Teeth require extraction if they are grossly decayed (caries), or are damaged by trauma and cannot be restored. A tooth may need to be removed if it is involved in disease processes such as abscess formation, gross periodontal disease (disease of the tissue around the root of a tooth, also called ‘pyorrhoea’), cystic disease of the jaws, or cancer of the mouth. Loss of teeth due to gum disease is often a result of poor oral hygiene. Healthy teeth may also be extracted as part of an orthodontic or restorative dentistry treatment plan.
What are the implications of tooth loss?
Tooth loss has both cosmetic and functional implications. The loss of front teeth can be unsightly, and the loss of back teeth could result in gastro-intestinal problems because food is not chewed sufficiently. There may also be temporomandibular (jaw) disorders (TMD) due to loss of support from the back teeth. It may therefore be necessary to replace extracted teeth with dentures, crowns, bridges, or implants.
What is involved in a tooth extraction procedure?
The majority of teeth can be removed directly using extraction forceps and elevators, after a local anaesthetic has been given, and without the need to remove soft tissue and bone.
Where teeth are broken down or impacted, e.g. roots and wisdom teeth, the procedure necessitates surgery under local anaesthesia, local anaesthesia with sedation or, occasionally, general anaesthesia. This type of surgery may be beyond the expertise of the general dental practitioner and, if that is the case, you will be referred to a specialist.
Most minor oral surgical procedures, such as the removal of roots, impacted teeth, the correction of ono-antral communications (a channel between the mouth and the sinus that may be created when the roots of the tooth to be extracted lie very close to the sinus lining), or the treatment of dento-alveolar trauma (damage to the tooth socket due to an accident or injury) can be carried out as day care procedures.
After such procedures you will normally have stitches (‘sutures’) placed over the wound in your mouth to help the healing process. You will normally have to return after a week to have these removed, unless they are the type of stitches that dissolve. Removing the stitches is a painless procedure that only takes a few minutes.
The most common minor oral surgical procedure carried out is the removal of wisdom teeth. There should be clear indications for their removal and they should not be removed just because they are present
