What are they?
Despite what people may believe, dentists only take teeth out as a last resort. We want to be able to save teeth whenever possible, but in some cases this just isn’t feasible. The teeth that need to come out are assessed and then all parts of the tooth are removed, leaving a gap. Adult teeth once taken out will have a permanent gap whereas baby teeth have an adult tooth underneath that will come up to fill the space. There are different ways the gaps can be filled after the extractions such as dentures, bridges, implants or just leave a space. These options can be discussed with your dentist to see which approach is best for the teeth being taken out and each patient as an individual.
Why are they done?
Teeth may need to be taken out for a variety of reasons. It might be because they have decayed very badly so cannot be filled or restored. Extractions may be needed due to trauma where a very large amount of the tooth and/or roots have broken. Also they might be needed if a tooth has an abscess or down to problems with the teeth coming through. Teeth may need to be taken out for orthodontic reasons in order to make space and allow the teeth to be moved, but this varies for each individual and is much more common in younger people.
Mostly the indication for tooth extraction is pain. In some instances the teeth can be treated with root canal therapy, but as a faster response to get out of pain they can be extracted. The dentist is there to provide advice about the situation and which approach is best in each instance.
Patients should ask any questions they have before treatment as once the teeth are out they cannot be put back!
How is it done?
After assessment (which will probably include taking an X-ray of the tooth/teeth wanting to be taken out), the dentist will numb you up around that tooth with local anaesthetic. Anaesthetics will usually last between 2-4 hours. It should mean you no longer feel any sharp pain during the procedure; however, if you do it might just be that you need a little bit more numbing before continuing. If you are very anxious some practices may be able to offer you sedation for the procedure. If not you can be referred to a hospital. Referrals also are made if the extraction is going to be complicated or possibly if it is going to need to be removed surgically.
Once the anaesthetic has been, given the area will be checked to make sure you are unable to feel any sharp pain. You should only feel lots of pressure and pushing throughout.
Then it is important to make the tooth nice and loose before using forceps to take it out the socket. This is done by using specially designed instruments called elevators and luxators which are used to make a bit of space around the roots, especially important for teeth with more than 1 root. At this stage lots of pushing and twisting will be done until the tooth is wobbly.
Once everything is nice and loose, the forceps will be used. There are many different forceps available. They are specially designed to get the best grip of the tooth before taking it out.
Teeth are not all the same shape, nor do they have the same number of roots, which is why different forceps are used in different areas of the mouth. Again with the use of forceps, you will feel some pressure being used along with movement.
These instruments are used until the tooth is removed. You’ll then need to bite down on something to help stop the bleeding which will be given to you by the dentist. They will then check that all of the tooth was taken out and that everything went well.
Normally stitches do not need to be placed unless lots of teeth have been taken out or it has involved some surgery. Without stitches the gum usually heals over by itself, but the time taken for it to heal varies from patient to patient and is something you can ask your dentist at the time.
Will it be painful?
Wherever possible dentistry should be painless which is why the anaesthetic is used. Pressure and pushing will be felt throughout the treatment but no sharp pain should be experienced. If it is let your dentist know as they can give you some more anaesthetic.
After the treatment you might have some pain so taking normal over the counter pain relief will help. Again your dentist will give you further advice about how to cope with the pain to be expected as well as any tenderness or swelling.
What happens after?
After the tooth has been taken out your dentist will give you some instructions on how to look after the area that the tooth came from. In order to help healing to be quick and avoid any infection the area needs to be kept clean. Mostly it is suggested to use warm salt baths to be held over the socket 3-4 times a day to kill any bacteria and aid healing.
How much will it cost?
On the NHS extractions fall into band 3, but privately the cost varies depending on if it is simple to complicated. The range can be from around £50 up to £230. This is something to discuss further with your dentist.