We do not just a lot, but a lot of similar operations. People come from other cities, even from other countries, to get rid of annoying eights in Moscow, but we don’t understand why such a simple operation cannot be done in our city.
When asked why they needed to come to us, patients answer that they are afraid to do it anywhere else.
In one clinic they are offered to do everything at once and under anesthesia (which, to put it mildly, is very expensive and very unsafe).
In another, they almost guaranteed a nerve injury with all that it entails. Moreover, it is assumed that this should “distort the face” - pure incompetence and lies.
In the third, they demand to buy biomaterials for the holes - a waste of money and simply a dangerous procedure.
In the fourth medical institution they promised to remove the wisdom tooth in 3-4 hours, bringing this trivial operation in complexity and duration to coronary artery bypass surgery.
Why do you want to have your wisdom teeth removed with us? Because we don't do any of that!
Anesthesia.
To remove even the most difficult wisdom teeth, local anesthesia is sufficient.
Firstly, it is as safe as you can imagine and is suitable for absolutely everyone. Properly administered local anesthesia is at least several hours of persistent pain relief, sufficient to not only remove wisdom teeth, but also perform rhinoplasty and mammoplasty as a gift.
Secondly, local anesthesia has one significant advantage. In our opinion, the most important thing is maintaining verbal and non-verbal contact with the patient. Local anesthesia and preservation of all cognitive functions, at a minimum, eliminate treating the patient like a piece of meat - we feel you, worry with you and strive to cause as little discomfort as possible. A number of researchers have studied the morbidity and incidence of complications, comparing operations under local and general anesthesia, and the results of the studies were far from in favor of the latter. And there is an explanation for this. The lack of reactions on the part of the patient under sedation “frees the hands” of the surgeon; direct and feedback connections are lost between him and the patient - because of this, the traumatic nature of the operation increases sharply.
For local anesthesia when removing wisdom teeth, we use anesthetics familiar to all dentists. Mainly based on Articaine - as the most effective and safe.
Is it necessary to remove wisdom teeth?
Due to the fact that wisdom teeth can be called “late” teeth, and in fact – “vestigial”, their formation and growth are associated with many circumstances, which, in turn, can negatively affect both the wisdom teeth themselves and other teeth and in general the jaw.
Thus, the incorrect position of wisdom teeth during their formation can lead to malocclusion, have a negative impact on the neighboring tooth, cause pericoronitis, inflammation of the trigeminal nerve, osteomyelitis and dental cyst.
In the case when the wisdom teeth are healthy and do not cause any discomfort (they are positioned correctly, provided with due attention during hygiene), it will be unnecessary to remove them. But when their formation and growth are associated with painful sensations, inflammatory processes, as well as deformation of the jaw dentition due to the pressure of wisdom teeth on neighboring teeth, removal is necessary.
Nerve damage – is it possible?
I’ll say right away that under general anesthesia it’s absolutely possible. Due to the same increasing morbidity.
The correct technology for removing wisdom teeth does not involve approaching the nerve trunk closer than 5 mm. Correctly formed access, opening and fragmentation of the tooth excludes access for cutting and sawing instruments to the apex of the wisdom tooth root, next to which the nerve usually passes. And during the removal process, you cannot make significant physical efforts, you cannot use a hammer and chisel (unfortunately, this still happens in some places). And then everything will be fine with the nerve.
Rarely, and in some patients, paresthesia still occurs after tooth extraction. It may be due to injury to the nerve trunk during anesthesia or swelling compressing the nerve in the area of surgery. After some time, sensitivity is restored. There has never been a time when she did not recover. It just takes time. Which? Alas, the process of restoring sensitivity takes different times for everyone. Some people need a couple of days, others a couple of months. But paresthesia always goes away - that's a fact.
Clinic doctors
Modern tooth extraction without pain and shock!
And this is not an exaggeration. Even the most complex tooth extraction procedures, with the right approach, will be comfortable and quick.
The tooth extraction procedure at DentaBravo is painless, takes an average of half an hour and brings you great relief. And right in this section you will find answers to your questions. Read and get rid of your fears!
Removal (extraction) is one of the most common operations in dentistry. As a rule, it consists of the following stages:
- taking an anamnesis (the doctor finds out whether the patient is allergic to medications, whether the person suffers from high blood pressure, heart disease and some other diseases);
- anesthesia;
- preparing the tooth for extraction;
- extraction of a tooth from the alveolus;
- medicinal treatment of the hole.
When is it necessary to remove teeth?
Molar tooth extraction can be performed for planned or emergency reasons. In the first case, teeth are removed that cannot be treated, are incorrectly located and interfere with the growth of other teeth, or injure the mucous membrane of the oral cavity. Emergency removal is necessary if a purulent inflammatory process develops in the periodontium, as well as in the presence of a number of diseases (periostitis, maxillary abscess, etc.)
Doesn't tooth extraction hurt?
Modern dentistry has all the means to remove a tooth absolutely painlessly. The most commonly used local anesthesia is an injection. Sometimes anesthesia is carried out in two stages: first, the doctor treats the gums with a solution or gel that reduces sensitivity, then the anesthetic solution is injected into the gums using a syringe.
What is complex removal?
This is a surgical operation that is performed if the tooth cannot be removed in the usual way. Complex tooth extraction in dentistry is necessary when it comes to unerupted (impacted) and incorrectly positioned (dystopic) teeth. It is difficult to remove the root of a tooth, as well as a tooth fused with bone tissue. The removal of a broken tooth can also be included in this category.
How long does it take to remove a tooth?
The tooth extraction procedure takes about fifteen to twenty minutes on average. In some situations, this may require more time (for example, if you have to remove a tooth in parts), but usually no more than thirty to forty minutes. Sometimes removal can take up to three hours. It all depends on the specific clinical case.
How many teeth can be removed at one time?
It is impossible to give an exact number. Usually no more than one or two teeth are removed at a time. If the teeth are mobile and the removal is simple, more can be removed. For complex extractions, it is not recommended to remove more than one tooth.
How long will it take for gums to heal?
If the tooth extraction operation is carried out correctly, the gums heal quite quickly - this may take about one week. Sometimes, if after extraction the tooth socket is not filled with a blood clot, it takes 2-3 weeks for complete healing.
How long after can I eat after tooth extraction? You are allowed to eat no earlier than two to three hours after surgery, and you can drink after an hour. However, during the first 24 hours, it is recommended to eat only soft or liquid foods to avoid additional injury to the gums. On the day of surgery, you should avoid hot and cold foods, as well as drinking alcohol.
How to care for your teeth after tooth extraction?
After tooth extraction, it is not recommended to rinse your mouth. This is due to the fact that during the rinsing process a blood clot may fall out of the hole, which can lead to inflammation. You need to brush your teeth very carefully, without touching the wound.
Is an examination necessary the next day after tooth extraction?
Usually this is not required. However, if a complex removal was performed, the doctor may order a follow-up examination. Then the next day you will have to visit the dentist to make sure that the procedure was successful, the socket is in order and there are no complications. If a visit to the doctor is not planned, but you have cause for concern, do not hesitate to go to see a specialist.
How soon can prosthetics begin?
Typically, prosthetics begin no less than one month after tooth extraction. If you plan to install a fixed bridge, it is enough to wait about three weeks. In those cases where dental implantation is proposed, it is advisable that more than a month pass.
How much does tooth extraction cost?
The cost of this service depends on the complexity of the procedure. For example, if a simple removal of a front tooth is required, dental manipulation will cost the patient much less than if it is necessary to remove an unerupted “wisdom tooth” from the mouth. The cost of tooth extraction in our dentistry can be found here.
Why do you need to place an artificial bone in the figure eight hole?
The purpose of this procedure is one thing - to shake out more money from you, otherwise the doctor has a car loan and a mortgage. Even the most expensive biomaterials placed in the sockets of wisdom teeth do not play any useful role; their use does not carry any meaningful meaning. But it can be worse - they often fester and complicate the course of the postoperative period, leading to very sad consequences. In other words, you cannot use “artificial bone” when removing a wisdom tooth. Even if you really want to.
The most we use are collagen sponges soaked in anti-inflammatory compounds. They help stop socket bleeding and minimize inflammatory symptoms (primarily pain) immediately after removal. And they stand... they cost almost nothing.
How is complete tooth extraction performed?
When it comes to complete tooth extraction, this does not mean that all dental units are removed in one visit. It all depends on the clinical situation, namely:
- how many teeth are preserved in the oral cavity;
- how badly they are affected.
Dentists recommend removing no more than three teeth in one visit. However, in a situation where teeth affected by periodontal disease are severely loosened and their root system is exposed by more than half, it is possible to simultaneously remove all affected teeth. This is due to the fact that in this clinical situation the removal procedure is carried out very quickly and is not accompanied by severe blood loss. In this case, no stitches are even applied, just tight tampons covering the wound and hemostatic agents are enough.
If all the teeth are preserved in the oral cavity, but they are affected by periodontal disease, or if prosthetics are the indication for their removal, then the removal is carried out in 8–9 visits. In most cases, removal is performed under local anesthesia, but if there is an allergy to the components of the anesthetic, then general anesthesia is indicated. In this case, they try to remove as many teeth as possible in one procedure.
The final healing of the extracted tooth socket occurs within 3 - 4 weeks. In case of complete prosthetics, to ensure good fixation of the prosthesis, the impression can be taken only after complete healing. Otherwise, protrusions will remain on the inner surface of the prosthesis in places of unhealed wounds, and these protrusions will injure the soft tissues of the oral cavity.
Molar tooth extraction in children
Unfortunately, young children often develop diseases in both their primary and permanent molars. Worse, it is not always possible to heal them. Dentists remove permanent teeth for children only when there is no way to save them.
Primary molars are both treated and removed. If a permanent tooth begins to grow under a baby molar, then the baby tooth is always removed, since it interferes with the normal formation of the permanent tooth.
At the same time, dentists never agree to premature removal of baby molars. Such teeth are sure to heal. If you remove a baby tooth ahead of schedule, then the baby will develop a crooked bite.
There are situations when a child’s molar tooth must be removed. Such situations include:
- molar root cyst;
- presence of granuloma;
- inflammation of the tooth root;
- inflammation of the nerve of the lower jaw;
- severe destruction of the integrity of the tooth.
Actions after removal
It is necessary to monitor the patient's condition for several days.
Negative manifestations if:
- The wound bleeds an hour after removal;
- There is clouding of consciousness;
- The person has a fever;
- The pain has become pulsating in nature - an urgent examination by a dentist is necessary, as a jaw injury is possible.
The difference in how to pull out a molar at home or a baby tooth is only in the length of the roots. To minimize negative consequences, it is necessary to work in gloves treated with an antiseptic composition.
Prevention of complications
The difficulty of the procedure is to avoid infection, since if microbes enter, complications will affect the entire oral cavity. To speed up wound healing, you need:
- When talking, try not to touch the hole;
- Monitor the integrity of the blood clot, which performs a protective function;
- For the first 4 hours after removal, do not eat, chew on the healthy side;
- Brush your teeth carefully and thoroughly, avoiding the socket so as not to damage the blood clot;
- Include food with plenty of liquid in the menu;
- Avoid cold and hot dishes;
- After eating, rinse your mouth with clean water or furatsilin solution to neutralize oozing blood;
- Apply warm, damp compresses to stimulate blood circulation.
Swelling may occur immediately after removal. If pain and swelling disappear within a few days, it means healing is proceeding normally.
When the likelihood of successful treatment is low and the doctor may suggest tooth extraction
Examples of a less favorable situation:
1) The crown of the tooth is severely damaged. All that was left of the tooth was the root. This means that the tooth will have to be restored with a crown on the stump tab.
tooth restoration with a core inlay and crown
You will find more detailed information in the article What guides a dentist when he suggests restoring a tooth: with a filling, inlay, veneer or crown?
2) The x-ray shows significant destruction of bone tissue. This means that bone restoration will take longer and worse.
3) Root canals have a complex shape and removing all the infected pulp (“dental nerve”) from them is a difficult task.
4) The roots of the tooth are thin and curved. Expansion of the canals when removing infection from them can lead to the fact that the walls of the tooth cannot withstand the chewing load.
There are many difficulties in endodontic treatment; it is not for nothing that this area of dentistry is considered one of the most difficult. In the article Why you can’t give a 100% guarantee on tooth root canal treatment, we talk in detail about the difficulties of endodontic treatment, but here we will only demonstrate what a bizarre shape canals can be.
shape of the canals of the teeth of the upper and lower jaw
5) The tooth canals were previously filled. Canal retreatment is the “highest aerobatics” in endodontic treatment. It is not always possible to even unseal them. Sometimes this treatment leads to tooth extraction.
6) After unsuccessful endodontic treatment, a pin or a fragment of an instrument is fixed in the root canal. Removing foreign bodies from canals is a complex procedure with an unknown result.
7) Several teeth are missing in the oral cavity and an increased load is placed on the diseased tooth. Any depulped (“dead”) tooth copes with its function worse, since after removal of the “nerve” it becomes more fragile.
The presence of granuloma and cyst further weakens the tooth.
9) The tooth periodically worries and the patient is “tired” of it.
10) The patient has concomitant diseases. And since any chronic disease weakens the immune system, the likelihood of successful treatment decreases.
The indication for tooth extraction may be one or more of the listed reasons.
When Removal is Required
Doctors recommend removal if:
- The tooth is destroyed to such an extent that filling will not solve the problem;
- With exacerbation of osteomyelitis;
- In the inflammatory process associated with infection;
- With advanced periodontitis;
- If the tooth is positioned incorrectly;
- If the jaw is damaged;
- With severe looseness;
- If a dental unit interferes with prosthetics;
- With severe caries damage.
There are rules to minimize the consequences of self-removal of a problematic tooth.
