and can be administered in a number of ways.
These medications do not send you to sleep, though you will feel sleepy and relaxed.
What types of sedation are available?
There are a few different types of sedation dentistry that facilitate performing dental procedures:
Oral conscious sedation – is exactly as it says, the patient is given oral sedatives which will relieve most of the stress although he will remain conscious in order to follow any instructions given by the dentist.
You will be given a sedative to be taken before you go to bed at night and another sedative to be taken the next morning when you wake up. These sedatives will make the patient feel drowsy and have a similar effect to amnesia and you may not remember a lot about the procedure. Although oral sedatives cannot relieve pain, you will be relaxed when the dentist administers the local anesthetic .
Due to extreme drowsiness effect, you are advised not to drive to or from the dental surgery.
Inhalation sedation – Nitrous oxide – this is more commonly known as laughing gas as one of the effects is the feeling of happiness.
Nitrous oxide is very popular with the dentists as it only takes around 5 minutes from inhaling for it to take effect and because of how quickly a patient recovers from it. Typically the patient will remember very little of the procedure and can sometimes fall asleep.
The added advantage of Nitrous oxide is that it can be used for the exact time span for which sedation is needed, unlike oral sedatives which have a specific and limited effect. Additionally, Nitrous oxide can be administered in incremental doses until the desired level is achieved.
Penthrox™ is a revolutionary inhale pain-relief product which also helps you feel more relaxed and comfortable. It is very much like nitrous oxide, with benefits that you are in control of your level of comfort, simply by inhaling Penthrox through the inhaler.
Intravenous sedation – this is sometimes referred to as IV sedation and is a drug administered through an injection to make people feel like they are asleep. You actually remain conscious and can follow the dentists instructions although the feeling of relaxation is so intense that you are unlikely to remember much about the procedure.
The sedation is administered into the vein and can only be performed by an experienced and trained dentist. The common anti anxiety sedatives that are used for IV sedation are benzodiazepine, propofol, and other medications.
Although IV sedation is very popular it is not recommended for patients with fear of needles, if you are pregnant, suffer from glaucoma, lung or kidney problems or if you are allergic to sedative drugs. Additionally, older patients are not recommended for IV sedation.
Local anaesthetic - This works by blocking nerve impulses to the site where the dental procedure is being performed. An anaesthetic gel or spray which has a numbing effect may be applied before the local aesthetic injection is administered. Under local aesthesia you are fully conscious although you do not feel any of the effects of the treatment.
General anaesthetic - General aesthesia is used to facilitate oral surgery and can be used for people who are not eligible for sedation dentistry. General aesthesia leads to a state of unconsciousness and the side effect may last for several hours after the procedure is done.
No Needles - In some cases, we use INJEX, a needle free alternative. Local anaesthetic is applied using a spray technique, and not via a needle. We can explain to you at the time of consultation