Dental Information on Dental Extractions and Surgeries

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The following Dental information pages answers many of your questions on dental extractions, wisdom teeth extractions and oral surgeries.

What is general anesthesia?

General anesthesia is reversible loss of consciousness along with loss of all sensation. General anesthetic drugs also help in controlling pain and relax the muscles of the body. General anesthetics are used in complicated surgical procedures that may take a long duration and when the surgery is done in multiple sites. They are also useful in unco-operative patients.

Why does it bleed after extraction?

Once the tooth is extracted a wound is created and therefore bleeding occurs. The bleeding stops once a stable clot forms. But in some patients minor seeping of blood may be seen for a day or two after extraction and their saliva may be tinged with blood. This need not be a cause for worry to the patient. However profuse bleeding must be brought to the notice of your dentist.

What happens after a tooth is removed?

After a tooth is removed, it leaves behind a socket in the bone that was once occupied by the roots. This socket very soon gets filled with blood. The blood in the extraction socket forms a clot. In a few weeks time the clot slowly reorganizes into bone and fills the socket. Thus the empty space in the bone left after the extraction of the tooth heals completely by formation of new bone and the gum completely cowers the area. This process may take a few months to complete.

Why is the wisdom tooth removed so often?

The wisdom teeth are the third molars, which are the last teeth in the dental arch. The teeth usually erupt between 18 and 25 years of age. In many individuals, the wisdom teeth remain in the bone as they may not have adequate space in the dental arch to emerge out. This condition is called impaction. In addition the third molar may erupt in abnormal inclination thus affecting the health of the adjacent teeth. So the wisdom teeth need to be removed often.

Why is it difficult to remove the wisdom tooth?

The wisdom teeth are often inside the bone and therefore cannot be removed easily by using the forceps. In addition their position and angulation may be abnormal. They often require surgical extraction by cutting open the overlying gums and cutting the bone around the teeth.

Why does a swelling appear after extraction?

Some extractions are followed by appearance of swelling. This is nothing to worry about, as it is a part of the normal healing process. In reaction to the extraction, the tissues show an inflammatory reaction to heal the wound created by the removal of the tooth. Swelling is a part of the normal inflammatory process. However the dentist may advice you to have cold fomentation over the area to reduce the swelling.

What is dry socket?

Dry socket is a condition characterized by onset of pain and foul odor a few days after the extraction. This occurs due to lysis or dislodgment of the clot that forms after the extraction leaving behind the bony socket that is very sensitive and tender. The socket may also get infected. This is one of the rare complications of extraction.

Why does the tooth break sometimes
during the extraction?

Teeth are embedded in bone. The principal behind extraction is that the tooth is held by forceps and rocked from side to side to allow the bony socket to expand. In patients who are aged, the bone is very hard and mature and does not easily expand. In addition the teeth also become brittle with age or may have been weakened due to dental decay. The two factors, namely weakened teeth and brittle bone may result in breaking of the tooth during extraction. The small piece of tooth left behind can be removed by appropriate root forceps or may require surgical opening of the gums and cutting of the bone to remove the broken fragment.

Should the gums be cut while
extracting some teeth?

Those teeth that cannot be gripped by a forceps or are embedded inside the bone may require cutting of the gums and the overlying bone to remove the teeth. This is called surgical method of extraction.

Dental Information on Dental Extractions and Surgeries

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wisdom tooth extrction

Can extractions be done on a patient having medical problems?

The dentist must be informed of any medical problems that you may have or had in the past. There are certain systemic problems, which may require certain precautions during the dental treatment so as to avoid complications. In some cases the dentist may require consent from your physician before he can extract.

steps in surgical extraction
1 - Tooth before extraction
2 - Administration of local anesthesia
3 - Cutting of the gums with a surgical blade
4 - Reflection of the gums away from the bone
5 - The exposed bone around the tooth
6 - Cutting the bone with a drill
7 - Removal of the tooth with a forceps
8 - Extracted tooth
9 - Smoothening the bony margins with a file
10- Irrigation of the socket
11- Suturing the socket
12- Suturing complete