Tooth extraction

If a tooth is simply beyond repair, then an extraction is the wisest thing to do. There are dangers involved with extractions, which we will soon talk about, but first I want to describe the process.
The removal of a tooth can be a relatively simple affair. The patient goes in because of a toothache, or because of severe discoloration; it is determined that the tooth is dead, then it is extracted. This procedure takes about 25 minutes. However, especially with back teeth, or teeth that have multiple roots, teeth that grow horizontally, impacted teeth and wisdom teeth, the treatment tends to be more complicated. Roots can intertwine or be in the way of each other, a tooth may be located in some place where it cannot be extracted in one piece, and teeth may be aligned in a way as to cause damage to each other if extracted. An x-ray is mandatory before an extraction to determine if any of these difficulties are present. If the x-ray shows us that none of the above mentioned complications can occur, then a normal tooth extraction is in order. We have an x-ray machine that can take small x-rays of a single tooth, and we have one that can take a full panoramic x-ray or OPG. The use of such a device incurs an additional fee of 10 GBP for a single tooth, and 40 GBP for the OPG.

If the x-ray taken does show some complication such as (but sadly not limited to) the ones mentioned above, than a surgical extraction is necessary. This means that the patient will need to undergo oral surgery in order to remove the tooth in question. These surgeries are almost always done under local anaesthetic, as we do not use gas because recovery and healing time is much greater and discomfort might be felt upon the anaesthetic’s diffusion. Sometimes a tooth is lodged in a way that it can only be removed by cutting the tooth into smaller chunks and taking it out piece by piece. This is also a surgical procedure.

Wisdom teeth almost always require surgical extractions. Wisdom teeth grow in the years after the jaw has set and all of the other teeth have come in. They can be impacted, which always requires surgery to extract, they can grow sideways, out of the front of the gum, and in many bizarre places, they can push and crack, even break other teeth, and can become terribly infected as well. These cases almost always result in the surgical extraction of the wisdom tooth.

The dangers involved in this treatment are that after extraction of the root of a tooth, the alveolar tissue that housed and surrounded the root starts to disintegrate. This means that it lessens in mass and starts to disappear. This leads to a chain reaction, because with less tissue, the teeth surrounding the tooth that is missing become more mobile, and so on, until (hopefully within decades, but sometimes in just a few short years) all of our teeth are missing. This process can be reversed only with dental implants. Missing teeth can be covered with dentures and a Maryland bridge as well, but the disintegration at the ossicular level cannot be reversed, so it is vital that we do not let it start.    


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