Tooth Extraction

How is a tooth extraction performed?

Tooth extraction is one of the most basic treatments in dentistry that is performed under local anesthesia. Simple extractions, which are the type of extractions that can be easily removed in about 5-10 minutes after anesthesia is applied, are usually the most common type of extractions.

Of course, not all extractions are as easy as this. There are several factors that determine whether the extraction will be easy or difficult and complicated. Factors such as the number and shape of the tooth roots, the amount of decayed tissue in the tooth, and whether root canal treatment has been applied before, are among the factors that determine the difficulty of the extraction.

Actually, before starting the tooth extraction, the type of extraction can be predicted about 90% with a panoramic x-ray and a clinical examination.

Patients should be informed about the extraction process and procedures for teeth that are not expected to be easily extracted and have a risk of complications. The meaning of difficult and complicated extraction is that the procedure and duration of the extraction will be longer. The patient will not feel any pain during complex extraction procedures.

The most common complication during a tooth extraction is breaking the tooth or the root. If the tooth is very decayed, the roots are long and have a curved shape, or if root canal treatment has been performed before, the probability of the tooth breaking increases. In such cases, the dentist will use suitable tools to remove the broken piece with different extraction techniques.

Sometimes, it may be necessary to surgically open the area to remove the broken piece or root. This procedure is called surgical tooth extraction.

Tooth Extraction in Ankara, Turkey

However, there is no need for patients to worry about complicated tooth extractions. During the procedure at our Ankara clinic in Turkey, patients will not feel any pain. Moreover, pulling a tooth that is not loose enough, broken, or difficult to see for an experienced dentist is a routine treatment.

Why is tooth extraction performed?

Many teeth in the oral environment, whether erupted or unerupted, may need to be extracted for various reasons. We can list the reasons for tooth extraction as follows:

• Teeth that have been broken down to the gum line due to decay or trauma and cannot be restored.
• Teeth that are infected and do not respond to root canal treatment.
• Teeth that have caused the formation of cysts in the surrounding tissues.
• Teeth that disrupt the planning of prosthetic applications or cause aesthetic problems.
• Impacted teeth.
• Wisdom teeth.
• Orthodontic reasons.

When do wisdom teeth come out?

The process of tooth eruption that begins at six months of age ends with the eruption of wisdom teeth. Wisdom teeth typically erupt or attempt to erupt between the ages of 18 and 25. However, we cannot say that everyone's wisdom teeth will eventually emerge into the mouth. Wisdom teeth may remain buried in the mouth without causing any problems throughout one's lifetime. Sometimes wisdom teeth may have never formed inside the jawbone.

Should wisdom teeth always be extracted?

If there is enough space in the mouth and the wisdom tooth can erupt and take its place just like a normal molar, and if it can chew in harmony with the opposite arch without squeezing the other teeth, then there is no problem with it staying in the mouth.

However, if it is partially erupted, unable to find a suitable place to settle, constantly causing abscesses, infections and odor, causing pain and swelling, then the extraction of the wisdom tooth is necessary. In addition, cysts and tumors can also be seen around wisdom teeth. In this case, the oral surgeon will remove these pathological structures along with the extraction of the wisdom tooth.

Wisdom Tooth Extraction

The extraction of fully erupted wisdom teeth with a smooth root morphology is extremely easy. Sometimes, there may be some gum left over the tooth that has not fully erupted, which are called mucosa-retained wisdom teeth, and these teeth can be easily removed with a simple gum incision.

However, if a part of the tooth is covered by bone in a semi-impacted state, these teeth are called bone-retained wisdom teeth. The procedure for removing these teeth involves surgically opening the area, removing the bone, and then extracting the tooth. Extraction of mucosa or bone-retained teeth is referred to as a surgical extraction. The procedure is completed by stitching after extraction.

Sometimes wisdom teeth may be fully buried inside the mouth. If these teeth do not cause any problems, extraction is not necessary.

Should the broken piece be removed when a tooth is extracted?

Root fractures that occur during tooth extraction should be removed. However, if the broken piece left inside is very small, there is no infection, and removing that piece poses a risk due to proximity to anatomical structures, it can be left in the socket.

Can you smoke after tooth extraction?

It is recommended to avoid smoking for a few days after tooth extraction. Smoking narrows blood vessels and reduces blood supply. If smoking is resumed after extraction, the socket may not be adequately supplied with blood, and it may dry out. The formation of a blood clot necessary for healing may not occur as desired. In this case, alveolitis may develop, and the healing process may be delayed.

What is alveolitis?

After tooth extraction, the socket, which is the space left by the extracted tooth, fills with blood and clots. Clotting is necessary for the wound to start healing and for fast and proper healing. Sometimes, there may not be enough blood supply to the socket after extraction, and it may dry out. If a moist and cell-rich environment necessary for bone healing does not occur, proper healing will not take place.

The dry socket may cause infection and pain. This condition is called alveolitis. The area is washed with serum, pain-relieving agents are placed in the socket, and antibiotics are used to promote healing within a few days.

Is it only wisdom teeth that can be impacted?

No, other teeth in our mouth can also be impacted, although less frequently. Impaction can also occur with canines and small molars.

Is numbness normal after tooth extraction?

Actually, numbness is an unwanted complication. Some teeth are located very close to the anatomical structures where the nerves pass through. If the extraction is traumatic, partial numbness may occur in the lip or tongue afterward. This feeling of numbness is mostly temporary. The degree of numbness will depend on the extent of nerve damage. This condition can last from a few weeks to up to two years. In very rare cases, permanent numbness may occur, but this requires disruption of nerve continuity.

What should be taken care of after a tooth extraction?

• After a tooth extraction, one should avoid eating until the anesthesia completely wears off, i.e. until the numbness sensation completely disappears. This applies not only after tooth extraction but also after all procedures that involve anesthesia. Otherwise, unintentional biting of the tongue or lip can lead to serious injuries and subsequent swelling. Something can be drunk as long as it is not hot.
• To avoid excessive bleeding, one should avoid spitting or rinsing. If there is only slight oozing of blood, it should be swallowed instead of spat out. If there is persistent or heavy bleeding, one should contact their dentist.
• If the dentist has prescribed medication, one should use it as advised. Antibiotics or painkillers are not always necessary after every extraction. The dentist will decide whether medication is necessary based on the difficulty of the extraction and the presence of infection.
• One should avoid using the extraction side for eating for about a week after the procedure to promote faster healing. Additionally, very hot, acidic, or grainy foods should not be consumed.
• If the extraction was traumatic, applying ice on the first day can be helpful.

Is it more difficult to extract root canal-treated teeth than live teeth?

Not always, but extracting root canal-treated teeth can be more difficult than extracting live teeth. A tooth that underwent root canal treatment many years ago may have fused with the surrounding bone due to the lack of blood vessels. In this case, extracting the tooth may take a longer time. There is also a higher chance of breaking the tooth root during the extraction process.