The removal of teeth is most commonly carried out under local anaesthesia. It can also be carried out under general anaesthesia, or a combination of sedation and local anaesthesia.
Dentists will always try a conservative approach first when trying to repair a tooth that is damaged. However, if the damage is too severe that even a crown or a filling can’t help , he/she may decide to remove the tooth completely.
- Reduced cost compared to other treatments
- Severe tooth decay or infection
- Supernumerary teeth
- Severe gum disease
- In preparation for orthodontic treatment (braces)
- Teeth in the fracture line
- Teeth which cannot be restored endodontically
- Fractured teeth
- Prosthetics – intentional extraction
- Preventive/prophylactic removal of asymptomatic impacted wisdom teeth.
- Cosmetic – to remove teeth of poor appearance, unsuitable for restoration
- Head and neck radiation therapy.
- Ensure patient has followed all pre-operative instructions.
- Administer local aesthetic to the patient.
- The tooth socket is dilated using an elevator (extraction of erupted teeth can sometimes be carried out using just forceps especially if the tooth is mobile).
- The tooth is grasped around the crown using forceps and movement is applied to break the periodontal attachment.
- The tooth is removed from the socket.
- A gauze pack is placed over the socket and pressure is applied to help stop the bleeding.
- Postoperative advice is given to the patient.
- Gauze pack is removed and socket is checked to confirm bleeding has stopped.
- Patient is checked to ensure they are fit to leave.
- Mirror, straight probe, tweezers
- Aspirator tip
- Local anaesthetic cartridge, syringe, and needle
- Selection of elevators
- Extraction forceps
- Gauze packs
- Postoperative instruction sheet
Following the procedure the dentist/assistance should give the patient the following postoperative instructions both verbally and in writing.
- Avoid rinsing today, because this will cause bleeding.
- Maintain a soft diet today— e.g. banana, egg, juice, pasta, and rice.
- Avoid very hot fluids.
- Warn the patient that they will experience numbness for a few hours, until the anaesthetic wears off.
- Rinse the wound with warm salt water four times a day for one week, starting tomorrow.
- Avoid alcohol and smoking for 48h to aid healing.
- Avoid strenuous exercise today.
- In the event of bleeding, bite firmly on the socket with a clean gauze pack for at least 30 mins.
- Provide a number to call if the patient has concerns or cannot control bleeding.
- Prescribe antibiotics and vitamin supplements for 3 days.
Sometimes just the root of a tooth may be left behind in the jaw following the fracture or the loss of the crown (due to extensive caries or fracture) or fracture during extraction. If the root is easily accessible a procedure similar to that of the extraction of an erupted tooth can be used. The remaining tooth structures can be loosened using elevators, and then root forceps (which are narrower than standard forceps) can be used to remove the root.
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