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Dental
extractions (or "exodontia") are one of the most common
procedures done by dentists.
In this procedure, a tooth
is pulled out of the alveolar bone
and gums. Procedural
dental extractions date back to the 14th century, in which a couple
of antique apparati for pulling
of teeth, called the "dental pelican"
and "tooth
keys" were used without the need for anesthesia,
making the patient feel excruciating pain and often lead to uncontrolled
bleeding because of the lack of X-rays. Nowadays, modern
technology has introduced instruments and precautionary
tools (such as the X-ray) and drugs
(anesthesia) to promote precision of tooth extractions, without the cringing
pain felt by the patient. Forceps are the most common tooth extraction
instruments, and come in a variety of models, each with its own
respective pulling power-designed for both children and adults.
There are a variety of reasons on why some teeth
should be extracted from the alveolar bone (or the socket) from which they are
connected:
1. Tooth
decay or infections that have made their way into the pulp
of the tooth, causing severe pain.
2. Hanging
baby teeth that are blocking the eruption of permanent
teeth.
3. Orthodontic
appliances (like braces) may require the extraction
of teeth (like first and second premolars) so that the teeth being
pulled in will have a place to rest.
4. Infected
teeth caused by successive chemotherapy
treatments.
5. Wisdom
teeth (or the third molars) are usually pulled out because of an impacted tooth
caused by the former's eruption. Either way, the patient can decide which tooth
to pull out: the wisdom
tooth or the impacted
tooth.
Wisdom teeth extractions have different procedural
extractions. The overall success of a wisdom tooth extraction depends on the
position and location of the wisdom tooth.
There are two types of extractions:
Simple
extractions are performed with use of the traditional anesthesia/dental
forceps tandem. Often done on teeth that have already erupted or
are visible in the mouth, the periodontal ligament
is first rocked and removed from its attachment to the alveolar bone, making
the tooth
loose and disconnected from any bone
and gum tissue, and then finally pulling it out of the gums.
Surgical
extractions are usually done on teeth that have not been fully
erupted or are in an awkward position not easily accessible to the dentist's
advantage. The dentist
incises the gum
of the patient, making the tooth
accessible and drills or uses an osteotome to remove the tooth
and its root.
There have also been both common and unprecedented risks
associated with tooth extractions, which usually happen when the patient has
not been X-rayed and when the dentist lacks the experience of pulling out
teeth:
1. Accidental damage to neighboring or adjacent teeth.
2. Dental infections
3. Post-operative swelling is commonly attributed to the
extraction of a second or third molar and usually subsides a few days after the
operation.
4. An incomplete extraction that leaves the root of the tooth
attached to the alveolar bone.
5. A sinus hole caused by the removal of an upper molar.
The hole usually heals in three week's time, but if it hasn't shown any sign of
healing in that span of time, accompanying surgery may ensue.
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