Of all types of surgical dental procedures, tooth extraction is the most common. Thanks to the development of new therapeutic techniques, this procedure is used only in extreme cases. Moreover, even removal with minimal trauma and in comfortable conditions leads to significant changes in the body.
When is it necessary to remove a tooth?
The decision to remove the tooth is taken by the dental surgeon after the examination, and often requires an X-ray diagnostic. Depending on the severity of the pathological process, the operation can be planned or emergency. Often, manipulation is performed under out-patient conditions, however, in the case of a patient's severe condition, removal can be carried out in a hospital.
The main indications for tooth extraction are as a matter of urgency the following:
- the emergence of acute purulent inflammation, transferring to bone tissue ( osteomyelitis , periostitis ) due to a sick tooth;
- maxillary abscesses, phlegmon , purulent lymphadenitis, sinusitis associated with the defeat of a non-conservative tooth;
- fracture of the tooth - longitudinal, in the crown part with the exposure of the pulp if it is impossible to restore by conservative methods.
Conducting planned manipulations can be appointed at a certain time, which is sometimes preceded by the necessary conservative therapy (removal of dental deposits, antibiotic therapy, taking anti-inflammatory drugs, and so on). In some cases, delaying the removal of a diseased tooth is required until the patient's condition is stabilized, remission occurs in certain pathologies (acute viral diseases, hypertension, arrhythmia, stomatitis, etc.). Scheduled teeth are removed according to the following indications:
- chronic radical periodontitis with obstruction of the root canal, as well as complicated by neuralgia, sinusitis;
- periodontitis with third and fourth degree teeth mobility;
- the destroyed root of a tooth, on which it is impossible to establish an orthopedic structure;
- atypical position of the teeth in the dentition, not subject to correction and leading to a violation of chewing functions, speech, chronic trauma of mucous in the mouth;
- fracture of the root of the tooth;
- fracture of the jaw , in which a tooth is located on the fracture line;
- tumors of the jaw;
- need for prosthetics (single teeth, which complicate the installation of the prosthesis);
- teeth that cut only partially, which cause chronic inflammation of the tissues and pain.
How to prepare a tooth?
Traditionally, a favorable time for surgical operations is morning. This is due to the fact that in the morning, an organism full of energy is easier to bear any stresses than in the evening. In addition, the pain after tooth extraction is better to withstand during the day, when there is, than to distract, and not to suffer, not sleeping at night. If there are any complications, it's easier to consult a doctor during working hours.
The main recommendations for those who expect a tooth extraction operation are as follows:
- If general anesthesia is not planned, you should eat 1.5-2 hours before the visit to the dentist, because after a while after manipulation you will not be able to eat, and this will reduce the risk of bleeding (the blood will be curtailed sooner) and reduce salivation.
- In severe swelling, it is acceptable to take a sedative, better than plant origin (based on valerian root, motherwort), in a standard dosage.
- Refuse from alcohol one day before surgery.
Is it painful to tear a tooth?
In modern conditions to pull out a tooth - it is practically painless, due to qualitative anesthetics of local action. Even with increased sensitivity to pain, this procedure can be performed with a minimum of uncomfortable sensations for the patient. The injected analgesic substance begins to act after a few minutes, and its effect continues for several more hours. Only after that there are painful sensations in the area of the socket of the removed tooth, which gradually subside and can be stopped by oral painkillers.
The question of the type of anesthesia is agreed with the doctor, who is obliged to find out and check if the patient has an allergy to the recommended anesthetic drug. When choosing a medicine, existing chronic pathologies are taken into account. Often, injecting methods are used - with the help of an injection, before which application of an anesthetic analgesia of the needle insertion site is possible. The tooth extraction can be performed using one of the following types of injection anesthesia:
- Conductor - the injection is done in the area of the last tooth in the row, where the branch of the nerve is located, and so the whole nerve is blocked (for anesthesia of several teeth).
- Infiltration - the medicine is injected into the area of the projection of the tip of the root of the tooth or into the gum from the side of the lip or from the sky to the end of the root.
- Intra-connective - the injection is done by a special syringe through the gum in the periodontal ligament of the tooth, supporting the tooth in the alveolus.
- Intraosseous - the drug is introduced into the spongy bone tissue, which gives maximum effectiveness.
For anesthesia, in general, they are used such drugs:
- Novocaine;
- Lidocaine;
- Articaine;
- Ubistezin;
- Ultracaine.
How to tear a tooth without pain?
Sometimes, the extraction of teeth under general anesthesia, relieving all discomfort, but this has its testimony:
- large volume and traumatism of the forthcoming intervention (removal of several units, complex removal of the "eight", a tooth with a branched root system);
- allergy to medicines for local anesthesia;
- pronounced emetic reflex;
- panic fear of surgery;
- mental disorders;
- some endocrine pathologies;
- treatment of osteomyelitis;
- complex maxillofacial trauma, etc.
The extraction of teeth under general anesthesia is carried out with the involvement of an anesthesiologist. For this, inhalation preparations are used (Sevoflurane, Halothane, etc.), agents for intravenous use (Propofol, sodium sibutyrate and so on). In this case, special preparation, holding of premedication, elimination of all contraindications is required. After the procedure, stay in the medical institution for a while.
How are the teeth removed?
Before tearing out the tooth, the oral cavity is treated with antiseptic and anesthetics. In standard situations, the procedure is carried out approximately as follows: first it is required to widen the tooth socket and separate the tooth from the ligaments as the bone tissue is compressed. This is done by loosening the tooth with a certain pressure back and forth and from side to side. After this, the tooth is removed from the well and a gauze swab is applied to stop the bleeding. Sometimes it is necessary to use hemostatic drugs, suturing.
Removing the tooth
The retina is an abnormally developed one, which is fully formed, but not broken or looking only partially. In many cases, such teeth cause inflammation, pain, and therefore must be removed. Such a complex tooth extraction, characterized by increased traumatism, provides an incision of the gum, releasing it from the bone by means of boron, dislocation and extraction. Sometimes a tooth is divided into fragments and their separate extraction. After that, the seams are applied.
Removal of the root of the tooth
Removal of the tooth, from which only the root part remained due to the destruction of the crown part due to caries or trauma, has its own peculiarities. It is worth noting that sometimes it remains possible to save the root, if it is not severely affected, having undergone treatment and resorting to restoration, prosthetics. To remove the root of the tooth, it often requires cutting the gums, crushing the tooth tissue, using special tools that are inserted between the wall of the hole and the root part (elevators).
Tooth extraction - complications
As in the case of any other surgical manipulation, after the extraction of the tooth, various complications may appear. Some of them are physiological - the operation is accompanied by damage to the tissues of the gums, muscles, ligaments, vessels, nerve fibers. They independently go through several days without treatment. Others - pathological, requiring urgent therapy. A normal reaction of the body can be considered the following manifestations:
- pain in the area of the hole and near it, not increasing with time, and with the removal of the eighth, seventh and sixth teeth - spreading on the jaw, ear region;
- edema after tooth extraction, affecting the gum and cheek, gradually diminishing;
- slight bleeding, stopping for several hours;
- increase in body temperature not higher than 38 ° C (no more than a day);
- a white hole after removal of a tooth on 3-4 days - tightening of a place where there was a tooth, a thin white film.
The pathological consequences are:
- alveolitis (dry hole);
- osteomyelitis;
- heavy bleeding from the socket;
- paresthesia (loss of sensitivity of the tongue, lips, facial areas).
In addition, due to incompetence of the doctor, his wrong actions, the development of such complications is possible:
- incomplete tooth extraction;
- damage or removal of an adjacent tooth;
- dislocation or jaw fracture;
- damage to the septum between the maxillary sinus and the oral cavity.
Alveolitis after tooth extraction
A common type of complication after tooth extraction is the alveolitis, consisting of an infectious-inflammatory process in the hole due to the entry of pathogenic microorganisms. Characteristic features are:
- severe pain in the area of the removed tooth, often of a pulsating nature, appearing after 3-5 days;
- prolonged persistent elevated body temperature;
- increased regional lymph nodes;
- bad breath;
- swelling of the cheek;
- deterioration of general well-being.
Temperature after tooth extraction
A natural rise in temperature, as a result of the immune response to tissue damage, is observed on the first day after the manipulation. Gradually the temperature should be normalized. If, after tooth extraction, the cheek is swollen, intense pain sensations are observed, the wound suppurates, does not heal for a long time and at the same time the body temperature keeps at high values for more than a day, this is a symptomatology of the infectious process.
What to do after tooth extraction?
If the procedure is normal, without complications, no special treatment is required after tooth extraction. Immediately after the operation, you should observe peace for half an hour, do not talk, keep the tampon in the hole. To prevent severe swelling to the cheek from the side of the removed tooth, a cold compress can be applied. In addition, after removing the tooth, you must:
- Refuse from active physical activity, baths, saunas for a couple of days.
- Drink and eat for 2-3 hours.
- Chew on the side of the removed tooth, eat hot food and drinks before healing the socket.
- Do not brush your teeth for 24 hours.
How much does the gum healing after tooth extraction?
Many patients are interested in how much the gum aches after tooth extraction is normal. Any trauma is associated with a pain syndrome, and after this operation, unpleasant sensations are common. Often the severe pain is felt after the end of the action of the anesthetic and 1-2 days are felt. Gradually it subsides, which serves as a sign of healing. Intense pain can still persist for 1-2 weeks, depending on the degree of tissue damage.
They pulled out a tooth, the gum hurts - what should I do?
In cases where the gum is very painful after tooth extraction, in the first days it is recommended to take painkillers as agreed with the doctor. Such means are effective:
- Ketanov;
- Ibuprofen;
- Paracetamol;
- Nimesil ;
- Solpadein;
- Analgin and others.
What to rinse your mouth after tooth extraction?
After the tooth was ripped out, how to rinse the mouth, how to do it, and whether there is a need for it, the dentist will tell. It is important to consider how the tooth is removed, whether a gum incision was made, whether complications occurred during the operation. Intense rinsing is in any case excluded - this can lead to the washing out of the protective blood clot and exposure of the socket. Oral baths with the following solutions can be recommended:
- Chlorhexidine;
- Chlorophyllipt;
- tincture of calendula;
- tincture of sage;
- Miramistin;
- strong saline solution.
Antibiotics after tooth extraction
By appointment, the dentist in some cases, you need to take the medicine after tooth extraction to eliminate the infectious processes. Popular antibiotic agents in dental practice are:
- Tsifran;
- Flemoxin;
- Amoxiclav;
- Lincomycin.