Reasons for Extractions
Dentists have made great strides in saving teeth, but there are still times when extractions are necessary. These situations often arise when there is not enough room in the mouth for an entire adult set of thirty-two teeth, when a tooth has been badly cracked down its root, or when the gum tissue surrounding a tooth is severely infected and the tooth has become too loose to function safely. Dentists also sometimes recommend that people with compromised immune systems who get dental infections undergo extractions instead of root canals. Circumstances such as whether a tooth is impacted, meaning caught below the gum line, will determine exactly how a dentist plans the procedure, but there are some commonalities which patients should understand.
There is more than one major nerve in the mouth which may need to be numbed prior to extraction. The lingual nerve is connected to the tongue while the inferior alveolar nerve relays feeling from the lower teeth. Injections are the most commonly used method to numb these nerves. Some offices also provide other means of sedating patients who are nervous or have difficulty sitting still, such as children or people with special needs. Sometimes, when dentists fear that wisdom tooth removal poses an unacceptable risk to the inferior alveolar nerve, they’ll recommend that a patient undergo a type of partial extraction called a coronectomy, in which only the crown of the impacted tooth is removed.
A dental extraction usually requires little preparation on the patient’s part, but it’s important for the dentist to know all the medications a patient is taking. Some may interfere with clotting after the tooth is pulled. Patients undergoing sedation will also need someone else to take them home.
An extraction is done using tools called elevators and forceps. An elevator is a long instrument with a flat end that is placed in between the tooth and the gum pocket. It is rocked back and forth to loosen the tooth. Forceps are used to grasp teeth from the top and loosen them before pulling them out. During the simple extractions done at most dental offices, these tools are all that are necessary and the procedure is usually over in less than an hour. However, there are more complex procedures which may be used if the tooth is impacted or had not yet erupted. These may involve making an incision into the gum tissue to provide another way of manipulating it or cutting it into sections before pulling it out.
Incisions have to be sutured, but the empty sockets left over from simple extractions are often simply cleaned and covered over with gauze. Patients should avoid smoking or sipping through straws for risk of dislodging the blood clot that will seal off their socket. If a person had anesthetic injected, they should be careful to avoid biting their lip in order to prevent swelling.