Tooth Extraction


Also found in: Dictionary, Thesaurus, Encyclopedia.
Related to Tooth Extraction: root canal, Tooth implant

Tooth Extraction

 

Definition

Tooth extraction is the removal of a tooth from its socket in the bone.

Purpose

Extraction is performed for positional, structural, or economic reasons. Teeth are often removed because they are impacted. Teeth become impacted when they are prevented from growing into their normal position in the mouth by gum tissue, bone, or other teeth. Impaction is a common reason for the extraction of wisdom teeth. Extraction is the only known method that will prevent further problems. Teeth may also be extracted to make more room in the mouth prior to straightening the remaining teeth (orthodontic treatment), or because they are so badly positioned that straightening is impossible. Extraction may be used to remove teeth that are so badly decayed or broken that they cannot be restored. In addition, patients sometimes choose extraction as a less expensive alternative to filling or placing a crown on a severely decayed tooth.

Precautions

In some situations, tooth extractions may need to be postponed temporarily. These situations include:
  • Infection that has progressed from the tooth into the bone. Infections may make anesthesia difficult. They can be treated with antibiotics before the tooth is extracted.
  • The patient's use of drugs that thin the blood (anticoagulants). These medications include warfarin (Coumadin) and aspirin. The patient should stop using these medications for three days prior to extraction.
  • Patients who have had any of the following procedures in the previous six months: heart valve replacement, open heart surgery, prosthetic joint replacement, or placement of a medical shunt. These patients may be given antibiotics to reduce the risk of bacterial infection.

Description

Tooth extraction can be performed with local anesthesia if the tooth is exposed and appears to be easily removable in one piece. An instrument called an elevator is used to loosen (luxate) the tooth, widen the space in the bone, and break the tiny elastic fibers that attach the tooth to the bone. Once the tooth is dislocated from the bone, it can be lifted and removed with forceps.
If the extraction is likely to be difficult, the dentist may refer the patient to an oral surgeon. Oral surgeons are specialists who are trained to give nitrous oxide, an intravenous sedative, or a general anesthetic to relieve pain. Extracting an impacted tooth or a tooth with curved roots typically requires cutting through gum tissue to expose the tooth. It may also require removing portions of bone to free the tooth. Some teeth must be cut and removed in sections. The extraction site may or may not require one or more stitches to close the cut (incision).

Preparation

Before an extraction, the dentist will take the patient's medical history, noting allergies and prescription medications. A dental history is also taken, with particular attention to previous extractions and reactions to anesthetics. The dentist may then prescribe antibiotics or recommend stopping certain medications prior to the extraction. The tooth is x-rayed to determine its full shape and position, especially if it is impacted.
If the patient is going to have deep anesthesia, he or she should wear loose clothing with sleeves that are easily rolled up to allow for an intravenous line. The patient should not eat or drink anything for at least six hours before the procedure. Arrangements should be made for a friend or relative to drive the patient home after the surgery.

Aftercare

An important aspect of aftercare is encouraging a clot to form at the extraction site. The patient should put pressure on the area by biting gently on a roll or wad of gauze for several hours after surgery. Once the clot is formed, it should not be disturbed. The patient should not rinse, spit, drink with a straw, or smoke for at least 24 hours after the extraction and preferably longer. Vigorous exercise should not be done for the first three to five days.
For the first two days after the procedure, the patient should drink liquids without using a straw, and eat soft foods. Any chewing must be done on the side away from the extraction site. Hard or sticky foods should be avoided. The mouth may be gently cleaned with a toothbrush, but the extraction area should not be scrubbed.
Wrapped ice packs can be applied to reduce facial swelling. Swelling is a normal part of the healing process. It is most noticeable in the first 48-72 hours. As the swelling subsides, the patient may experience muscle stiffness. Moist heat and gentle exercise will restore jaw movement. The dentist may prescribe medications to relieve the postoperative pain.

Risks

Potential complications of tooth extraction include postoperative infection, temporary numbness from nerve irritation, jaw fracture, and jaw joint pain. An additional complication is called dry socket. When a blood clot does not properly form in the empty tooth socket, the bone beneath the socket is painfully exposed to air and food, and the extraction site heals more slowly.

Normal results

After an extraction, the wound usually closes in about two weeks. It takes three to six months for the bone and soft tissue to be restructured. Complications such as infection or dry socket may prolong the healing time.

Resources

Organizations

American Association of Oral and Maxillofacial Surgeons. 9700 West Bryn Mawr Ave., Rosemont, IL 60018-5701. (847) 678-6200. http://www.aaoms.org.

Key terms

Dry socket — A painful condition following tooth extraction in which a blood clot does not properly fill the empty socket. Dry socket leaves the underlying bone exposed to air and food.
Extraction site — The empty tooth socket following removal of the tooth.
Impacted tooth — A tooth that is growing against another tooth, bone, or soft tissue.
Luxate — To loosen or dislocate the tooth from the socket.
Nitrous oxide — A colorless, sweet-smelling gas used by dentists for mild anesthesia. It is sometimes called laughing gas because it makes some patients feel giddy or silly.
Oral surgeon — A dentist who specializes in surgical procedures of the mouth, including extractions.
Orthodontic treatment — The process of straightening teeth to correct their appearance and function.

extraction

 [ek-strak´shun]
1. the process or act of pulling or drawing out.
2. the preparation of an extract.
breech extraction extraction of an infant from the uterus in cases of breech presentation.
flap extraction removal of a cataract by making a flap in the cornea.
menstrual extraction a form of induced abortion in which a flexible cannula is inserted through an undilated cervix for the purpose of removing the fertilized embryo and endometrium. The cannula is attached to a syringe, which is used to aspirate the uterine contents and induce the onset of the “missed period.” This technique is not always effective, and sometimes a second procedure is required. It should be done within two weeks of a missed menstrual period.
serial extraction the selective extraction of primary teeth during an extended period of time to allow autonomous adjustment.
tooth extraction forcible removal of a tooth; called also odontectomy.
vacuum extraction removal of the uterine contents by application of a vacuum, done either for delivery of a viable fetus or for an abortion.
References in periodicals archive ?
Tooth extractions which most often are due to infections such as marginal or apical periodontitis have been found to predict mortality in individuals with diabetes [10, 11].
Absolute and relative (%) frequency distributions were obtained for all qualitative, nonnumerical variables (such as patients' gender, age, according to age intervals, and smoking habit and as implant site, position, reason for tooth extraction, and presence/absence of endodontic lesion).
It is obvious that a simple tooth extraction in the posterior maxillary region can cause a serious complication such as infratemporal space infection.
As result of data evaluation it was detected that 922 patients under age of 18 underwent sedation/ analgesia for tooth extraction. Demographic information of patients is presented in TableI.
This supports other research findings that identified caries as the primary reason for tooth extraction in many other populations.
Patients were randomized to either having their ASA therapy suspended for seven days before tooth extraction and restarted the day following the surgical procedure or not having their ASA therapy suspended at any point before or after the procedure.
After tooth extraction, the levels of inflammatory cytokine in the serum of the normal and diabetic rats were determined.
There are several possible explanations for this patient's relief from cluster headaches following the tooth extraction. First, the relief could have been purely incidental.
In cases of minor surgical intervention (tooth extraction, supragingival periodontal treatment) and major surgical intervention (surgical tooth extraction with complication, subgingival periodontal treatment) the desired foctor levels should be approximately >50 IU/dL and >80 IU/dL, respectively (4).
I needed a wisdom tooth extraction so I went to a well-known dentist clinic and was told I had three impacted wisdom teeth, which needed to be extracted surgically
They are usually administered into the gum or inner cheek just before a filling, tooth extraction or root canal treatment, which would otherwise be excruciatingly painful.
Histological examination carried out in control rats two weeks after the tooth extraction showed the alveolar socket occupied by mature connective tissue and delicate bone trabeculae lined with osteoblasts (Figure 1A), which formed from the inner surfaces of the alveolar walls.