This is one of the most commonly carried out procedure in a dental clinic. Let us see a few of the situations that demand tooth extraction. Tooth extraction in medical terms is called as exodontia. Ideal tooth extraction should be painless removal of whole teeth or tooth root, with minimal trauma to the surrounding oral tissues of the teeth. This leads to easy wound healing and no postoperative prosthetic rehabilitation problem.
Indications for tooth extraction:
- Deep dental caries which cannot be saved by endodontic or root canal treatment
- Severe abrasion of the cervical region of the teeth or severe cases of non-carious cervical lesions
- Apical pathologic conditions of teeth
- Improper teeth in the dental arch
- Teeth causing trauma to dental tissues
- For orthodontic purposes i.e. for the braces treatment in order to gain space on the arch for correction in dentition
- Severe periodontal / gum related diseases i.e. problem of the supporting structures of the teeth
- Before radiotherapy in cancer patients
- Malposed teeth, supernumerary teeth or teeth that causes crowding in the dental arch
- Wisdom tooth / impacted tooth
- Teeth in the region of fracture lines of the jaws
- These are the major situations calling for tooth extraction
Contraindications for tooth extraction:
As far as possible, it is always better to save a teeth than extract. Dentistry has come a long way with various technological development and development in material aspect. This helps a lot in saving the natural tooth.
In patients with immunocompromised states such as diabetes, anemia, hypertension, jaundice and also during pregnancy, it’s always better to avoid or postpone tooth extraction procedure.
Procedure of tooth extraction
The tooth extraction is carried out under local anesthesia therefore patient doesn’t feel the pain during the procedure. A thorough patient history related to health is mandatory. It should be carried out with less blood loss. Proper sterilization protocol needs to be followed to prevent contaminations. Achieving a secure anesthesia depends on technical skills of operator. The time duration for extraction of teeth depends on difficulty of a case and skill of dentist. A radiographic image of tooth to be extracted is always necessary. This helps in assessing the supporting structure of the tooth. It also helps in having an idea about how close are the nerves to the apex / tip of the teeth. Damage to the nerve should be avoided. Else it can cause in permanent numbness. Patient co-operation is of utmost importance. After tooth extraction, suture is placed whenever necessary. Post – operative instructions are to be followed well. Eating spicy, forced spitting, usage of straws, smoking etc are all contraindicated after tooth extraction. Taking up a course of antibiotics and pain killer if the dentist has mentioned is compulsory.
Take home message
It’s always better to save a teeth than get it extracted. Removal of tooth is the last resort in dental treatment when all the other tooth saving treatment cannot be performed. Later, the missing tooth has to be replaced by crown, implant or denture whichever suits the clinical situation without fail. This will restore masticatory function, boost the confidence of the patient while talking and improve the esthetics.
Author: Dr. Siri P.B.