Extractions

At The Dentist Place, we always make every attempt to treat your teeth and remedy any dental malady. Unfortunately, in some cases damage to teeth is in so advanced a stage that is may be necessary to extract the tooth in order to maintain dental health.

If a tooth is broken, cracked or extensively decayed it may be necessary to remove it. Likewise, a tooth that is associated with advanced stages of periodontal disease should be removed, as well as teeth that are poorly positioned or non-functional.

Our commitment is to providing the highest quality of dental care for our patients, and we want to do the same for you. For more information or to schedule an appointment, please contact us today.

Wisdom Tooth Extraction

When a tooth is deemed unsalvageable, often the best choice of treatment is to have the tooth removed, or extracted. Here at The Dentist Place, our doctors will make sure you are comfortable throughout the whole procedure. We do offer sedation options in the office for those patients who are a bit more nervous about such a procedure.

Is It A Good Idea To Remove Wisdom Teeth?

If there is not enough room to fully grow into one's mouth, and food may get trapped under the gums that partially cover the tops of the wisdom teeth. Unless one practices a rigorous, daily program of dental hygiene that focuses on the wisdom teeth, the trapped food will produce decay and gum infection.

In addition to avoiding decay and infection, extraction is a good idea for other reasons. If one is 18 years old, the roots of the wisdom teeth may still be small and far from the large nerve that runs along the jawbone. After the extractions, bone will more easily fill in the spaces left by the wisdom teeth. All of this means that the extraction process should be easier and the healing more rapid and complete.

Extracting Wisdom Teeth

Before we explain precisely how wisdom teeth are removed, here are some suggestions to make the procedure easier and more comfortable for you:

• You probably won't feel like driving home after your surgery appointment, so arrange to have a friend or family member come with you.
• If you plan to have intravenous sedation, remember not to eat or drink after midnight the night before surgery. If you forget, you'll either have to be awake, or reschedule the appointment.
• Schedule some time off from work or school. You'll probably want to take it easy for several days after your appointment.
• If you choose intravenous sedation, remember to wear comfortable, loose-fitting clothes with sleeves that can roll up.

An appointment to have all four wisdom teeth removed normally only takes an hour or two. You will have gas or intravenous sedation to relax you, and then your Dentist will numb the entire area around your teeth. The procedure will not begin until you are completely numb. Although you will feel pressure when a tooth is removed, you should not feel any pain. If you do, let your Dentist know. He will stop immediately and give you more anesthetic.

Sometimes it is easier for your Dentist to remove the tooth if he cuts it in half before removal. If your tooth is below the gumline, it will be removed through a small incision in the gums. A couple of stitches will close the incision. Having your wisdom teeth extracted will prevent many future problems, and with modern dental techniques, the procedure should be completely comfortable.

Alternatives to Extracting Wisdom Teeth

The alternative to having wisdom teeth removed is to keep them. A few lucky people are able to keep their wisdom teeth, and care for them as they would their other teeth. However, for most of us, this is not possible, and a delay in their removal can cause serious problems.

In the first illustration above shown is an impacted wisdom tooth that may push on other teeth. It can be excruciatingly painful when a wisdom tooth that has started to erupt becomes infected. This is a common dental emergency that can cause pain for days, even after antibiotics are started.

A misaligned tooth can also cause cavities. In the second illustration above, is shown an x-ray of a wisdom tooth coming in sideways and causing a cavity in the second molar. Additionally, wisdom teeth are nearly impossible to keep free of plaque.

Shown in the 3rd illustration, plaque caused the cavity in this wisdom tooth. Plaque also causes periodontal disease, which may start near the wisdom teeth and spread throughout the mouth. Sometimes cysts form around impacted wisdom teeth; cysts can destroy a tremendous amount of bone before they are even noticed. The dark area shown in the 4th illustration above is a cyst that will require surgery to repair.

As time passes, the roots of wisdom teeth may grow around a nerve in the jaw. When this happens, the nerves entwined in the roots of the wisdom teeth can be damaged during extraction. This could leave your lip and chin permanently numb.

Because of these many serious problems, it's usually better to remove wisdom teeth early, even before they break through the gums.

Wisdom teeth, or "third molars," are the last teeth to develop. If there is room for them, they usually start to appear in the late teens or early 20's, and that is when problems can begin.

An impacted wisdom tooth may push on other teeth. It can be excruciatingly painful when a wisdom tooth that is partially erupted becomes infected. This is a common dental emergency, and can cause pain for days, even after antibiotics are started.

There are many advantages to removing wisdom teeth in the mid-teen years:

• The roots of the teeth are still short.
• There is still a space around them, making them easier to remove.
• There is less risk of nerve damage.
• Bone will fill in better behind the second molar.

All of this adds up to less pain and faster, easier healing.

Following A Tooth Extraction

After an extraction, it is important for a blood clot to form to stop the bleeding and begin the healing process. That is why your dentist will ask you to bite on a gauze pad for 30-45 minutes after an extraction. If bleeding or oozing continues after you remove the gauze pad, place another gauze pad on the area and bite firmly for another 30 minutes. You may have to do this several times.

After the blood clot forms, it is important to protect it, especially for the next 24 hours. It's important to not:

• Smoke
• Suck through a straw
• Rinse your mouth vigorously
• Clean the teeth next to the extraction site

These activities would dislodge the clot and slow down healing.

Limit yourself to calm activities for the first 24 hours. This keeps your blood pressure lower, reduces bleeding, and helps the healing process.

After the tooth is extracted you may feel some pain and have some swelling. You can use an ice bag (20 minutes on, 20 minutes off) to keep this to a minimum. The swelling usually starts to go down after 48 hours.

To control discomfort, take pain medication as recommended. Do not take medication on an empty stomach or nausea may result. If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone. Also:

• Drink lots of fluids
• Eat only soft, nutritious foods on the day of the extraction
• Do not use alcoholic beverages
• Avoid hot and spicy foods

You can begin eating normally the next day, or if not by then, as soon as it is comfortable. Gently rinse your mouth with warm saltwater three times a day (put a teaspoon of salt in a cup of warm water, gently rinse-swish-spit). Also, rinse gently after meals. This helps keep food out of the extraction site.

It's very important to resume your normal dental routine after 24 hours. This should include brushing your teeth and tongue and flossing at least once a day. This will speed healing and help keep your breath and mouth fresh. Call your dental office immediately if you have:

• Heavy bleeding
• Severe pain
• Continued swelling after two or three days
• A reaction to the medication

After a few days, you will be feeling fine and can resume your normal activities.