Tooth extraction is an irreversible process. Therefore it is done in extreme cases and in those cases where the extraction is absolutely necessary to ensure the health of the surrounding teeth and the gums. This article explains when tooth extraction becomes necessary and how it’s done in practice.
Why is tooth extraction done
Reasons for the extraction of the tooth:
* Chipped tooth – a tooth is removed if it’s damaged beyond repair. Sometimes the tooth may become chipped, broken or twisted. This affects its proper usage and necessitates its removal.
* Crowding of the teeth – this condition can lead to misaligned teeth and an improper bite. To correct this problem, a severely misaligned tooth is extracted and the rest are brought in line with the help of braces. Such an extraction is an orthodontic treatment.
* Rotting tooth – this condition happens when the tooth and the gum are severely infected. In this condition the tooth will also be loose and wobble while chewing. This is also done when the tooth has developed severe cavity which cannot be repaired through filling or capping.
* Baby tooth – this problem is seen more in children than adults. Sometimes it is necessary to remove the baby tooth to allow the adult tooth to emerge out safely. If the baby tooth is not extracted then the underlying adult tooth will cause it to bend abnormally leading to scratches on the gum and chin as well as loosening of the surrounding teeth.
* Failed root canal implant – some root canal surgeries and implants can fail. This can happen due to various reasons. When this happens, the site usually becomes infected and develops an abscess. This necessitates tooth removal to help the wound to heal.
* Impacted tooth – this usually happens where the wisdom tooth emerges through. This condition leads to Pericoronitis, which is a bacterial infection of the impacted tooth’s crown. The bacteria flourish in the plaque which accumulates at the crown. This can lead to tender gums, development of cysts and the tilting of the neighboring teeth.
* Periodontal disease – not all cases of periodontal disease require tooth extraction. Only in those cases where the disease has eroded the gum severely and where it has affected the density of the bone at the jaw. If the gum is worn out and unable to support the tooth, then the tooth needs to be extracted to enable a trouble free mouth. This condition prevails mostly in the elderly.
* Health risks – people who have to undergo radiation therapy may be forced to remove some of their teeth which can become a hindrance for proper radiation delivery. Moreover those who undergo chemotherapy or are put on immunosuppressive medication following a major surgery may have all their infected teeth removed as they will not be able to fight a dental infection.
How is tooth extraction done
The most common tool used in tooth extraction is the extraction forceps. This is used to grasp the tooth and pull it out safely. However extraction of the tooth is not a simple process. Based on the method used in the extraction, it can be divided into either a simple extraction or surgical extraction.
* Simple extraction – This method is suitable for weak tooth or on ones that are already loosened due to weak and infected gums. It can also be used in people who do not have strong gums or those whose teeth can be easily pulled out. This procedure can be done by a dentist, a dental surgeon or a periodontist. The dentist grabs the tooth with the forceps tightly and rocks it sideways to make it loose in its socket. When the tooth is adequately loose, the dentist may twist is sideways to break the bonds of ligaments attached to the tooth. Once the ligaments are broken it becomes easy to pull out the tooth from its socket. Sometimes the dentists will be forced to use an “elevator” to create a wedge between the tooth and the surrounding gum. The elevator itself can be used to elevate the tooth out of its socket.
This is done under local anesthesia. Children or the elderly who cannot tolerate higher pain may be given general anesthesia to dull the pain during the extraction.
* Surgical extraction – This method is used in circumstances where it’s difficult to simply shake and pull out the tooth. It is often used to remove molars and pre-molars which can pose problems during loosening. Wisdom teeth and partially broken teeth or teeth with large cavities which can break when grabbed are extracted using this method.
After injecting a local anesthesia at the jaw joint to numb the pain, the surgeon will cut and separate the gums from around the teeth. The anesthesia used in this procedure is strong hence patients are advised to take rest after the surgery for a few hours. They are also advised not to drive vehicles. Though the patient will not feel pain when under the influence of the anesthesia, he will still be able to feel the pressure of the scalpel and the forceps grabbing the tooth.
Once the gum tissue has been separated, the surgeon breaks the tooth from the jawbone to extract it. Sometimes a hard set tooth or a large tooth may need to be broken into pieces to enable easy extraction. In some cases though, it will simply be enough to shake the tooth loose using extraction forceps and pull it out from its socket. Elevators can be used to expand the tooth socket and to break the ligaments holding it.