Teeth extraction

Estrazione dei denti

What is tooth extraction?

Tooth extraction is an oral surgery practice that consists of removing teeth from their socket. It may be necessary for various reasons, but it is always considered the last resort, to avoid more serious damage to the mouth.
For a dentist, tooth extraction is always a sad event, which one would never want to resort to, but in some cases necessary to heal the mouth from more serious situations.

What are the cases in which tooth extraction is necessary?

There are several situations in which it is necessary to resort to tooth extraction. Below are the most common:
– teeth infected with deep caries on which conservative treatment is not possible; in this case, extraction is necessary to prevent the infection from spreading to the supporting structure of the tooth and neighboring teeth;

– advanced periodontitis: in these cases extraction is necessary to avoid worsening of the disease and spontaneous tooth loss and to stop the continuous bone loss;

– large apical granuloma or cyst that cannot be treated by apicoectomy;

– advanced tooth mobility;

– impacted teeth, i.e. teeth trapped in the gum that have not completed their growth path; in some cases, extraction and self-transplantation may be necessary in the correct position;

– supernumerary teeth: it may happen that some people have more teeth than normal; this situation can lead to malocclusion and crooked teeth, for this reason the extraction of extra teeth is performed;

– Advanced bone loss;

– wisdom teeth that can cause pain or other problems.

How is tooth extraction performed

A fully erupted tooth is extracted with special instruments (forceps and levers) after local anesthesia. In the case of impacted teeth, however, the situation is more complex; the dentist must first make an incision in the gum and if necessary remove fragments of bone or divide the tooth into several parts and extract it in stages.
The extraction is not only limited to the extraction of the tooth, but also provides for the reconstruction of the bone. Material is inserted to replace the lost bone and the gum is closed. Then the bone graft is stopped with a gingivoplasty. This restores stability in the jaw and jawbone.

Precautions after an extraction

After surgery it is helpful to:

– bite down on gauze over the extraction area for a few minutes to facilitate coagulation;

– ice the jaw at the affected area for about 10-15 minutes;

– Do not eat hot, hard food for the next 48 hours;

If necessary, the dentist can also prescribe medications (painkillers, anti-inflammatories, antibiotics).

Conversely, it is also very important to:

– do not take hot foods;

– Do not rinse your mouth in the hours following the extraction;

– Do not smoke or drink alcohol in the first few days after extraction;

– Do not take drugs containing salicylates that could affect coagulation (eg aspirin);

– do not chew with the affected part for the first 10 days after extraction;

– do not use a high-pressure cleaner to clean your teeth or suck in the extraction area.

Replacing extracted teeth

After extraction, it is very important to replace the missing teeth as soon as possible, in order to avoid changes in bone volumes. The extraction of a tooth, in fact, causes a resorption of the bone that leads to a decrease in its volume. Consequently, the gingiva also undergoes the same process of recession. Moreover, the lack of a tooth can also affect the stability of the neighboring ones.
There are several techniques, safe and reliable, that allow the replacement of missing teeth; these can be chosen according to the needs and characteristics of the patient. These include bridges and dental implants.