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Extractions
You and Dr. Vali Mirzayan may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.
The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.
To avoid these complications, in most cases, Dr. Mirzayan will discuss alternatives to extractions as well replacement of the extracted tooth.
You will have several choices for replacing the newly missing teeth. All of the options rely on bone support and bone contour for the best function and aesthetics. Here is a list of the possible options:
- Dental implants: These are root-shaped supports that hold your replacement teeth. The more bone support you have, the stronger the implant replacements will be. In some cases, the bone can degenerate to a point where implants can no longer be placed without having more complex bone grafting procedures to create the necessary support. Obviously, preventing bone loss is much easier than recreating the bone later.
- “ Fixed bridge”: This is a restoration that is supported by the teeth adjacent to the missing tooth space. The replacement tooth (or pontic) spans across the space. If the bone is deficient, there will be an unsightly space under the pontic that will trap food and affect your speech.
- Other replacement alternatives include removable partial or full dentures. These often perform better with more supporting bone as there is added support against dislodgement.
The Extraction Process
At the time of extraction the doctor will need to numb your tooth, jawbone and gums that surround the area with a local anesthetic.
During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.
You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.
Sectioning a tooth
Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can't expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.
After Care:
Bleeding
Some bleeding may occur. Placing a piece of moist gauze over the empty tooth socket and biting down firmly for 45 minutes can control this.
Blood clot that forms in the empty socket is an important part of the healing process and you must be careful not to dislodge the clot.
This is an important part of the healing process and you must be careful not to dislodge the clot.
- Avoid rinsing or spitting for 24 hours after the extraction.
- Avoid use of a straw, smoking or hot liquids.
Swelling
If swelling occurs you can place ice on your face for 10 minutes and off for 20 minutes. Repeat this cycle, as you feel necessary for up to 24 hours.
Pain and Medications
A mild pain medication should ease the discomfort if you have not been prescribed any medication.
Eating
For most extractions just make sure you do your chewing away from the extraction site. Stay away from hot liquids and alcoholic beverages for 24 hours.
A liquid diet may be recommended for 24 hours.
Brushing and Cleaning
After the extraction avoid brushing the teeth near the extraction site for one day. After that you can resume gentle cleaning. Avoid commercial mouth rinses, as they tend to irritate the site.
Beginning 24 hours after the extraction you can rinse with salt water (1/2 teaspoon in a cup of water) after meals and before bed.
Dry Socket
Dry socket is when a blood clot fails to form in the socket where the tooth has been extracted or the clot has been dislodged and the healing is significantly delayed.
Following the post extraction instructions will reduce the chances of developing dry socket. Dry sockets manifest themselves as a dull throbbing pain, which doesn't appear until three to four days after the extraction. The pain can be moderate to severe and radiate from the extraction area. Dry socket may cause a bad taste or bad breath and the extraction site appears dry.
Dr. Vali Mirzayan will apply a medicated dressing to the dry socket to sooth the pain.
Healing
After a tooth has been extracted there will be a resulting hole in your jawbone where the tooth was. In time, this will smooth and fill in with bone. This process can take many weeks or months. However after 1- 2 weeks you should no longer notice any inconvenience.
Replacing teeth with: