A tooth extraction is done when there is no possibility of saving the tooth, it should be considered as a last resort in modern dentistry. Our priority should be in promoting the prevention for the conservation of tooth structure as part of the overall oral health of patients. This should be done at the primary care level.
Tooth extraction is the surgery by which teeth are removed from their sockets with the least trauma possible. It is a laborious surgical technique, that if not done carefully accidents and complications can occur, from very simple to very complex.
Reasons for tooth extraction
The most common reason why teeth are removed is when cavities have done so much damaged due to neglecting of proper oral health care and tooth decay has caused tooth destruction. The second most common reason for tooth removal is caused by periodontal disease. Periodontal disease is a disease of the gums and the supporting structure of the teeth.
There are other situations where a tooth extraction is needed, although less frequent than the previous two:
· Fractured Teeth: When there is trauma to the face and the teeth are affected. If a fracture occurs in the root below the gum, you can not restore the tooth and is has to be removed.
· Extraction of teeth for orthodontic treatment. A tooth malposition that may need to be aligned through orthodontic treatment, this can cause a serious lack of space in the mouth. In these cases the only way to get enough space for proper placement of our teeth is extraction of a tooth, usually the first premolars.
· Extraction of teeth to facilitate the construction of a prosthesis. A tooth in a malposition may hinder the placement of a prosthesis to rehabilitate the jaw.
· Retained temporary teeth. If the deciduous dentition or “baby teeth” do not erupt in time, this can cause an alteration in the position or eruption of permanent teeth, so it should be removed.
· Impacted teeth. These are teeth that have not erupted during its normal eruption period. In these cases we must rule out any type of pathology and make a panoramic radiograph to determine the cause for this delayed eruption.
Psychological aspects:
It is well known that the thought of extracting a tooth strikes fear on the majority of patients. The patient should be treated with kindness, keep the cartridges away from view, and only bring them in, during anesthesia with a shield to the patient’s mouth. Words or phrases that further frighten the patient should not be used. For example, should not use the word pain, and if necessary, be replaced by discomfort. It should be especially careful with the elderly. In patients that are very anxious, anxiolytic premedication should be administered.
Medical History:
Any patient who needs a tooth extraction done, should be aware that although this type of surgery may seem simple, it may have serious complications. The dental clinic should have a medical history record of the patient. Mainly the pathological history with emphasis on allergies, blood diseases or history of bleeding.
The medical history should also reflect the date, if accidents occurred as well as drugs and anesthetic solution used.
For high risk patients due to illnesses and medications a special consultation must be done before the extraction.
Requirements for tooth extraction:
• health and hygiene conditions of the clinic and staff.
• Good lighting.
• Patient privacy.
• Equipment for treatment if complication or injury occurs during the performance of extraction
Although not frequent, accidents and complications can occur during tooth extraction, it is necessary for the dentist and assistant be prepared. An effective method to treat any accident must be in place, but above all it is necessary to prevent and avoid them.
Post tooth extraction instructions
• Bite sterile gauze for 1 hour.
• Keep your head elevated the first few hours, avoiding bedtime, if you must sleep, rest the head on two pillows.
• Do not make any physical effort during the next 24 hours.
• do not swish.
• Place a cold pack the first 24 hours alternating short periods of time in the area indicated by the doctor.
• Do not take aspirin.
• Eat soft foods and warm the first 2 days.
• Do not salivate (spit)
• After 24 hours perform normal oral hygiene except to that area.
• Consult with the dentist in case of complications:
◦ hemorrhage (profuse output of blood)
◦ Inflammation (swelling of the face)
◦ If the pain, infection and delayed wound healing persist contact the office.
In case of any complications communicate with your dentist immediately.
