• How can you transfer the procedure of tooth extraction with minimal loss to your health, nerves and wallet;
• Why teeth sometimes have to be removed and what indications the dentist-surgeon is guided by, passing the appropriate verdict;
• In what situations is it better to wait a little with the extraction of a tooth or not even remove it at all;
• What are the stages of the procedure and what awaits you in the dentist's office;
• Is it possible today to remove teeth without terrible forceps, without pain and with minimal trauma;
• How difficult and lengthy can be the removal of problematic teeth - impacted, semi-retinated, resorcinol-formalin and even ordinary molars, but with specific roots;
• How can the patient help the attending physician so that the tooth extraction goes smoothly;
• What to do if you need to urgently remove a tooth at night, on weekends or holidays;
• Is it possible to remove teeth in hospitals today for free and what is often hidden behind the cheapness of the service ...

Tooth extraction (extraction) is considered a dental operation and involves surgical intervention. In other words, when you go to extract a tooth, you are going for a surgical operation, and therefore this procedure should be taken with all responsibility.

Next, we will consider many nuances that will help an ordinary unprepared person go through this test with minimal loss to the nerves, wallet and health (mistakes and negligence of the patient can lead to very serious consequences).

On a note

Situations are different: sometimes a tooth has to be removed urgently, sometimes it is planned, but in both cases the question immediately arises: which dentist is more appropriate to contact? Which doctor can most competently and painlessly remove a tooth?

Someone can immediately say without hesitation that you need to contact a dentist-surgeon. On the one hand, this is the correct answer, but in practice things may not be so simple. The fact is that in clinics, hospitals and even in private dentistry, there is often a situation where one dentist works at a mixed appointment. That is, he treats (preserves) teeth that can still be saved, and also removes “bad” teeth, conducts professional teeth cleaning, and in addition, the same doctor also deals with prosthetics of missing teeth. In total, we get 2-3 or more specialties “in one bottle”. Is it worth contacting such a specialist?

Of course, everything depends on the professionalism of the doctor and his experience, but in practice, most dentists focus on one area of ​​work, having significantly less experience in other areas. For example, there are dentists at a mixed reception who devote a lot of time to dental treatment, but the removal is not very high quality. Here much still depends on the complexity of the work ahead. But after an hour and a half of torment, during which the doctor cuts, drills and even chisels with tools, it is unlikely that any of the patients would like to hear that, they say, the tooth is too complex and cannot be removed (it happens).

That is why it is best to remove a tooth from a dentist-surgeon who specializes only in this manipulation in its various forms.

In addition, there are also maxillofacial surgeons - relatively speaking, they are even higher in level than dental surgeons. These specialists are not limited in their work to “pulling out” teeth (even the most complex ones), but can also help with injuries of the maxillofacial region, dangerous complications of periodontitis (periostitis, osteomyelitis, abscess, phlegmon, lymphadenitis), congenital and acquired deformities, diseases TMJ, tumor processes, etc.

For example, with significant problems with opening the mouth, when it is necessary to remove a wisdom tooth with diffuse swelling of the face and neck, dislocation of the jaw or fracture, it is worth contacting maxillofacial surgery.

Why do teeth sometimes have to be removed?

Before performing a tooth extraction, the dentist determines the indications for this in advance, that is, weighs all the pros and cons. There are such clinical situations when a tooth can be considered controversial - this means that a dentist, even taking into account the available indications, cannot unambiguously say whether it is worth the risk of saving it, or still remove it from harm's way.

It is not uncommon for situations when in one clinic they offer to immediately pull out a bad tooth, and in another they undertake to save it.

On a note

Sometimes, in order to recognize a tooth as subject to extraction, a council of dentists of various profiles gathers: a therapist, surgeon, orthopedist, orthodontist, periodontist.

How to explain such uncertainty in dental practice?

In life, as you know, everything is not as simple as it may look in books and textbooks. The indications and contraindications for tooth extraction that exist today were developed back in Soviet times by reputable scientists, and most of them have passed into modern protocols that guide dental surgeons in their practice. However, they may not always be suitable for a specific clinical situation, and there are a number of reasons for this:

• Improving equipment, instruments and methods of dental treatment increases the chances of saving teeth, sometimes contrary to existing protocols;
• At the same time, thanks to the latest diagnostic methods and modern approaches in dentistry, a dentist alone or collectively can decide to remove a tooth, even if there are indications for its preservation.

The following are examples of the main indications for tooth extraction:

1. The failure of endodontic treatment in the area of ​​the periapical inflammatory focus (in other words, when a cavity with pus has formed on the root of the tooth, and the treatment procedures do not work);
2. Emergency cases - sick teeth, which are the source of an active microbial process, not subject to treatment and provoking diseases such as periostitis, osteomyelitis, abscess, phlegmon, lymphadenitis, sepsis, etc.;
3. Technical difficulties associated with curved or hard-to-pass canals, leading to the impossibility of conservative treatment, as well as perforation of the tooth cavity or root wall;
4. The location of the teeth, leading to permanent trauma to the oral mucosa or tongue;
5. Tooth mobility of the third degree and its extension due to bone resorption in periodontitis or periodontitis;
6. Location in the fracture line (teeth that interfere with the reposition of fragments and are not subject to conservative treatment);
7. Complete destruction of the tooth crown when it is impossible to use the root for orthopedic purposes;
   
8. Supernumerary teeth that interfere with prosthetics or cause injury to soft tissues, violating aesthetics and chewing;
   
9. Protruding teeth with the loss of the antagonist, as well as those that interfere with the creation of a functional prosthesis;
10. In case of bite anomalies, according to orthodontic indications, even teeth that are not affected by caries can be removed;
11. Some types of root fractures as a result of mechanical trauma.

Wisdom teeth are a separate category, which a number of dentists recommend removing urgently, while other doctors suggest trying to save them, even at some risk of complications.

On a note

There are situations when orthodontic treatment (for example, on braces) cannot be started without the removal of wisdom teeth, even if they have completely erupted and do not interfere with the bite.

The same ambiguous situations often arise in relation to the preservation of teeth, for example, when it is impossible to pass root canals, perforate the wall, or break off an instrument in the canal. In one clinic, the removal of such a tooth may be recommended, and this formally falls under the indications, while in another dentistry they may offer to save the tooth using the latest technologies (for example, a microscope plus removal of instrument fragments from the canal using ultrasound).

In other words, when extracting teeth, an individual approach, common sense and medical logic, combined with the experience and professionalism of a doctor, are very important. And not a simple old-fashioned method of chopping from the shoulder, which took place in Soviet times, not from a good life: a tooth is badly damaged - under the forceps, there is no third channel - under the forceps, a slight edema appeared in the area of ​​​​the transitional fold in the projection of the tooth root - also urgently "Tear out" without waiting for periostitis.

Such antediluvian tactics (which, unfortunately, are still sometimes found in some polyclinics by patients who are tired of the flow and low salaries of doctors) are currently unacceptable and fraught with negative consequences for patients.

Situations when you can wait a little with the extraction of a tooth or not remove it at all

Despite the variety of options noted above, involving the extraction of a tooth, there are also many situations when it is better not to remove a problematic tooth or to postpone it.

The most common situation is related to pediatric dentistry, when parents of babies with a carious lesion of a milk (temporary) tooth strongly demand that the tooth be pulled out, accompanying this with something like this: “It will fall out anyway - why treat it?”.

This logic is too straightforward and does not take into account the fact that the change of teeth should normally occur at an appropriate age: symmetrical groups of teeth gradually become mobile and in many cases fall out on their own. If the tooth is removed prematurely (even a year earlier), then there is a high risk of malocclusion and the development of anomalies in the eruption of permanent teeth.

In other words, with the early removal of milk teeth (especially multiple ones), future permanent teeth can literally “spread” in different directions, or even not erupt in a single or group version. No sane parent needs such a prospect, therefore it is better now to save the child from surgical intervention by curing caries or its complications, rather than later investing effort and money in correcting the bite and the child's psyche.

On a note

Meanwhile, there are clinical situations where acute conditions that threaten the health and life of the baby require the immediate removal of a temporary tooth. Or when the tooth can no longer be saved even with modern methods of treatment.

As for the impossibility of cooperation between a child and a doctor at the stage of dental manipulations: there is not only treatment and extraction of teeth under anesthesia, but also various forms of superficial sedation and premedication, which allow the procedure to be carried out as comfortably as possible and minimize the possibility of a child becoming afraid of a white coat in the future.

Cases when a person wants to pull out an innocent tooth are quite common in adult dentistry, especially among men and women over 45-50 years old. This is largely due to old memories of the remnants of Soviet dentistry, when a tooth, at any opportunity (even with caries), was sent under forceps. Until now, such categories of citizens often get an appointment, especially in budget (free) dentistry with requests or even demands to remove a tooth in case of caries or pulpitis.

For example, a tooth began to hurt from cold, hot, sweet, or night pains of a aching nature had just begun, and the patient was already negatively disposed to the treatment of the tooth. The motives can be different: from “love to pull out teeth” (quickly, inexpensively and there is no terrible drill with its sound) to 100% certainty that after treatment the tooth will still have to be removed (the negative experience of past decades, when teeth were treated for a long time, but in the end, I still had to apply for removal).

So, what is important to keep in mind: modern dentistry has long crossed out these prejudices. Now, not only with caries (even deep) and pulpitis, but also with most periodontitis, the teeth are treated remarkably, and they do not need to be rushed to be removed at all. And even if the tooth, it would seem, has broken at the root, it is not yet a fact that the root will need to be removed, since it is quite possible to restore the functionality and aesthetics of the tooth with the help of a root inlay and a crown.

Stages of tooth extraction: how it all happens in most cases

After the decision to remove the tooth is made in accordance with the indications, the stage of preparation for the procedure begins.

The photo below shows an example of a broken front tooth to be removed:

The nature of the preparation depends on the characteristics of the future manipulation (under or without anesthesia, with or without premedication), but the most basic steps include:

1. Collection of anamnesis (especially allergic status);
2. Psychological preparation of the patient (many are afraid, so it is important for the doctor to calm the patient and set him up in a positive way);
3. Medical preparation of the surgical field (rinsing the mouth with antiseptics, treatment of the injection site).

On a note

It is recommended to sign up for tooth extraction in the morning, when you and the doctor are still full of strength. If anesthesia or sedation is not planned, then it is better to eat well before the procedure - this way you will have more strength, and the blood will clot better.

If it is possible to remove a tooth with forceps, then the removal is called simple, and it is carried out in several stages:

In some cases, sutures may be required.

To remove the tooth was not painful, both domestic anesthetics (for example, Lidocaine) and imported ones (drugs of the articaine series) can be used. Articains are recognized as the most effective today, however, the correct technique of anesthesia is also very important - much depends on the level of professionalism and experience of the doctor.

Today in dentistry, there are different options for anesthesia when removing a diseased tooth. During conduction anesthesia, a group of teeth is “frozen”. A good example is the torusal or mandibular technique: during its implementation, the patient does not feel the lip, the tip of the tongue and the cheek on the corresponding side.

Infiltration anesthesia is done in the projection of the root of the tooth on the gum: in this case, freezing occurs only in the removal zone: almost always this is enough for all the upper teeth, as well as the lower ones - from the first to the fifth. For the 6th, 7th and 8th lower tooth, infiltration anesthesia will not be enough, so a torus is done. If this conduction technique is not done or done poorly, then during the removal of the lower large molars it can be very painful.

Of the modern methods, intraligamentary anesthesia (intraligamentous) can also be noted. It is done with a special syringe and has a lot of advantages (does not cause facial numbness, comes on quickly, lasts for 20 minutes, which is enough for most outpatient removals).

For difficult removals, anesthesia is sometimes used. A characteristic difference between a complex tooth extraction and a simple one, in addition to the time it takes, is the use of a drill (for sawing a tooth into pieces, cutting out a bone), screws, ligatures and some other specific tools (sometimes a tooth is literally split into pieces with a chisel and hammer).

The photo below shows an example of a tooth sawn into three parts using a drill before removal:

On a note

It is not always possible for a dental surgeon to determine in advance whether a tooth extraction will be difficult or simple. In many cases, the doctor can only roughly guess which tooth should be expected to have difficulties, and which one will almost “jump” out of the hole during removal.

Sometimes a specialist immediately sees a potentially complex tooth (resorcinol-formalin, semi-retinated, impacted, with specific roots) and warns the patient in advance that the procedure will be difficult and slow.

“The day before yesterday I removed the lower wisdom tooth. It was a real nightmare ... For more than an hour they sawed a tooth, hollowed it out with a hammer, broke out the roots, almost broke the jaw. They cut the bone and turned everything there completely. The most terrible feeling is when the doctor tried to break out a tooth several times, I thought that he would dislocate or break my jaw. All four roots of the tooth stuck out in different directions, so it was removed badly. Now half of my face is swollen, the pain is terrible, I can’t swallow normally and open my mouth. The doctor said that he had not seen this for a long time ... "

Natalia, Moscow

Option to remove teeth without "terrible" forceps: ultrasound technique

In order to minimize tissue injury during tooth extraction, and therefore to speed up and make the subsequent healing process more favorable, there is a so-called atraumatic method of tooth extraction. Such removal could be classified as complex, but the use of additional tools (drill, periotome, etc.) in this context, on the contrary, simplifies the procedure, reduces its time and makes it minimally traumatic.

Suppose the patient has a severely damaged upper sixth tooth (at the level of the gum or even under the gum), however, the roots do not exist independently, but are connected into one whole. With the help of a drill, the crown part of the tooth in the middle is carefully sawn out: in this case, each root becomes independent. Periotome allows you to quickly and accurately remove them without damaging the septa, walls of the alveoli, as well as the gingival margin.

The photos below show the individual stages of the atraumatic method of removing three teeth at once with a preliminary cut:

On a note

If, however, only forceps are used in this case, then the cheeks of the forceps would have to be advanced deep under the gum in order to “loosen” and “dislocate” the soldered roots. In 50% of cases, this will work, but with varying degrees of breaking off the outer and inner wall holding the root. After such root removal, uneven or sharp bone tissue remains, creating new problems for both the doctor and the patient.

Often, with the help of forceps, the removal of complex teeth cannot be carried out at all, and the result is only a waste of time and useless “biting” with forceps of both the alveoli and the roots.

Atraumatic tooth extraction can also be accompanied by the use of ultrasound. It is this technique that modern clinics are currently actively using as a "know-how". The piezosurgical apparatus allows, using an ultrasonic scalpel, to separate the periodontal ligaments that hold the tooth bloodlessly and remove it from the socket.

The main advantages achieved by tooth extraction using ultrasound:

• Bloodlessness;
• Acceleration of work;
• Antiseptic effect;
• No overheating;
• Help in the removal of complex teeth (impacted, semi-retinated, dystopic, resorcinol-formalin).

This type of atraumatic tooth extraction is ideal for subsequent immediate implantation, when the implant is installed immediately in a fresh hole.

Features of the removal of potentially problematic teeth (impacted, semi-retinated and resorcinol-formalin) - should we be afraid?

To remove impacted and semi-retinated teeth (i.e., not erupted or erupted only partially and largely hidden in the jaw bone), as well as resorcinol-formalin teeth (that is, previously treated with resorcinol-formalin paste and become brittle because of this), the doctor can apply as anesthesia, if there are indications for it, and local anesthesia.

Most often, these teeth are removed under local anesthesia.

The picture below shows an impacted wisdom tooth:

From the practice of a dentist

Some budget dentists (especially in small towns and villages) who work on a mixed basis (therapy plus surgery) are afraid to remove teeth from this category. Seeing a semi-impacted or, moreover, impacted tooth (according to the picture), they can immediately refuse to remove it and send the patient to maxillofacial surgery at the nearest regional clinic or dental center. The motivation for this can be both unwillingness to mess with these teeth (the procedure may take 1-2 hours of painstaking work), and the fear that the lack of experience and tools will not allow you to remove all the roots - which means that the exhausted patient will still have to be sent to another a more qualified dentist.

Stages of complex tooth extraction:

1. Preliminary preparation (premedication, treatment of the surgical field, etc.)
2. Anesthesia (general or local);
3. Creation of access to the removed tooth;
4. Instrumental technique to improve the conditions for the "dislocation" of the roots of the tooth;
5. Extraction of roots;
6. Hemostasis;
7. Preservation of the hole to prepare for implantation (according to indications);
8. Suturing (according to the situation);
9. Appointment of recommendations.

Creating or improving access to a tooth involves the use of elevators, a periotome, trowels, a drill with a set of burs and cutters, and (rarely) chisels and a hammer. After partially creating access to the tooth to be removed (gingival retraction, flap detachment), the tooth is removed with an elevator, and if this is not possible (as with impacted ones, for example), then the alveolus bone is sawn with cutters in the projection of the tooth location. At the same time, cooling is applied to the area being prepared, since the bone tissue should not overheat, otherwise necrosis will develop.

When the tooth to be removed becomes visible, the surgeon can immediately begin to use elevators to “pick up” it. Often, the tooth can be sawn (or split) into pieces to make work easier.

On a note

How long can such a complex removal take? Depending on the complexity of the procedure, the availability of the necessary instruments and the experience of the doctor, the procedure can take from 10 minutes to 2 hours.

After extracting the diseased tooth and removing the granuloma or cyst (if any) from the hole, suturing is performed and recommendations are made. In a number of situations, the hole is preserved before subsequent implantation so that there is no atrophy of the bone walls. For this, natural bone substitutes are used, or synthetic (inorganic bone matrix).

After a complex tooth extraction, the doctor necessarily prescribes home treatment to ensure the most comfortable postoperative period and prevent alveolitis, which may include preparations of various directions:

1. Painkillers (Ketorol, Ketanov, Nise, etc.) for pain relief in the first days after surgery;
2. Antibiotics and sulfa drugs (to eliminate a bacterial infection in the maxillofacial region);
3. Antihistamines (to reduce swelling and other manifestations of the inflammatory response);
4. Preparations for rinsing and treatment of the removal area (gels, ointments) with anti-inflammatory, wound healing, analgesic, antiseptic and antibacterial action.

On a note

Generally speaking, the list of recommendations that exists in the arsenal of Russian dentists is huge, and each dentist adheres to his list of necessary postoperative treatment. Someone prescribes the same thing to each patient, while someone has an individual approach (which is the most correct).

But it should be borne in mind that some dentists may not say anything at all to the patient, even as parting words or advice. If you had a tooth removed and were not given recommendations, be sure to ask for them, or find out from another doctor, as this helps to avoid unnecessary anxiety and very unpleasant complications.

How to help your doctor so that a tooth extraction goes smoothly

Despite the fact that anesthesia is used in dentistry before tooth extraction, there is always a risk that the procedure may not go as smoothly and painlessly as we would like. Often this is due to the fact that the patient is not ready for the procedure and behaves not quite correctly.

Let's see how to prepare for tooth extraction, in order to at least help a good doctor to carry out the manipulation without any problems.

Firstly, surgical intervention on a “neglected” tooth, when the stage of an acute process has reached its climax (because of pain, you cannot even touch the root, a “flux” has arisen) is tolerated in many cases much worse than the planned removal of a “calm” tooth. Moreover, in this context, it does not matter which particular tooth will have to be removed: the root (six, seven, eight) or some front tooth is to be removed.

It is not difficult to imagine what unforgettable emotions a patient (as well as a doctor) can experience when you have to remove a diseased tooth or its remains against the background of periostitis and other purulent complications, when anesthesia has almost no effect, and any touch on the tooth causes hellish pain. But the tooth needs to be loosened! At the same time, there is still a risk that the rotten crown part may break off, and you will have to separately “pick out” the roots ...

It is interesting

Often anesthesia is done in the projection of the root of the tooth, when pus is everywhere under the gum in this area. At the same time, the “sufferer” demands from the dentist-surgeon that everything be absolutely painless: “Give a strong injection, doctor, if only it doesn’t hurt!” However, it is immediately clear that where the pus is located, a priori they are “not happy” with the new solution: there is nowhere to put the existing exudate.

A bad doctor, as a punishment for such a patient who walked too long to the doctor's office, will simply inject the entire portion of the anesthetic at a time, and in terms of sensation, the procedure will be similar to removing a tooth without anesthesia, when there are already "sparks from the eyes" from pain. A normal surgeon will gradually inject the gum with an anesthetic in 2-4 stages, release milliliters of purulent fluid to eliminate pain during the administration of the drug and try to achieve stable anesthesia for painless tooth extraction.

So the patient's excessive patience before going to the doctor can give rise to a lot of problems. Therefore, if it is known for sure that a badly damaged tooth is to be removed, then it is better to get rid of it as planned: make an appointment and, in the absence of contraindications, once and for all end the problem before the tooth gets sick.

For tooth extraction, the ideal option would be to sign up in the morning:

There are a few more practical tips that help the patient safely endure the tooth extraction procedure:

1. Before removing a tooth, you should eat well (unless anesthesia or sedation is planned). A well-fed person copes with stress better, faints much less often and blood coagulates better, which is important after the procedure;
2. Do not take alcohol for courage. The risk of edema and prolonged bleeding in drunk people is increased, not to mention inappropriate behavior;
3. In case of great fear of the procedure or fear, you can resort to sedatives (Tenoten, tincture of valerian, motherwort, Corvalol, etc.) 20-60 minutes before the operation, depending on the activity of the remedy. At the same time, the choice of the drug must be coordinated with the attending physician or the local therapist and have an idea of ​​​​the measure (especially regarding alcohol tinctures, since their intake can smoothly turn into alcohol intoxication);
4. It's good to have a positive attitude. If you are initially set up for a successful outcome of the procedure, then almost always the removal goes well, and the healing time is as short as possible. The more a person tells himself that nothing will work out and the more he winds himself up, the more anxiety he causes to himself and the doctor, sometimes simply because of anxiety, doing the wrong things (using unnecessary ointments, rinses, dangerous folk remedies, etc.) ;
5. When planning complex operations (removal of a difficult impacted tooth, all wisdom teeth at once, etc.), it is recommended to consult with your doctor about starting anti-inflammatory, painkillers and even antibiotics before the intervention.

If the tooth is deemed unusable, then in emergency cases it is removed urgently. But there are situations when the patient is going to apply for a planned tooth extraction - in these cases, it sometimes makes sense to postpone the procedure.

1. SARS and acute respiratory infections in the active period;
2. Painful and heavy periods;
3. Cardiovascular diseases, when their treatment is accompanied by the intake of certain drugs (for example, anticoagulants - Warfarin, Xarelto, etc.);
4. Pregnancy (on some terms - an exclusively individual approach);
5. Acute diseases (acute appendicitis, acute pancreatitis, etc.).

It is not difficult to guess that after the disappearance of many of the listed conditions, you can safely consult a doctor about a planned tooth extraction.

What to do if you need to urgently remove a tooth at night, on weekends or holidays?

You can often observe panic among residents of large cities and metropolitan areas, when a badly damaged tooth suddenly starts to hurt on weekends or holidays. That is, emergency surgical care is required, and a person is squeezed within four walls and does not know where to go for a tooth extraction and what, in general, to do.

Meanwhile, it doesn't matter what day it is (Sunday, March 8, New Year or another holiday), because in cities there is a round-the-clock emergency dental care with a duty schedule of dental surgeons. It is enough to contact the regional dental clinic or the regional hospital with the department of maxillofacial surgery.

But not only in large cities there is an "ambulance" in dentistry. Even in the district center at night, on weekends and holidays, as patients say, it is possible to “pull” teeth after a preliminary call to the post. Usually it looks like this: you call an ambulance or a paramedic's post, find out the possibility of urgent tooth extraction. The specialist contacts the duty dentist, and he comes to the office within an hour to help you (if on holidays the dentist keeps his appointment according to the schedule until a certain time, then at night he most often has to be called).

As for the private sector, everything is much simpler here. There are dentists that are open 24/7. Doctors in such clinics work in 3-4 shifts, and are ready to remove a tooth at any time when required.

On a note

The night shift is popular not only with people caught off guard by pain, but also with late-night parents of toddlers who have toothaches. In addition, many people employed in business have free time only after 22:00, and some even after 00:00.

Is it possible to remove teeth in hospitals today for free?

But what about those people who do not have money to extract teeth in a private clinic? Moreover, the price for such services today varies, depending on the region and the complexity of the procedure, from 500 rubles. up to 20,000 rubles

Someone may even be surprised by such a high price - to pull teeth for 20 thousand rubles for one pulled tooth? Isn't it too expensive?!

On a note

The fact is that 20 thousand rubles is also not the maximum for tooth extraction, since there are complex clinical cases that require increased time and materials.

Usually, an additional mark-up is made for the following types of removal (the following are the wordings from the price lists of the clinics):

• "Atypical tooth extraction" (that is, complex);
• "Laser" (using a laser scalpel);
• "With the use of ultrasound";
• "Without tongs";
• "In a dream" (anesthesia or superficial sedation).

The list can be continued and expanded. Moreover, for example, under atypical removal in clinics, they often mean not only complex extractions of teeth, but also the removal of any wisdom tooth in general, even if the removal is simple. This is most often done for commercial purposes, as a kind of fear-mongering in patients about wisdom teeth allows you to set a higher price in the price list for getting rid of them.

So is it still possible to remove a tooth cheaply?

Firstly, given the great competition, private dentistry sets different prices for the same service, and the price can be very democratic, regardless of what kind of tooth it is: a canine (or, as patients often call it, an “eye tooth”) , wisdom tooth or any other chewing. It happens that in one clinic you can remove a wisdom tooth for 1000 rubles, and in another they will offer a price of 5000 rubles.

And there, and there, the removal is paid, and the main question that confronts the patient is whether it is possible to trust a more budget option?

According to the recommendations and reviews of relatives, friends and colleagues, you can almost always find a professional doctor who removes teeth well. Whose office wall, though not hung with dozens of certificates and letters, but who knows his job well and is attentive to the patient. There are small private offices where they can remove a tooth for 500 rubles painlessly and efficiently without cheating for coffee, magazines, leather chairs and other surroundings.

Another thing is that you need to go to such a specialist on the recommendation of trusted people, and not just go to remove a tooth in the first clinic that comes across, where they will offer the lowest cost of the service.

Is it possible to remove a tooth qualitatively, but for free?

Free cheese (especially in dentistry) can only be in a mousetrap - perhaps this is the first thing that can come to mind in such a case. However, hundreds of thousands of citizens receive free surgical care every year under a regular CHI policy.

The principle is as follows: a person who is attached to this institution applies to a hospital or clinic at the place of residence for the purpose of removing a tooth. He gets a ticket to the dentist, and he removes one or more decayed teeth for free using this coupon. If there is no attachment, and the coupon does not pass through the computer, then, of course, you can also remove the tooth, but for a fee.

If the dentist cannot perform the extraction (for example, we are talking about an impacted or resorcinol-formalin tooth, or there is a diffuse edema that threatens life, pediatric specialization is required, etc.), then the patient has the right to receive a referral to free care, where the medical institution, the referral diagnosis according to ICD-10 and the need for this or that manipulation will be indicated.

On a note

There is also a list of free medicines that a dentist under the CHI policy can provide to the patient at the stage of assistance. This is especially true for anesthesia.

Not all hospitals (especially in villages, settlements, small towns) are regularly and in full allocated the necessary materials. Most often, they are supplied with domestic drugs for anesthesia (Lidocaine, for example), although today there are even anesthetics of the articaine series on the list under compulsory medical insurance, which, however, practically do not reach the addressee. In order to work as comfortably as possible and be able to give high-quality anesthesia to the patient without risking his health, dentists are forced to extract a tooth for a fee, where a person pays money for a “good injection”. Of course, this is cheap compared to a private clinic, and costs about 100-400 rubles, depending on the region.

But this does not mean at all that free tooth extraction “under lidocaine” will necessarily be painful. Free removal in many public institutions can mean increased risks, ranging from the fact that the anesthetic injection will be done in haste and will not work as expected, and ending with a long many hours of the same sufferers in the corridor, with the likelihood of getting from a tired surgeon for any an inaccurately spoken word with a three-story obscenity over the ears.

So here everyone chooses where to apply for a tooth extraction and how much he is willing to pay for this service. In conclusion, we can only note that having decided on the budget, you should not look for a clinic, but first of all for a good doctor - this will be a guarantee that tooth extraction will most likely be almost painless and without unnecessary problems.

Be healthy!

An interesting video with an example of atraumatic tooth extraction by ultrasound

What to do after tooth extraction to avoid complications

After tooth extraction - if the tooth and gum hurt after removal, the rules of conduct for the prevention of complications, what to do after the removal of a wisdom tooth, how many days does the hole heal?

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Removal (extraction) of a tooth This is an invasive surgery. That is, the procedure for removing a tooth is an operation with all the signs inherent in this manipulation, normal consequences, as well as possible complications. Of course, tooth extraction is a small operation compared to, for example, removal of uterine fibroids, part of the stomach with peptic ulcer, etc., therefore it is considered a relatively simple intervention with minimal risks. In terms of volume, degree of complexity, likelihood of complications, as well as the behavior of tissues after the intervention, tooth extraction can be compared with small operations to exfoliate benign tumors (lipomas, fibromas, etc.) or erosions on the surface of the mucous membranes.

Symptoms that normally occur after tooth extraction

During operations to remove a tooth, the integrity of the mucous membrane is violated, blood vessels and nerves are torn, and the ligaments, muscles and other soft tissues that held the tooth roots in the socket are damaged in the immediate vicinity. Accordingly, in the area of ​​damaged tissues, a local inflammatory process is formed, which is necessary for their healing, which is characterized by the following symptoms:

• Bleeding (lasts for 30-180 minutes after tooth extraction);
• Pain in the area of ​​the extracted tooth, radiating to nearby tissues and organs (for example, ear, nose, neighboring teeth, etc.);
• Swelling in the area of ​​the extracted tooth or surrounding tissues (eg cheeks, gums, etc.);
• Redness of the mucous membranes in the area of ​​the extracted tooth;
• A moderate increase in body temperature or a feeling of heat in the area of ​​​​the extracted tooth;
• Violation of the normal functioning of the jaw (inability to chew on the side of the extracted tooth, pain when opening the mouth wide, etc.).

Thus, pain, swelling and redness of the mucous membrane in the area of ​​the extracted tooth, as well as an increase in body temperature and the inability to perform normal, habitual actions with the jaws are normal consequences of the operation. These symptoms normally gradually decrease and completely disappear within about 4-7 days, as the tissues heal and, accordingly, self-destruction of local inflammation. However, if infectious and inflammatory complications are attached, then these symptoms can intensify and last much longer, since they will be provoked not by local inflammation caused by tissue damage, but by infection. In such situations, it is necessary to carry out antibiotic therapy and ensure the outflow of pus from the wound in order to eliminate the infection and create conditions for normal tissue healing.

In addition, after the extraction of the tooth, a sufficiently deep hole remains, in which the roots were previously located. Within 30 - 180 minutes, blood may ooze from the hole, which is a normal tissue reaction to damage. After two hours, the blood should stop, and a clot should form in the hole, which covers most of its surface, creating sterile conditions for the speedy healing and restoration of the normal tissue structure. If blood flows for more than two hours after tooth extraction, then you should consult a dentist, who will either suture the wound or perform other manipulations necessary to stop the bleeding.

There is a damaged mucous membrane on the gum along the edges of the hole, since in order to remove a tooth it must be peeled off, thus exposing its neck and root. Inside the hole are damaged ligaments and muscles that previously held the tooth securely in its place, that is, in the hole in the jawbone. In addition, at the bottom of the hole there are fragments of nerves and blood vessels that previously entered the pulp through the root of the tooth, providing nutrition, oxygen supply and providing sensitivity. After the extraction of the tooth, these nerves and vessels were torn.

That is, after the removal of a tooth, various damaged tissues remain in the area of ​​\u200b\u200bits former localization, which should heal over time. Until these tissues heal, the person will be disturbed by pain, swelling, swelling and redness in the area of ​​\u200b\u200bthe hole from the tooth and the surrounding gums, which is normal.

As a rule, after the extraction of a tooth (even a complex one), shallow traumatic injuries of soft tissues remain, which completely heal within a relatively short period of time - 7-10 days. However, the filling of the socket with bone tissue, which replaces the root of the tooth and gives density to the jaw bone, lasts much longer - from 4 to 8 months. But this should not be feared, since pain, swelling, redness and other symptoms of inflammation disappear after the healing of soft tissues, and the filling of the hole with bone elements occurs within several months unnoticed by a person, since it is not accompanied by any clinical symptoms. That is, the symptoms of inflammation (pain, swelling, redness, temperature) after tooth extraction persist only until the mucous membrane, muscles and ligaments heal, and torn blood vessels collapse. After that, the process of formation of bone tissue in the hole instead of the root of the extracted tooth is asymptomatic and, accordingly, imperceptible to humans.

Rules of conduct after tooth extraction

Despite the relatively small amount of damage, tooth extraction is a surgical operation, and therefore, after its production, certain rules must be observed, the effects of which are aimed at minimizing the risk of infectious and inflammatory complications and maximizing the healing process and restoring the normal tissue structure. In fact, various activities after tooth extraction must be performed for a limited period of time during which soft tissue healing occurs, that is, within 7 to 14 days. After the integrity of the soft tissues is restored, you can lead a normal life, since the overgrowth of the hole with bone tissue occurs independently, asymptomatically and does not require a person to follow any rules.

The rules of conduct after tooth extraction help to minimize these unpleasant sensations, accelerate tissue healing and prevent complications.

So, after the extraction of a tooth, it is imperative to adhere to the following rules:

• If the dentist, after removing the tooth, gave a bite a special swab soaked in the drug, then it should be left in the oral cavity for at least 20 to 30 minutes. Only after half an hour the tampon can be removed;
• Do not rinse, spit out, or otherwise remove a blood clot that has formed in the socket within 24 hours after tooth extraction;
• Do not feel the hole and the surrounding tissues with your tongue, hands, toothpicks and any other objects (even sterile ones);
• Within 24 hours after tooth extraction, you should not draw in any liquids, creating a vacuum effect in the oral cavity (for example, drinking through a straw, pulling water from a spoon with your lips, etc.), as this can lead to the removal of a clot from the hole and , as a result, to increased pain, swelling and redness, as well as to the appearance of bleeding;
• Do not engage in sports and physical labor for two days after tooth extraction. This does not mean that you can not do anything, on the contrary, any light work around the house (washing dishes, vacuuming, dusting, etc.) is quite acceptable and even useful, because it distracts from unpleasant sensations and painful thoughts. And it is necessary to give up physical activities that require strong muscle tension (for example, active training, hard work, etc.);
• Within a day after tooth extraction, do not go to the bathhouse, sauna, do not take a hot shower and do not overheat in the sun;
• Do not warm up the area from which the tooth was removed, as this can provoke an increase in the volume of inflammation, and therefore an increase in pain, and an increase in swelling and redness, as well as an increase in body temperature;
• Within 2-3 hours after tooth extraction, refuse to eat, since its pieces can additionally injure the wound and lengthen the healing period of soft tissues;
• For several days after tooth extraction, until the pain subsides, you should eat and drink only warm, since cold and hot can provoke an increase in the severity of pain, swelling and other symptoms of tissue damage;
• Within a few days after tooth extraction, spicy and spicy seasonings, as well as dishes with a sour and sharp taste, should be abandoned, as they can provoke re-bleeding;
• For several (3-7) days, do not chew on the side of the jaw from which the tooth was removed;
• If pieces of food get into the hole while eating, then you should not remove them with your fingers, toothpicks or any other objects, as this may lead to accidental removal of the clot, which is unacceptable. It is better to rinse these pieces of food with water after eating;
• Within 3-7 days after tooth extraction, you should stop smoking and drinking alcoholic beverages, since tobacco smoke and ethyl alcohol irritate and dry out the mucous membranes, provoking an increase in pain and increasing the risk of developing infectious and inflammatory complications;
• Within 24 hours after tooth extraction, you should not rinse your mouth so as not to remove the clot from the hole. In the following days, it is necessary to regularly carefully rinse your mouth with various antiseptic solutions or water and salt;
• Within 8 hours after tooth extraction, you should not use a toothbrush. In the following days, it is necessary to brush the teeth twice a day - in the morning and in the evening, but at the same time be careful in the movements of the brush in the area of ​​the extracted tooth;
• With poor tolerance for pain that occurs after tooth extraction, you should take painkillers from the group of non-steroidal anti-inflammatory drugs (NSAIDs), for example, Paracetamol, Ketorol, Ketanov, Ibuprofen, Nimesulide, etc.;
• To reduce sensitivity, it is recommended that antihistamines be taken within 7 to 10 days after tooth extraction (for example, Erius, Telfast, Zirtek, Cetirizine, Parlazin, Suprastin, Telfast, etc.) in standard dosages;
• Within a week after tooth extraction, drafts and contact with people with flu, SARS, tonsillitis and other similar diseases should be avoided, and also not supercool;
• If the tooth was removed against the background of existing infectious and inflammatory processes in the oral cavity (for example, periodontitis, gingivitis, flux, etc.), then after the operation, broad-spectrum antibiotics should be taken for 7-10 days.

It is routine to apply cold to the cheek in the area of ​​the extracted tooth, that is, in all cases it should not be, because, on the one hand, this reduces swelling, pain and inflammation, but on the other hand, it reduces the activity of local immunity, which, in turn, significantly increases the risk of developing infectious and inflammatory complications. However, if bleeding after tooth extraction has not stopped within 30 minutes, then cold can be applied to the cheek for 15 to 40 minutes. In other cases, it is not recommended to use cold to reduce swelling, redness, and pain.

Can I smoke after a tooth extraction?

For at least a day after tooth extraction, you can not smoke for two reasons. Firstly, drawing smoke into the lungs causes a vacuum effect in the oral cavity, as a result of which the clot can escape from the hole, which will provoke re-bleeding, lengthen the wound healing period and increase the risk of developing infectious and inflammatory complications. Secondly, tobacco smoke dries and irritates the oral mucosa, which also significantly increases the risk of complications.

One day after tooth extraction, you can start smoking, but this should be done with caution and in a minimal amount. In general, it is recommended to stop smoking for 7 to 10 days after tooth extraction.

Rules of conduct after the removal of a wisdom tooth

The general rules of conduct after the removal of a wisdom tooth do not differ from those after the removal of any other tooth. Therefore, after the removal of a wisdom tooth, it is necessary to adhere to the general rules outlined in the section above.

Healing after tooth extraction (how long does a tooth heal after extraction)

Stages of healing

The duration of tissue healing after tooth extraction is individual for each person and can vary within fairly wide limits, since it depends on the complexity of the manipulation, the volume of injured tissues, the presence of infectious and inflammatory complications before, during or after surgery, as well as the speed of reparative processes. However, there are general approximate terms of wound healing after tooth extraction, which can be relied upon.

So, the wound in the form of a hole left after tooth extraction heals completely within 2 to 3 weeks. During this time, the hole is filled with granulation tissue, and its surface is completely covered with epithelium. That is, the surface of the hole becomes the same as the gum surrounding it. Starting from this moment, you can safely chew on the side of the jaw from which the tooth was removed, eat your favorite dishes without restrictions and, in principle, lead a normal life. The healing of the hole occurs the faster, the smaller the amount of tissue was damaged during the extraction of the tooth. That is, the hole from a single-rooted tooth heals faster (within about 16-18 days) than from a multi-rooted one (within about 19-23 days). In addition, it should be remembered that in the presence of infectious and inflammatory processes that occurred before, during or after tooth extraction, the hole will heal 1 to 2 weeks longer.

If the wound turned out to be too large (for example, when removing teeth with improperly located roots, etc.), then sutures are applied to tighten the edges of the wound and, accordingly, to ensure optimal and rapid healing. Absorbable or conventional sutures can be used for sutures. If ordinary threads were used, then the dentist removes them 5-7 days after tooth extraction, and the self-absorbable suture material is left in the tissues. Sutures should not be afraid, since their presence does not indicate complications and does not lengthen the healing process of the hole.

However, the overgrowth of the hole is only the end of the soft tissue healing stage, since the reparation process after tooth extraction, which consists in the formation of bone at the site of the root of the extracted tooth, will continue for about 4 to 8 months. But all subsequent stages of healing will pass unnoticed by the person himself, but they still need to be known and remembered.

Approximately 2 weeks after tooth extraction, second phase reparation, which consists in the formation of elements of bone tissue on the bottom and side walls of the hole, which slowly grow, filling its entire volume. After about 6 to 7 weeks, the entire hole is filled with young bone tissue. This concludes the second stage of reparation.

Next begins third stage reparation, which consists in compaction of young bone tissue and the formation of mature bone from it, which will have sufficient strength to replace the tooth root in the jaw structure. The formation of mature bone in the hole of the extracted tooth occurs after 3-4 months.

After the formation of a mature bone, the last begins, fourth stage reparation, which consists in the complete fusion of the newly formed bone tissue with the previously existing one (jaw bone). The fusion of the bone tissue of the socket with the jaw bone occurs approximately by 4-6 months after tooth extraction in the absence of complications and by 6-10 months with a complicated course of the postoperative period. After this stage is completed, it is impossible to distinguish the former socket from the surrounding bone on x-rays. And it is after the complete fusion of the bone tissue of the socket and jaw that the reparation process launched by the body after tooth extraction is completed.

Hole (clot) after tooth extraction

On the first day after tooth extraction, a blood clot forms in the hole, which closes it by about 2/3 of the depth. The clot has the appearance of a dark red or even burgundy formation, visible in the hole. This clot cannot be removed, since it is necessary to stop bleeding, the wound healing process and the prevention of infectious and inflammatory complications.

By 3 - 4 days after removal, white thin films appear on the surface of the hole, which represent a young epithelium, and therefore they should not be afraid. These films should not be torn off and removed as they are a sign of a normal healing process. However, if the films are not white, but grayish, yellow, green or any other shade, then this may indicate the development of infectious and inflammatory complications, and therefore, if they appear, you should consult a doctor as soon as possible. A few days after the appearance of white films, the entire hole becomes white, which is also the norm.

For 7 - 8 days after tooth extraction, a thin layer of transparent epithelium appears on the surface of the hole, through which white granulation tissue shines through.

By 14 - 23 days the hole is completely covered with epithelium (mucous membrane), and young bone tissue begins to form in its depth.

By 30 days after tooth extraction, the entire hole under the epithelium layer is filled with young, newly formed bone tissue.

After 4 - 6 months the hole is completely filled with bone tissue, which merges with the surrounding jaw bone. Outside, the hole, overgrown with bone, is covered with epithelium, but the thickness of the gum in the area of ​​the extracted tooth is reduced. In addition, the height of the edge of the overgrown hole is lower than those of the surrounding teeth by about 1/3.

Normal and pathological symptoms that occur after tooth extraction

Consider the various symptoms that may occur after tooth extraction and briefly describe when they are the norm, and when they indicate pathology.

White hole after tooth extraction

Normally, by the 3rd day after tooth extraction, the hole is covered with a thin white film, which indicates the beginning of healing. By 4-5 days, the entire hole becomes white, which is also the norm. Therefore, if the color of the hole is white, and not any other shade, and an unpleasant odor does not come from the oral cavity, then this only indicates the normal course of the healing process.

However, if films of a grayish, yellowish, reddish or any other shade except for white appear on the hole, or an unpleasant odor comes from the oral cavity, then this indicates the beginning of the development of an infectious-inflammatory complication. In this case, you should consult a doctor as soon as possible.

Sore tooth or gum after extraction

Since tooth extraction is an operation, the integrity of the gum tissue, muscles and ligaments that held the tooth in the hole is violated during its execution, and blood vessels and nerves are also torn. Naturally, such damage is accompanied by an inflammatory reaction, which is manifested by pain, swelling and redness. Accordingly, pain in the gums or in the hole in the area of ​​​​the extracted tooth is a normal reaction of the body to tissue damage.

Usually, pain after tooth extraction is felt for 5 to 7 days in the area of ​​​​the hole or next to it, after which it completely disappears. When removing the eighth, seventh or sixth teeth, pain can spread to the ear, since the injured tissues are located close to the structures of the auditory analyzer. Sometimes the pain spreads to the area of ​​​​the joints, as a result of which it is difficult for a person to open his mouth and chew. All of these options for pain are normal options, provided that the pain does not increase over time. Doctors recommend taking painkillers for a week after tooth extraction in order not to endure excruciating and unpleasant pain.

However, if the pain begins to intensify, rather than subside, or a temperature appears, or general well-being worsens, then this indicates an infection and requires urgent medical attention. In other cases, pain is a normal reaction and does not require any special treatment other than pain medication.

Nerve damage after tooth extraction, it is fixed relatively often, but this complication is not severe. As a rule, the nerve is damaged when the roots of the tooth are branched or improperly located, which, in the process of being removed from the gum tissue, capture and break the branch of the nerve. When a nerve is damaged, a person has a feeling of numbness in the cheeks, lips, tongue, or palate that persists for several days. As a rule, after 3 to 4 days, the numbness disappears, as the damaged nerve grows together, and the complication heals itself. However, if numbness persists a week after tooth extraction, then you should consult a doctor who will prescribe physiotherapy procedures necessary to accelerate the healing of the damaged nerve. It should be remembered that sooner or later the nerve damaged during tooth extraction grows together, and the numbness disappears.

Photo after tooth extraction

This photo shows the hole immediately after the extraction of the tooth.

This photo shows a hole after tooth extraction in the stage of normally proceeding healing.

There are contraindications. Before use, you should consult with a specialist.

Good day, dear site visitors. Today I will tell you about such an interesting topic as the removal of a molar. Many are afraid of the very thought of it. But is the devil so terrible, or rather, a dentist-surgeon? How does the process go, what are the consequences? Surely these questions concern many of you.

There are a lot of articles on the web on dental topics. But they are written by experts. The information is replete with terms, and therefore is not particularly useful to a simple layman. The same articles that ordinary people write are often unprofessional and full of medical errors. It's time to paint everything as it is, avoiding complexities and typical amateur mistakes.

Reasons for removal

So where should you start? Any professional dentist believes that the tooth should be saved if it does not harm the health of the patient. Therefore, if a decision has already been made about the need to contact a surgeon, then there are serious grounds for such a decision.

How is the procedure performed

The simplest and most common way is to remove a molar tooth with dental forceps. First, the patient is given an injection. Then the tooth is loosened by rocking, trying not to break the root. After that, its extraction begins. Due to the peculiarities of the anatomy, it is easier to remove teeth from the upper jaw.

Wisdom tooth removal - photo

Molar extraction - pain and anesthesia

The main fears and problems of patients are related to the fact that it is painful to remove a molar tooth. I do not argue - if you do it without anesthesia, then in some cases you can even lose consciousness. However, such operations are not often performed without an injection. The patient is given local anesthesia using one of the popular drugs:

• Novocaine;
• Lidocaine;
• Ubistezin;
• Septanest;

Immediately dismiss Novocain. Many people are allergic to it. In addition, its power in comparison with more advanced developments is very small.

During the doctor's work, the effect of anesthesia may end and you will begin to feel pain. You will have to do a re-injection.

The more they do to you, the higher the risk of parasthesia. There are many nerves around the diseased tooth. The drug paralyzes them. Sometimes numbness persists for several weeks, and in the most difficult cases does not go away at all. Someone stops feeling part of the gum with the cheek, someone touches the facial nerve. After such trouble, people warp their faces.

Modern medicines are safer, do not cause allergies. They are recommended, for example, for asthmatics. Some anesthetics also contain adrenaline. They are not suitable for diabetics and people with thyroid disease.

Ultracain D is recognized as one of the safest and most effective means. In it, among other advantages, there are no preservatives. It is also recommended for heart patients and hypertensive patients.

However, the injection that is given during the work of the dentist does not save you from pain later. The action of local anesthesia is not infinite. After a few hours, the patient begins to experience increasing discomfort, soreness in the gums. Post-traumatic gums appear.

Extraction of teeth during pregnancy

Many women in position are interested in how safe the procedure for removing a tooth is for them. After all, drugs used for pain relief can harm the child. Doctors comment on these issues on the Web and in specialized literature.

The task of the doctor is to choose a remedy that does not cross the placenta or does not harm the baby. There are several such funds. The most popular are Ultracain DS and Ubistezin. The fact is that there is very little epinephrine in them (1: 200,000). They do not pass into breast milk and do not penetrate the placental protection.

It is not recommended to use Scandonest and Mepivastezin for pregnant women. They do not contain adrenaline (it constricts blood vessels, preventing the drug from quickly entering the bloodstream). In addition, these drugs are more toxic than even regular Novocain.

It is forbidden to remove a molar tooth in the first two and last two months of pregnancy. These are the most critical moments when any intervention in the body, stress, even the use of modern anesthetics are dangerous.

Warnings and contraindications

In real dental practice, anything happens. Doctors are people too. They tend to make mistakes. Including when removing teeth. Someone left one root that was not removed, someone did not notice the cyst. Plus - a lot of injuries that patients receive during the procedure.

Many of my friends had very unpleasant consequences of the removal of molars. One had a cheek injury, the other had a torn gum. I had to sew up, and then for two weeks he walked with a swollen cheek and could not eat anything hard.

The procedure has many contraindications. These are a number of cardiovascular diseases (check with your doctor for a list), kidney failure, an acute stage of infectious hepatitis, and an acute form of leukemia. Also, this procedure is not performed for influenza, tonsillitis, and other similar infections. If the patient has abscesses and phlegmon (not of a dental nature), he will also be refused a tooth extraction. A temporary contraindication is the presence of menstruation at the time of treatment.

Tooth extraction procedure

What to do after tooth extraction

Be sure to follow all the instructions and prescriptions of the doctor.

Please note that if the clot is damaged, the hole will fester and an inflammatory process known as alveolitis will begin. If left untreated, it will lead to osteomyelitis and other, even more dangerous consequences.

To remove the molar tooth without complications, it is better to initially contact a good clinic for professional help.

I wish you not to face such problems! To do this, it is worth remembering the need to visit the dentist's office twice a year for the purpose of prevention.

Video - Removal of a molar tooth

Is it necessary to treat caries at the initial stage if the tooth does not hurt?

It depends on the person's approach to their own health. Someone brushes their teeth, and someone treats them. The same with caries. We can definitely say that caries almost never hurts. Very rarely in my practice a person complains about a tooth affected by caries. Therefore, it is better to treat it at the initial stage, when it is superficial and has not reached the nerve - so as not to start and not undergo additional treatment, because then it will be more difficult, and longer, and more expensive. To diagnose latent caries, it is important to visit the dentist for a preventive examination every six months.

Why is dentures necessary?

Why is dentures necessary? There are two main reasons. The first is a decrease in chewing efficiency and, as a result, poorly chewed food. This has a negative effect on the stomach (we have repeatedly received patients from gastroenterologists with a referral for treatment and prosthetics; it is not an easy task to fight stomach diseases without putting the oral cavity in order).

The second is that over time, dentoalveolar deformities may occur (the teeth that are next to the removed one begin to “fall over” towards the free space that has appeared; the tooth on the opposite jaw, which previously closed with the removed one, now begins to move forward without experiencing chewing load). All this leads to pathological changes in the joints of the lower jaw. There is another reason, which in most cases is the main one for the patient, but from the medical point of view it is absolutely not significant - this is not an aesthetic appearance.

How long do implants last?

How long do implants last? It's actually hard to predict exactly how long an implant will last - 10, 20 years or more. Considering that Interdent Clinic uses only the best modern titanium implants (9 different systems), which are absolutely biocompatible, have no contraindications and do not cause rejection, the service life of new teeth increases significantly.

And of course, the health of your entire oral cavity and the life of your new teeth will depend on good oral hygiene.

DURATION OF ENGRAVATION OF IMPLANTS?
The duration of engraftment of implants in the upper jaw is about six months. On the lower jaw, engraftment takes less time - from 3 to 6 months. The recovery period is individual. The recovery period is affected by the density and quality of bone tissue, the physiology of the body.

Are there any contraindications for implantation?

Are there any contraindications for implantation? There are very few contraindications. Neither periodontal disease, nor even diabetes mellitus (except for a severe form), nor bone tissue atrophy due to long-term absence of teeth are no longer a contraindication for implantation today.

Implantation is not indicated for patients with severe blood diseases (such as leukemia), after chemotherapy, with severe systemic diseases, mental disorders such as schizophrenia, paranoia, dementia, various psychoses and neuroses.

Among the contraindications specifically for dental implantation, age restrictions are distinguished: implants cannot be placed on young people from 16 to 22 years old. In diseases of the skeletal system, the installation of dental implants is also impossible, since the regenerative capabilities of bone tissue are reduced.

Dental forceps were and remain a tool for removing teeth. For certain groups of teeth, a different type of forceps is used, since our teeth have a different structure and are located differently in the dentition. For example, there are straight forceps to remove the front upper tooth and canine of the upper jaw, while the remaining upper teeth are removed with S-shaped ones. The incisors of the lower jaw are pulled out using 90º curved forceps with narrow cheeks (the part of the forceps that captures the crown or root of the tooth being removed). The fangs and the two teeth following them are torn with forceps, on the contrary, with wide cheeks. To remove large molars of the lower jaw, forceps with spikes that go between the roots are used.

How does a typical tooth extraction process work?

When removing teeth, local anesthesia is first performed. Then the doctor separates the gum tissue from the tooth by about half a centimeter. Then forceps are placed on the crown of the tooth to be removed. When extracting teeth in the upper jaw, the doctor presses on the forceps with the entire right hand. When removing teeth in the lower jaw, pressure is applied with the thumb of the right hand. The tooth is then dislocated to destroy the tissues holding it. To remove single-rooted teeth, such as the anterior, rotational or pendulum movements are carried out. When removing molars, pendulum-like movements are performed. The culmination of this action is the tooth extracted from the hole.

How is a complex tooth extraction performed?

Complicated extraction of a wisdom tooth is considered the case when the tooth cannot be removed with a simple application of forceps. As a rule, in such situations, access to the root of the tooth to be removed is first created by dissecting the mucous membrane and periosteum. Complex tooth extraction with an oblique or horizontal position takes place in parts, for which a laser or a special saw is often used. This should not be feared, since dissection of a hard-to-reach tooth only reduces the time for its removal. After the procedure, the doctor smoothes the sharp edges of the bone wound, rinses it with hydrogen peroxide or furacilin, the mucoperiosteal flap is put in place and fixed with sutures.

In difficult cases, the operation of removing teeth does not have a single technique. How the doctor will act depends on the specific case.

When is a complex tooth extraction indicated?

It is considered difficult to remove a tooth with a tumor or edema, with periodontitis, periodontitis, with an abscess and flux. The presence of a cyst and a fistulous tract in the tooth also complicate the extraction procedure. Impacted (not erupted) teeth are also indications for surgical extraction of teeth. Difficult cases include removal of a dystopian wisdom tooth, standing outside the dentition; removal of 4 teeth to correct malocclusion; removal of milk teeth in children at an early age. A pronounced curvature of the roots, a fracture of the apical section of the root are also indications for surgery. It should be noted that complex extraction of teeth during pregnancy is not carried out.

The way your tooth will be removed depends on the specific case. The removal strategy can only be determined by a specialist. In any case, you should not be afraid of this procedure. A competent doctor will perform the removal correctly, and you will only have to say “thank you”