Dental Extraction

Definition

Dental extraction (or avulsion) is a surgical procedure that involves the removal of a tooth from the alveolus, the natural mandibular / maxillary bone cavity in which it lodges.

A tooth is subjected to an "extraction when, for pathological reasons or physical impediments, the permanence in its natural location would create greater damage. It should be emphasized, however, that a tooth is extracted only when necessary, and only if it cannot be saved. or treated by other conservative methods (eg devitalization, filling, apicoectomy). Different speech, however, for the wisdom teeth: with the exception of the other teeth, the third molars can be extracted even in the absence of dental pathologies or infections in progress, therefore for preventive purposes to avoid possible future disorders (eg dental malocclusion, crooked teeth, toothache, gingival inflammation, etc.).

When and why it is needed

With the exception of third molars, teeth should be extracted under the following circumstances:

• Teeth severely infected by deep CARIES, PULPITES or DENTAL ABSCESSES and not treatable by other conservative methods: extraction is the only (and extreme) solution conceivable to prevent the spread of infection in other nearby teeth or in bone / gingival structures contiguous.
• Teeth affected by GRANULOMA or DENTAL CYSTS that cannot be cured by apicoectomy: dental extraction is the only possible alternative to prevent the risk of expansion of the infection to the supporting bone or, even worse, to the blood (septicemia).
• DANGEROUSLY DANGEROUS TEETH that cannot be recovered through orthodontic interventions.
• ADVANCED PIORREA: in such circumstances, the avulsion of one or more teeth may be necessary to prevent a possible worsening of periodontal disease or the spontaneous loss of a permanent tooth.
• DENTAL CROWDING that cannot be remedied by orthodontic methods (dental appliance).
• SUPERNUMERARY TEETH: more than 32 teeth appear in permanent dentition. This condition requires the extraction of unnecessary teeth because it causes dental malocclusion and crooked teeth.
• DENTAL INCLUSION: the tooth is totally or partially trapped in the gum and, by not completing its growth path, creates pain or alters the harmonious alignment of the dentition. Dental inclusion often requires the extraction of the imperfect tooth, followed by " autotransplantation of the same tooth in the correct position.
• FAILURE TO FALL WITH MILK TEETH within the established physiological times: when it is late in falling, a milk tooth can hinder the correct development of the corresponding permanent teeth, laying the foundations for dental malocclusion or dental inclusion.
• CHEMIO-RADIOTHERAPIES that require the extraction of a tooth.

Regardless of the summary indications described above, it is then up to the specialist's judgment to decide whether or not to proceed with the extraction of a tooth. a "full-fledged surgical operation which, as such, involves risks.

Simple and surgical extraction

A tooth can be extracted in two different ways:

1. Simple extraction (most common avulsion surgery): it is performed on a clearly visible and totally erupted tooth through the gum. The dentist, after having carefully anesthetized the diseased / problematic tooth, simply extracts the tooth with special tools (elevator and forceps), exerting more or less significant pressure on it.
2. Surgical extraction: more complex avulsion surgery, performed on teeth that are impacted or not easily accessible (they are still partially or completely covered by the gum). The surgical extraction of the tooth requires a careful and precise preliminary incision on the gum, which is essential to create an entrance from which to access the tooth more easily. It is not uncommon for a dental element that is particularly difficult to remove requires the removal of some bone fragments confined to it. In these cases, the problem tooth can be divided into several sections to facilitate avulsion. The intervention can be performed under local anesthesia (in the dental office) or general (in the hospital setting).

Dental extraction and pain

Thanks to the improvement of anesthetic techniques, today, the dental extraction operation is not particularly painful. Practicing the operation under local anesthesia, the tooth falls asleep; therefore, a skilled dentist must be able to perform the operation without the patient feeling pain or pinching. On the other hand, a sensation of pressure or traction of the tooth is normal during this type of intervention.
If you experience unbearable pain or discomfort while extracting a tooth, it is strongly recommended that you report this to your dentist.

Prepare for surgery

Before proceeding with the extraction of a problematic tooth, the dentist will have to perform all the necessary investigations, such as radiographs of the "suspect" tooth or, if necessary, the panoramic (radiography of both dental arches). extraction, the doctor must carefully educate the patient on all possible precautions to be taken to prevent post-surgery complications. The patient, in fact, must be made aware of all the risks and complications that could run after the extraction of a tooth.
Before proceeding with the operation, it is necessary - as well as essential - to always address all doubts, concerns and uncertainties to the dentist. It is recommended to always inform the doctor in the presence of allergies to drugs or materials (eg allergy to latex , allergy to nickel), diseases (past or current) and a possible pregnant state (presumed or current pregnancy). Also, it is equally important to tell your dentist if you are taking any medications to treat a given disease.

Prevention of complications

Oral infections - in particular alveolitis, cysts, granuloma and dental abscess - are the most common complications after tooth extraction.
To prevent them, it is necessary to proceed in two steps:

1. Thorough cleaning of the oral cavity at home, supported by rinsing of medicated-disinfectant mouthwashes (formulated for example with chlorhexidine) in the 4 days prior to tooth extraction.
2. Prophylactic antibiotic treatment to be followed before tooth extraction to minimize the risk of infection. It should be noted, however, that antibiotic therapy is not always prescribed before surgery. Generally, dentists recommend taking these drugs as a precaution in case of weakening of the immune system, predisposition to infections, ongoing dental infection or extraction. particularly complex dental.

After "tooth extraction"