Disease, trauma, and crowding are the primary reasons for tooth extraction. A badly decayed tooth may not have enough structure left to place a filling or even put on a crown. A bridge or dental implant may be a better solution, but the tooth must be extracted first. A badly broken tooth may be splintered beyond repair. People who have small jaws and large teeth may have so much crowding that it affects tooth development, makes oral hygiene nearly impossible or changes the bite. Sometimes it’s necessary to remove a tooth in order to apply braces.
The administration of a local anesthetic is the first step in single tooth extraction. Patients who need multiple or all the teeth extracted usually need a general anesthetic; these procedures are usually done in an outpatient surgery center or hospital. Once the tooth is numb, the dentist may need to make an incision (cut) in the gum to provide access to the tooth root. A special tool called an elevator is used to loosen the tooth from its socket. Finally, the dentist grasps the tooth with a pair of forceps and levers it out of the socket. If necessary, the incision is closed with sutures.
Preventing infection, managing swelling and discomfort and protecting the surgical area are the most important aspects of aftercare. Rinsing the mouth with diluted mouthwash or lukewarm salty water helps keep debris cleaned out and decreases bacteria. The remaining teeth can be flossed and brushed, but patients should avoid the surgical area. A little swelling is normal and can usually be managed with an ice bag (protect the skin with a towel or washcloth). Over-the-counter medications usually manage any discomfort. Straws, toothpicks, and smoking should all be avoided until the site has completely healed. A soft diet may be easier for the first few days after the extraction.
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