Posts for: March, 2020
Removing a problem tooth (extraction) is a common dental procedure. But not all extractions are alike — depending on the type of tooth, its location and extenuating circumstances, you may need an oral surgeon to perform it.
Fortunately, that's not always the case. Teeth with straight or cone-shaped roots, like an upper front tooth, have a fairly straight removal path. A general dentist first carefully manipulates the tooth loose from the periodontal ligament fibers that help hold it in place (experienced dentists, in fact, develop a “feel” for this process). Once it's loosened from the fibers it's a simple motion to remove the tooth.
But as mentioned before, a “simple extraction” won't work with every tooth or situation. To find out if it can we'll first need to determine the true shape of the tooth and roots, as well as the condition of the supporting bone. We might find any number of issues during this examination that make a simple extraction problematic.
For example, teeth with multiple roots (especially in back) may have complicated removal paths. If the roots themselves are unhealthy and brittle from previous injury or a root canal treatment, they can fracture into smaller pieces during removal. A tooth could also be impacted — it hasn't fully erupted but remains below the gum surface. It's these types of situations that require surgery to remove the tooth.
During a surgical extraction, the oral surgeon will first numb the area with a local anesthetic, as well as a sedative if you have issues with anxiety. They then perform a surgical procedure appropriate for the situation to remove the tooth. More than likely they'll insert bone grafts before closing the site with stitches to deter bone loss (a common occurrence after losing a tooth).
Afterward, your provider may prescribe antibiotics and an antibacterial mouthrinse to ward off infection. You'll also be given care instructions for the extraction site to keep it clean. Any discomfort should subside in a few days and can be managed effectively with a mild anti-inflammatory drug like ibuprofen or aspirin.
It can be overwhelming having a tooth removed. In your dentist's capable hands, however, the experience will be uneventful.
If you would like more information on tooth extraction, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Simple Tooth Extraction?”
This year's Carol Burnett Award, presented at the Golden Globes, goes to Ellen DeGeneres for her “outstanding contributions to the television medium on or off the screen.” This is the latest in a long list of honors for the comedienne, talk show host and activist that includes Emmys, Grammys and Teen Choice Awards. And one not quite as well-known: a 2004 “Flossy” award.
DeGeneres received this honor from the National Flossing Council in recognition of her passionate promotion of oral hygiene, particularly flossing. She wrote about its virtues in her 2003 book, The Funny Thing Is…., saying, among other things, “Don't even think for a second that you can get away with not flossing.”
DeGeneres's motivational cheerleading for flossing is helpful and necessary because, well, many of us just don't like doing it. It requires more manual dexterity than its more popular sibling, brushing. And the tendency for the floss to gunk up with plaque residue for some is simply unpleasant.
Mainly, though, many folks think brushing is enough. Not so fast, according to dental professionals. While brushing removes disease-causing bacterial plaque from broad tooth surfaces, it can't effectively get into the spaces between teeth. It takes flossing to clear plaque from these more difficult areas.
But don't fret: There are ways to make flossing an easier—and more pleasant—task.
Ask us for help. As we said before, flossing does take some hand dexterity and coordination to perform. You may also wonder if you're doing it effectively. We can provide training and tips on how to be a more effective flosser at your next visit.
Practice, practice, practice. You probably think nothing of riding a bicycle, and yet it probably took you weeks or months as a kid to become proficient. Similarly, your first attempts at flossing might feel awkward, but you'll improve with practice, so don't give up.
Brush before you floss. Most people floss before brushing, but if you tend to encounter a lot of soft plaque debris that makes flossing “icky” for you, then try brushing first to clear a good portion of it out of the way before you floss. Just be aware, most professionals believe that flossing first is better because it loosens up debris between teeth so the bubbles from the toothpaste can carry it away. But any flossing is better than no flossing!
Try flossing tools. For some people, floss picks, small pre-threaded tools you can use with one hand, seem easier to maneuver than regular floss thread. If you have issues with manual dexterity, an oral irrigator can make the task easier: This handheld device uses a stream of pressurized water to loosen and flush away plaque between teeth.
So, follow Ellen DeGeneres's advice she gave Tulane University graduates during a commencement speech: “Remember to exfoliate, moisturize, exercise…and floss.” The latter, along with brushing, will certainly help keep your teeth and gums healthy.
Dentists around the world routinely remove diseased or damaged teeth every day. While some extractions require surgery, many don't: Your family dentist can perform these simple extractions, usually with little complication.
The term simple doesn't necessarily mean easy—as we'll note in a moment, it takes a deft and experienced hand to perform this type of extraction. The term in this case refers more to the type and condition of the tooth: The tooth roots are relatively straight and reside in the bone at an accessible angle. There are otherwise no meaningful impediments to removing it straight out.
The idea of “pulling a tooth” out of the jaw isn't the most accurate way to describe the procedure. A tooth is actually held in place within its bony socket by the periodontal ligament, a tough, elastic tissue between the tooth root and the bone that attaches to both through tiny fibrous extensions. The best method is to first loosen the tooth from the ligament's tiny attachments, for which experienced dentists can develop a certain feel. Once released from the ligament, the tooth will usually come free easily from its socket.
Not all teeth, though, can be removed in this manner. Teeth with multiple roots like back molars, and without a straight trajectory out of the socket, can have a complicated removal. Other dental conditions could also prove problematic for simple extraction, such as brittle roots that might fragment during removal.
For these and other complications, your general dentist may refer you to an oral surgeon for the tooth extraction. But even with the surgical component, these more complicated extractions are relatively minor and routine—millions of wisdom teeth, for example, are removed every year in this manner.
If you have a tooth that needs to be removed due to disease or injury, your dentist will first determine the best way to remove it and will refer you, if necessary, for surgical extraction. And whatever kind of extraction you undergo, the dentist performing it will make sure you remain pain-free during the procedure.
While tooth preservation is usually the best course for long-term dental health, it's sometimes best to remove a tooth. If that should happen, your dentist will make sure it's done with as little discomfort to you as possible.
If you would like more information on dental extraction methods, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Simple Tooth Extraction?”