Unlike most of the cold blooded animals and some mammals like kangaroos, elephants and manatees, humans unfortunately do not have the ability to regrow teeth multiple times. Humans in their lifespan will only have a set of milk teeth and the permanent adult teeth. Although these permanent teeth are meant for a lifetime there are umpteen reasons why adult teeth are pulled out.
Some of which are:
- Severely mutilated teeth either due to decay or fracture
- Recurrent pulpal or periodontal infections
- Extractions for orthodontic treatment ( for alignment though uncommon nowadays )
- Wisdom teeth
- Additional teeth or supernumerary teeth
Tooth Extraction is an art and science of pulling a tooth out from its bony socket without causing any injury to the adjacent structures, optimally and conservatively. It is a surgical process which most often requires local anaesthesia or conscious sedation. There are rare instances where tooth extractions are done under general anaesthesia.
Wisdom teeth are the most commonly extracted teeth, either because of their non-eruption into the oral cavity, or improper alignment or for prophylactic reasons. In patients with severe crowding or proclination, teeth are extracted either to align or to enable good bite or both. Severely damaged, decayed, fractured and infected teeth are also pulled out to maintain good oral hygiene.
Today, in reputed dental hospitals tooth extractions however simple, are handled by oral surgeons. During an extraction the treating oral and maxillofacial surgeon uses a numbing gel to anaesthetise the injection site and deposits local anaesthesia either in close proximity of the nerve or the bone. Once the numbness is ascertained the oral surgeon either elevates or extracts tooth using elevators or forceps ensuring no damage to the adjacent structures.
Tooth extractions are mostly painless considering efficient and skilled oral surgeons handle with a principle of tissue conservation. Since the designated specialist handles the extraction with optimised clinical protocols the risks of fracture of roots, fracture of tooth, compromise of surrounding gum and bony structures does not arise. However if handled inefficiently the above risks are paramount.
Recovery from tooth extraction depends on the procedure being simple or complex, mostly 3 to 4 days of care and caution helps with speedy recovery. After extraction, the site is either sutured or allowed to heal with primary intention depending on exposure.
The exposed socket will get filled with bone eventually as if there was no tooth at all. Mostly one can resume work the next day sometimes a couple of days rest is advised, again depending on severity of the procedure.
The cost of extraction would also depend on the following:
- Which tooth
- Type of extraction – surgical extraction tend to be slightly expensive than simple extractions
- The cost would also depend on the involvement of skilled professional
- Type of anaesthesia used can influence the cost of extraction
Risks of tooth extraction usually cumulate to inefficient skill, unhygienic conditions, usage of non sterile tools and equipment, underlying systemic disorders and poor surgical protocols. If efficiently handled the risks and side effects are almost negligible.
In certain conditions like, patients with bleeding disorder, clotting disorders, thyroid disease, hepatitis and in the first trimester of pregnancy certain care and precautions need to be followed to minimise risks.
Abstinence from spitting for a day, avoidance of hot and hard food, cold compressions on the site with ice pack and medication post extraction are some of the obligations which need to be strictly followed. Like they say a ‘stitch in time saves nine’, being a little cautious and careful after tooth extraction puts you back on your feet in a couple of days.