Though the priority is always to save the tooth but sometimes due to following reasons it is advised for extraction and then replacement afterwards:-
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Grossly decayed with very brittle tooth structure left.
- Infected root pieces left.
- Grade III mobile tooth that can't be saved by splinting.
- Wisdom tooth-infected or impacted.
- Impacted teeth.
Nowadays with every effective local anesthesia and fine forceps and elevators, the extractions are not only painless but no more fearful.
Atraumatic Extraction
Atraumatic extraction is the latest technique of extractions in which the surgeon doesn't use forceps for extraction but uses elevators so that there is no damage to underlying bone and no unnecessary forces are applied. In maximum cases now surgeons do atraumatic extractions. Only in some complicated situation like:
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Ankylosed roots (roots fused to underlying bone).
- sharply curved roots(dilacerated roots)
- Fused roots
- Brittle roots
The surgeon might have to perform surgical extraction. But in such cases also, their nothing to worry about because with effect of local anaesthesia the entire procedure is painless.
Wisdom Tooth (III molars/Impacted molar)
Wisdom teeth are the last molars to erupt in mouth. They erupt at the age of 18-25 years. It shows maximum number of variations anatomically, regarding direction of eruption and regarding age of eruption. Since it is the last tooth to erupt, in most of the people there is lack of space for III molar. So in attempt to erupt, they apply forces on the adjacent molar and when fail to erupt called impacted. You might experience one /maximum of the following signs & symptoms:
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Severe pain in back region of jaws.
- The pain might radiate to front region of jaw.
- Swelling.
- Swelling in lymph modes.
- Feeling of pus oozing out.
- Mild rise in body temperature.
- Sourness of throat.
- Reduced mouth opening.
So in those situations when III molar is impacted, it is advised to go for surgical extraction. This procedure is a minor surgery.
Points to be taken care before extraction/surgery for impacted tooth:
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Always take food 1 or 2 hrs before you go for extraction unless you are asked by your surgeon to come empty stomach.
- Always inform your dental surgeon about your:
-
medical history
- if allergic to any medications.
- Always give honest history of alcohol intake or cigarette smoking or any other form of tobacco intake.
- Go with a relaxed and calm mind.
Sometimes even after eruption, since it's the last backmost tooth in the jaw, proper cleansing by brush is not done so it gets carious very often. In that case also it is advised for extraction because it is not functionally important hence not saved by RCT & crown capping.
Postoperative care after extraction of impacted III molar:
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After extraction, there is little pain and discomfort and for that your surgeon will prescribe you antibiotic and painkillers.
- Cool drinks (not carbonated drinks)/ice creams after surgery prevent bleeding.
- Nothing warm or hot should be taken for 24-48 hours as advised by surgeon.
- then might be little swelling after extraction but it's a good sign of healing so then nothing to sworry about it as it will subside in 3- 4 days.
- Taking soft food for 3-4 days after extraction will enable faster recovery.
- Warm saline rinses after 24-48 hours of extraction.
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