Removing the root of a damaged or rotten tooth: does it hurt, the removal process

1. Removal cost
2. Indications
3. Preparation
4. Methods and steps
5. Complications
6. What to do after the procedure
7. Our doctors
8. Reviews
9. To make an appointment with a doctor

In practice, specialists at Plomba dentistry periodically encounter cases of complete destruction of the crown of a tooth and infection of the root system, in which a purulent-inflammatory process occurs. Most often, this problem can be solved only by removing the root and remains of the tooth. But sometimes the root system can be preserved for subsequent prosthetics. How the removal will be carried out, what measures and tools will be used, the doctor will be able to decide after familiarizing himself with the clinical picture.

Indications for tooth root removal

• Complete destruction of the coronal (supra-gingival) part, affecting the root system;
• extensive purulent-inflammatory process at the root: cyst, abscess;
• longitudinal axial fracture;
• previous incorrect extraction - during removal, fragments remained in the hole, causing an inflammatory process that affected nearby tissues.

The damaged area of ​​the tooth is easily identified visually. Additional symptoms of the need for urgent medical intervention and even possible removal of a diseased tooth are:

• twitching, throbbing pain;
• acute pain due to mechanical action - pressing, biting, chewing food;
• unpleasant odor;
• gum hyperemia;
• a purulent process is a direct indication of the need to remove the root of a diseased tooth;
• elevated body temperature.

If one or more symptoms are present, the destroyed units are removed. In some cases, incomplete removal is performed - resection of the tooth roots. This usually occurs when the root apex is affected by periodontitis, a small cyst, or granuloma. Often in such diseases the coronal part is preserved. In this case, the damaged part is removed through an incision in the gum. Subsequently, installing a crown solves the problem of restoring the chewing unit.

Features of postoperative care

There are a number of recommendations that can significantly speed up the healing process of a wound formed during surgery and avoid the development of complications. In particular, dentists advise:

• during the first 24 hours, avoid too warm baths, do not go to the baths, refrain from any, even minor, physical activity, apply ice to the cheek on the side of the removed root every half hour;
• give up alcohol and smoking, too hot and spicy food for 2 days;
• take analgesics if pain occurs;
• for several days, try not to chew food on the operated side, give up the habit of biting your lips or sucking in your cheeks (this creates a vacuum in the mouth that can displace a blood clot formed on the wound);
• undergo a full course of treatment with antibacterial agents if prescribed by a dentist.

If signs indicating the development of complications appear, it is necessary to abandon attempts at self-medication and seek help from a doctor at the 24-hour A.Dent dentistry as soon as possible.

Preparing for tooth extraction

Removing a tooth or its roots is a rather complex surgical dental procedure, but it will not be difficult for the patient to prepare for it. If local anesthesia is planned to be used for pain relief, the patient should eat a large meal before visiting the dentist because:

• After removing a tooth or root, it is forbidden to eat for several hours;
• salivation after eating is significantly reduced, which will make the dentist’s work easier;
• after eating, blood glucose levels are normalized and the risk of loss of consciousness under the influence of local anesthesia is reduced

In the case of general anesthesia, on the contrary, it is necessary to abstain from eating for several hours before the removal procedure begins. Drinking alcohol before visiting the dentist is prohibited. Alcohol affects the structure of the blood and does not combine well with anesthetics, not to mention the negative impact on the human psyche and behavior.

Inflammatory and infectious diseases of any nature must be cured before surgery to remove a tooth or its roots. The dentist must be warned about the presence of allergies to certain medications, in particular to anesthesia drugs.

A normal pregnancy in general is not a contraindication to dental procedures. However, during this period the use of a number of drugs used in dentistry is prohibited, so information about pregnancy is entered into the patient’s dental record. Also, detailed information about the patient’s chronic diseases, especially heart pathologies, is recorded in the dental record.

Anesthesia (pain relief)

To minimize discomfort during an injection, you need to treat the injection site with a special anesthetic gel. This is the so-called topical anesthesia. It is very often used in pediatric dentistry, but we also use it in working with adults. As practice shows, there are fewer unpleasant sensations, and the taste is pleasant... at least some kind of joy.

When removing teeth from the upper jaw, as a rule, a simple infiltration of anesthetic into the area of ​​the tooth being removed is sufficient. It is carried out using a special syringe with specially selected anesthetics and is called infiltration .

When removing teeth on the lower jaw, infiltration anesthesia is usually not enough (with the exception of the frontal group of teeth, from canine to canine). Therefore, the anesthesia technique changes somewhat - the anesthetic, using a long but very thin needle, is applied directly to the nerve bundle responsible for the innervation of the desired areas. This anesthesia allows you to “turn off” sensitivity not only in the area of ​​the tooth being removed, but also in the lip, chin, part of the tongue, etc.

It should be noted that during and immediately after anesthesia, a number of interesting phenomena may be observed - increased heart rate, trembling of limbs, an inexplicable feeling of anxiety. Many patients begin to panic about this. But there is no need to panic! These are side effects of most modern anesthetics and go away on their own within 10-15 minutes.

Well, the anesthesia is done! Now you need to make sure that it was carried out successfully?

Those places that should ideally be numb are listed above. Also, using a special instrument and pressing on the gum in the area of ​​the operated tooth, we determine whether the pain still remains or no longer exists. The only thing that should be felt is the sensation of “something” touching the gum. That is, tactile sensations are still preserved, but pain is no longer present.

And then our actions differ depending on what type of wisdom tooth we are dealing with.

Methods and stages of removing teeth or their roots

Most often in modern dentistry, only two methods of removing teeth or their roots are practiced:

• removing a tooth from the gum using forceps;
• rocking of the tooth and its rotation around its axis by elevators.

In cases where the roots are deep, the gum tissue can be cut with a scalpel. In general, the process of removing teeth or their roots is divided into the following stages:

• separation of the round ligament from the neck of the tooth (ligamentotomy);
• applying (installing) forceps to the tooth;
• advancing the fixing elements of the forceps under the gum;
• final fixation of the forceps;
• rotation (rotation) or luxation (swaying) of the tooth;
• extracting a tooth or its roots from the socket.

Tools used for complex removal

When extirpating figure eights, a number of instruments are used:

• Pliers consisting of cheeks, a handle, and a lock are used if the crown is not destroyed or is slightly damaged (there is something to grab onto). They differ in shape, structure, and size. Different forceps are used to extract the upper or lower tooth.
• The elevator acts like a wedge - it loosens the dental unit, tearing the ligaments and pushing it out of the socket. The tip is immersed in the periodontal fissure, then rotated around the axis using a handle. It removes fragments well from a damaged crown, a shallow fracture, and is suitable for the extraction of dystopic, impacted teeth.
• An excavator is used to extract softened parts and root fragments. It has an angular shape with pointed edges. Easily inserted between the alveolus and the remaining tooth.
• The chisel allows you to destroy the interroot connection, actually gouges out the tooth, but is rarely used for the figure eight.
• The drill is used to divide a multi-root system into parts, especially in cases of crown destruction, atypical location, impacted teeth. The gradual extraction of dental elements causes less trauma to surrounding tissues.
• An osteotome is used to cut and remove part of the bone that is blocking the removal of a molar.

Modern techniques include the use of laser or ultrasound equipment. In this case, fewer complications arise, and the recovery period takes less time.

Common complications after tooth extraction

Tooth extraction is essentially a full-fledged surgical intervention. Symptoms such as pain and inflammation in the surgical area are considered normal for the rehabilitation period, unless they are too severe and are not eliminated 3-4 days after tooth (root) extraction. The rehabilitation period may also be characterized by increased body temperature and enlarged lymph nodes.

More serious clinical complications include:

• renewed bleeding from the socket after tooth (root) removal - methods for eliminating minor bleeding can be discussed by the dentist; in case of intense bleeding, it is necessary to urgently consult a specialist;
• incomplete removal of the tooth root - the presence of residues is diagnosed by x-ray and follow-up and quickly eliminated;
• alveolitis is a dangerous, but easily eliminated by antibiotics, inflammatory process in bone tissue, characterized by a significant increase in body temperature, swelling, severe pain, and requires immediate treatment, as it can lead to sepsis.

In the first hours after removal, the patient should not eat. Cotton swabs from the surgical area can be removed 30 minutes after completion of all manipulations. In the first days after surgery, it is not recommended to eat sour, sweet, salty, very chilled or hot foods. Short-term cold compresses can relieve pain in the first days after tooth extraction.

Tooth extraction is a last resort in modern dentistry. A qualified specialist must strive by all means to save the tooth even in the most difficult cases.

The final stage of restoring oral health is not the removal, but the replacement of teeth (except for wisdom teeth).

Your feedback

I had my wisdom teeth removed at the RUTT clinic.
After six years of torment, during which he constantly made himself known at the most inopportune moments, she finally decided to break up with him. Removal was difficult (or so they said), with sawing and pulling out in parts. In terms of time, the doctor worked for at least 20-30 minutes. But it doesn’t feel like it hurts at all. Apart from picking at the jaw and pressing, I actually felt nothing. Unpleasant - yes, but not painful at all. Victoria |
10/31/2020 Leave a review Other reviews

What to do after tooth extraction

The operation cannot be prescribed without an X-ray examination, which makes it possible to determine the amount and degree of root destruction and the extent of the inflammatory process. Before root removal, the patient is given anesthesia, after which the gum is separated from the neck of the tooth. The surgeon's further actions are determined by the clinical picture. Dentists call the most difficult operation the removal of the deep and often twisted roots of the “figure eight” – the eighth tooth in the dentition. But the specialists of the Plomba clinic successfully cope with this too.

Does it hurt to remove?

A typical mistake made by patients before tooth extraction is the desire to start the procedure faster in order to “get over it” faster. In this case, the anesthesia does not have time to completely dissipate through the tissues and the patient will face a painful procedure. Therefore, you need to wait a certain time, which is suggested by the dentist.

Stress factors can also affect pain during surgery. During the effect of anesthesia, you need to remain as calm as possible, which will allow you to carry out the procedure quickly and with the least risk.