Extractions are performed for a wide variety of reasons

Some of these include tooth decay that has destroyed enough tooth structure to render the tooth non-restorable. Extractions of impacted or problematic wisdom teeth are routinely performed, as are extractions of some permanent teeth to make space for orthodontic treatment.

The most common reason for extraction is tooth damage due to breakage or decay. There are additional reasons for tooth extraction:

• Severe tooth decay or infection. Despite the reduction in worldwide prevalence of dental caries, still it is the most common reason for extractions.
• Extra teeth which are blocking other teeth from growing.
• Severe gum disease which may affect the supporting tissues and bone structures of teeth.
• In preparation for orthodontic treatment / braces.
• Teeth in the fracture line
• Fractured teeth
• Insufficient space for wisdom teeth (impacted third molars). Although many dentist remove asymptomatic impacted third molars, most dental professionals recommend against this routine procedure, unless there are evidences for disease in the impacted tooth or the near environment.
• Receiving radiation to the head and neck may require extraction of teeth in the field of radiation.

Types of extraction

Extractions are often categorized as “simple” or “surgical”.

Simple extractions are performed on teeth that are visible in the mouth, usually under local anesthetic, and require only the use of instruments to elevate and/or grasp the visible portion of the tooth. Typically the tooth is lifted using an elevator, and using dental forceps, rocked back and forth until the Periodontal ligament has been sufficiently broken and the supporting alveolar bone has been adequately widened to make the tooth loose enough to remove. Typically, when teeth are removed with forceps, slow, steady pressure is applied with controlled force.

Surgical extractions involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line or because they have not erupted fully. Surgical extractions almost always require an incision. In a surgical extraction the doctor may elevate the soft tissues covering the tooth and bone and may also remove some of the overlying and/or surrounding jawbone tissue with a drill or osteotome. Frequently, the tooth may be split into multiple pieces to facilitate its removal. Surgical extractions are usually performed under a general anaesthetic.

What should you expect when you are scheduled for a tooth extraction?

Your dentist will numb the area to lessen any discomfort. After the extraction, your dentist will advise you of what post extraction regimen to follow, in most cases a small amount of bleeding is normal.

Avoid anything that might prevent normal healing. It is usually best not to smoke or rinse your mouth vigorously, or drink through a straw for 24 hours. These activities could dislodge the clot and delay healing.

For the first few days, if you must rinse, rinse your mouth gently afterward, for pain or swelling, apply a cold cloth or an ice bag. Ask your dentist about pain medication. You can brush and floss the other teeth as usual. But don’t clean the teeth next to the tooth socket.

For further information about this topic, or any other dental topic, contact Dr Slootsky at info@drslootsky.com, or call 954-972-1000

What is a laser and how does it work?

A laser is an instrument that produces a very narrow, intense beam of light energy. When laser light comes in contact with tissue, it causes a reaction. The light produced by the laser can remove, vaporize, or shape tissue.

Are lasers used in dentistry?

Yes, lasers have been used in dentistry since 1990. The U.S. Food and Drug Administration has determined that lasers can be used as a safe and effective treatment for a wide range of dental procedures. Lasers are often used in conjunction with other dental instruments.

How are lasers used in dentistry?

Dental lasers can be used to:

• correct speech problems caused by a tongue-tie, which prevents normal tongue movement.
• uncover partially erupted wisdom teeth.
• remove decay from a cavity and prepare the tooth for a new filling.
• remove muscle pulls, as seen in orthodontic patients.
• manage gum tissue during impressions for crowns.
• remove swollen tissues caused by medications.
• perform biopsy procedures.
• remove inflamed gum tissues and reduce the amount of bacteria within a periodontal pocket.
• remove or reshape excess gum and bone tissues during crown lengthening procedures.
• treat abscessed gums and infections in root canals.
• reduce the discomfort of canker and cold sores.
• activate whitening chemicals that are used to lighten teeth.

What are the benefits of using dental lasers?

There are several advantages. Dentists may not need to use a drill or administer anesthesia, allowing the patient to enjoy a more relaxed dental experience. Laser procedures can be more precise. Also, lasers can reduce symptoms and healing times associated with traditional therapies; reduce the amount of bacteria in both diseased gum tissue and in tooth cavities; and control bleeding during surgery.

Are dental lasers safe?

If the dental laser is used according to accepted practices by a trained practitioner, then it is at least as safe as other dental instruments. However, just as you wear sunglasses to protect your eyes from prolonged exposure to the sun, when your dentist performs a laser procedure, you will be asked to wear special eyeglasses to protect your eyes from the laser.

How can I be sure my dentist is properly trained to use a laser?

Ask your dentist questions about the extent of his or her laser education and training. Make sure that your dentist has participated in educational courses and received training by the manufacturer. Many dental schools, dental associations, and the Academy of Laser Dentistry (ALD) offer dental laser education. The ALD is the profession’s independent source for current dental laser education and credentialing.

How will I know if treatment with a dental laser is an option for me?

Ask your dentist. Although the laser is a very useful dental instrument, it is not appropriate for every dental procedure.

For further information about this topic, or any other dental topic, contact Dr Slootsky at info@drslootsky.com, or call 954-972-1000

Published with permission by the Academy of General Dentistry. © Copyright 2010 by the Academy of General Dentistry. All rights reserved

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