Much as it is avoided by any dentist in Tunbridge Wells worth their salt, sometimes a tooth just has to come out. Whatever the circumstances leading to it, carrying out an extraction in the least invasive manner without collateral damage to other teeth is as much an art as a science.
Simple extractions are performed using a pair of forceps to securely hold the tooth as it is gently rocked backwards and forwards until loose in the socket. The sign of a good extraction is when the tooth is loosened right the way down to the root and when firmly pulled upwards away from the gum line, a whole tooth and its complete root comes away in one piece. It should not be a feat of strength, but one of technique.
Simple extractions are the most suitable and easiest to perform on healthy and complete teeth; this drastically reduces their remit, as you rarely have to remove healthy teeth. Sometimes, exactions are needed when space is required in an overcrowded arch or as part of orthodontic treatment.
During the surgical extraction, the tooth is approached from the front, and the gum is opened via incisions exposing the root. Often the tooth is removed in pieces, the gum is then closed with surgical glue or sutures and it is the end of the procedure. Great care has to be taken to ensure that all fragments of tooth have been removed and there’s often a final X-ray used to ensure this.
Surgical extractions can be used to remove teeth which are structurally unsound and would simply break under the force of forceps. It is also necessary to remove a tooth with compacted or convoluted roots that may be intertwined with neighbouring teeth.
After an extraction, you’ll be given simple instructions by your dental team on maximising healing and recovery when there are relatively few complications, the most common of which are infections and dry socket. If you have a reduced immune system you may be prescribed antibiotics.
Dry socket is a complication in healing, where tissue has not grown over the socket but instead from the surface of the gum line down to the jawbone. This leaves a patch of jawbone exposed to the environment of the inside of the mouth and can be extremely uncomfortable. Thankfully, it can be avoided by allowing the empty socket to heal with minimal disruption. It’s important not to brush or clean the socket aggressively.
Note to anxious patients
Many anxious patients will default towards an extraction, seeing it as a faster treatment option; this can be particularly true with dental abscesses, where a root canal which is a relatively long procedure is avoided over an extraction. Extractions result in a loss of teeth and a far worse outcome compared to a root canal. If you do suffer with dental anxiety please talk to your local clinic about options like sedation dentistry and other methods of modifying treatment, to make root canal procedures easier rather than jumping to extractions.