Peter J Waidzunas, DDS, Ltd
Windsor Court I Office Centre
501 N. Riverside Dr. Suite 119
Gurnee, Illinois, 60031
EXTRACTIONS: SIMPLE, MULTIPLE AND SURGICAL
Sometimes, for whatever reason, a tooth or multiple cannot be saved and, must be removed. When removing a tooth it is important to consider what will be done with the empty space after that tooth is removed. If a tooth is removed and nothing is done with the extraction site, the jawbone will degenerate and change shape during healing. If that happens extensive and perhaps costly bone grafting may be needed to rebuild the jaw back to it's original shape. Further, if nothing is done with the site it can cause your teeth to shift and create problems in your bite and affect your ability to speak and chew.
If you want to fill the space with a dental implant, a sturdy jawbone is necessary to install the implant. If you opt for a dental bridge, the bridge must be placed before the teeth shift and before the bone degenerates. Either way, preservation of the bony form at the time of extraction, may prove helpful in making implant placement or a bridge more predictable and cost effective.
Please talk to us about what you would like to do with your extraction site before removing a tooth. We will be able to make a recommendation and layout a treatment plan.
There may be a difference in perception of the word, “simple.” From the dentist's perspective, this probably implies a routine extraction. To you, the patient, it may well be a totally new experience, so it's a reasonable question.
The ease or difficulty of tooth removal is related to the size, length and the number of the roots as well as the location of the tooth in the mouth. This picture is for illustrative purposes only and not meant as an exhaustive guide.
From a procedural or professional standpoint, a simple extraction refers to removing a tooth in which the shape of the root or roots lends to easy removal. This usually involves teeth that have a single and straight root shape, which allow for a more or less straight path of removal. In the case of an upper front tooth the root is generally cone-shaped, so there is not too much resistance to removal. One source for this particular procedure's name is from the dental insurance code ascribed to it, “simple uncomplicated extraction.”
Removing teeth, while not a particularly pleasant experience, is a routine and uncomplicated procedure in the hands of an experienced dentist. What keeps a tooth in place in its native bone is a membrane or ligament that surrounds the tooth root called the periodontal ligament (“peri” – around; “odont” – root). The main fibers of the ligament surround the tooth at a slanted angle similar to a hammock or socks and attach it to the bone. By carefully manipulating the tooth, these fibers can be fairly easily dislodged, allowing the tooth to be removed quite simply. Believe it or not, there is a real art and “feel” involved in tooth removal, making it both uncomplicated and relatively simple. It is certainly easier in experienced hands and therefore inconsequential for a patient on the receiving end.
To ensure the extraction is “simple” in the professional sense, involves proper assessment and diagnosis beforehand, in particular of the shape and status of the tooth or teeth to be removed, and the surrounding bone in which they are encased. Routine radiographic (x-ray) examination will allow that determination. In addition Dr. Waidzunas will also take a thorough medical and drug history, to both ensure that you are healthy enough to undergo this minor surgery, and that you have normal blood clotting and wound healing mechanisms.
It may also be likely that the doctor will fill the socket (the space formerly occupied by the tooth), with a bone substitute or other grafting material if it is necessary. Most grafting materials today act as scaffolds upon which your body builds or replaces the grafting material with bone. This ensures that any existing boney defect is reconstructed and the original bone mass or volume is reestablished. This is particularly necessary if a dental implant is contemplated to replace the tooth root.
Another important factor in making an extraction procedure “simple” is recognizing what to do if there are any minor complications. For example, if a tooth root is brittle it may fracture due to previous trauma and/or a root canal treatment. This may require some surrounding bone removal to access and remove the fractured root fragments. While this complication may sound dramatic, it is not—and is routinely encountered and planned for.
Immediately after tooth removal it is normal to place sterile gauze over the socket for 10-20 minutes with gentle pressure to control bleeding while a clot forms. Some small sutures (stitches) may also be placed over the socket to help control bleeding. As for your after surgery care, you will receive instructions for cleaning and caring for the extraction site. You may also be provided with any or all of the following: antibiotics, anti-inflammatory (swelling control) and analgesic (pain control) medication.
It is important that all the potential risks, benefits and possible outcomes of tooth removal are reviewed with you beforehand, so you know what to expect. We hope that this puts your mind at ease and addresses your question.
Windsor Court I Office Centre
501 N. Riverside Drive Suite 119
Gurnee, IL 60031