When do I need a Surgical Extraction?
At Milltown Dental Clinic we always aim to save your teeth and restore them. Sometimes this is not possible and the tooth needs to be removed. Here are some cases which may indicate a need for surgical extraction:
- You have a severely damaged tooth that is non-restorable with a tooth filling, crown, or root canal treatment and has little to no tooth structure left above the gum line.
- A radiograph revealed that there is a permanent tooth which failed to erupt in the jaw or impacted tooth.
- Simple extraction can end up with a surgical extraction when a tooth breaks off into parts during the procedure.
- Tooth ankylosis or a condition wherein the tooth fused to the bone.
- Tooth with long, curved, or crooked roots. Forcing to remove the tooth with long, curved, or crooked roots through simple extraction can lead to tooth/bone breakage which delays healing.
When Removal is more beneficial
The dentist will analyse whether the tooth can be repaired or must be removed using diagnostic tools such as radiographs. A tooth is considered salvageable when there is enough tooth structure to support dental restorations and a healthy bone around it.
For instance, a severely damaged tooth with little tooth structure left is almost impossible to hold a restoration properly. Thus, removal of the tooth is the best option. Another example of a tooth that needs to be removed is a horizontally impacted wisdom tooth that causes severe pain and damage to the tooth beside it. An impacted tooth has no function at all; thus removal is appropriate.
What are the complications if nothing is done?
You might think that problems in the mouth would not affect your overall health. Certain conditions (i.e. Tooth abscess), if left untreated, can cause a negative impact on your overall health. For instance, an abscess from infected upper tooth can cause cheek swelling, brain abscess, or sinus infection while an abscess from infected lower tooth can spread and cause swelling of the lower jaw (Ludwig’s Angina) which can obstruct the airway.
Since each tooth has blood vessels and nerves connected to the main circulatory system, there are higher chances of infection spreading to the heart and lead to a condition called endocarditis.
It’s better to repair damaged or infected tooth when it’s still treatable or remove it if untreatable already than wait for it to worsen and cause life-threatening problems.
How a Tooth is removed
The dentist will start by administering local anaesthesia to numb the tooth and gums. In some cases, anxious patients have the option for sedation. Once the local anaesthesia is potent already, the dentist will do an incision in the gums and make a flap or retract it away from the bone. If the tooth to be removed is covered with bone, a minimal amount of bone will be drilled to have access to the infected tooth.
Once the dentist has complete access to the tooth, it will be removed using different hand instruments. After the tooth has been completely removed, the dentist will irrigate the site with a solution to remove debris and infection. And lastly, the dentist will bring back the gums to its normal position and stitch it in place to promote better healing.