Dental (tooth) extractions involve the removal of a tooth from its socket in the jaw bone, due to various circumstances. If your tooth is broken or compromised by infection or decay, our priority will always save your tooth by other means, including root canal therapy, and the placement of dental crowns.
Sometimes, there is too much damage done to the tooth, making other options impractical, or too expensive, thus making extraction necessary. The treatment of advanced gum disease may also require that a tooth to be extracted, so that it doesn’t affect the healthy surrounding tissue and bone structures of your mouth. Occasionally, while having orthodontic work done, teeth may need to be extracted to create room for the teeth that are being moved into place, or are blocked from coming in.
Having a tooth extracted is typically a quick and simple process. First, an anesthetic is administered to numb the area, and minimize any discomfort. During the extraction, you will feel some pressure while the tooth is being removed but not any pain. Most often, your tooth will be removed within minutes. Immediately after the tooth extraction, a small amount of bleeding is normal and patch of gauze will be placed in the affected area. The area may bleed minimally for the next hour or so, and taper off after that. Follow the instructions provided on this site about how often to change the gauze, and what other post-procedure steps to follow.
Endodontics (Root Canal Therapy)
Natural teeth are meant to last a lifetime. Years ago, diseased or injured teeth frequently were extracted. But today, even if the pulp in one of your teeth becomes injured or infected, the tooth often can be saved through root canal (endodontic) treatment. Endodontics is the branch of dentistry concerned with the prevention, diagnosis, and treatment of diseases or injuries to the dental pulp.
What is the dental pulp?
The pulp is soft tissue inside the tooth that contains blood vessels and nerves. It lies in a canal that runs through the center of the dentin- the hard tissue on the inside of the tooth that supports the enamel- the outer layer of tooth structure. The crown (the portion of the tooth visible above the gums) contains the pulp chamber. The pulp extends from this chamber down through the root canal to the tip of the root that lies in the bone of the jaws. Teeth have only one pulp chamber but may have more than one root and several root canals.
What happens if the pulp is injured?
When the pulp is diseases or injured and unable to repair itself, it loses its strength. The most common causes of the pulp dying are a cracked tooth, a deep cavity requiring large fillings, or traumatic injuries to the tooth all of which may allow bacteria and their products to enter into the pulp.
Why should the pulp be removed?
If the injured or diseased pulp is not removed, the tissues surrounding the root of the tooth can become infected, resulting in pain and swelling. Even if there is not pain, certain substances released by bacteria can damage the bone that anchors the tooth in the jaw. Without treatment, the tooth may have to be extracted.
Removing a tooth can create problems
There are downsides to losing a natural tooth. When a tooth is removed and not replaced, the nearest teeth may begin to shift from their normal position. This may cause the teeth to become crooked or crowded, which makes biting and chewing more difficult. Crooked or crowded teeth are more likely to have gum disease because they are harder to keep clean than straight teeth. A replacement tooth (an implant or bridge) is usually more expensive than endodontic treatment and can involve more extensive dental procedures on nearby teeth. A natural tooth is normally better then an artificial tooth.
What does treatment involve?
Treatment involves one or more visits. There are several steps in the process of endodontic treatment that your general dentist or endodontist will perform to save your tooth.
- First, local anesthesia is usually given so that you will be more comfortable. To isolate the tooth, the dentist will use a rubber dam, which is a thin sheet of latex rubber or plastic that keeps the tooth dry during treatment. An opening is made through the crown of the tooth into the pulp chamber.
- The pulp of remaining tissue is then removed carefully from both the pulp chamber and root canal(s). Each root canal is cleaned and shaped to allow it to be filled.
- Medication may be placed in the pulp chamber and root canal(s) to help eliminate bacteria.
- A temporary filling may be placed in the crown opening to prevent saliva from entering the chamber and root canals, or your dentist may immediately begin the next stage of filling the root canal(s). You might also be given antibiotics if infection is present and has spread beyond the end of the root(s). If your dentist has prescribed medication, us it only as directed. If you have any problems with the medication, call your dentist.
- During the next stage of treatment, after placement of a rubber dam, the temporary filling is removed (if one was placed at an earlier visit). The root canal(s) are usually filled with gutta-percha, a rubber-like material made from various tropical trees.
- In the final step, the temporary filling is removed and the tooth may be restored by a crown or a filling to strengthen it and improve its appearance. A crown may be made of porcelain or metal alloy, and the filling may be made of many different materials. If and endodontist performs the root canal treatment, he or she will usually recommend that you return to your general dentist for the final restoration.
How long will the restored tooth last?
A tooth with a root canal filling can provide years of service similar to nearby teeth that have not been treated. However, teeth with root canal fillings may become decayed, develop fracture lines, or gum disease can develop around the treated tooth, just like any other tooth. Good daily cleaning habits and regular dental exams will help you keep and maintain your teeth.