Dental extractions

The procedure for completely removing a tooth from the oral cavity is called a dental extraction. There are generally two types of extractions, depending on the position of the tooth and accessibility:

Simple: when the crown of the tooth is entirely visible in the mouth and the bone covers only the roots.
Complex (surgical): Sometimes the tooth is partially or completely covered by bone and gum tissue or, in some situations the tooth is fractured or worn down in such a way that a simple extraction is not possible. Therefore, we would need the help of an oral surgeon in order to remove it, because some additional manoeuvres are required to create access to the tooth.

dental extractions, oral surgery Sopron Hungary

When do we need a tooth extraction?

As professionals who adhere to the conservative dentistry principles, we will always try to save natural teeth with all the means at our disposal, so an extraction is the last resort in our practice. Sometimes, however, we are confronted with complicated dental problems and we have no other option.

Here are the main reasons for extracting a tooth:

Extended tooth decay or an abscessed tooth. A carious cavity not properly treated in time is at the origin of most dental problems. Tooth decay will extend beyond the hard tissues of the tooth, affecting the pulp and then later bacteria will invade the supporting bone. In many cases this will create irreparable damage, sometimes evolving into an abscessed tooth.
A severely fractured or worn-down tooth, may be impossible to restore correctly. In this case, an extraction is required.
Patients who suffer from cancer will sometimes require radiation therapy in the affected area. If teeth are in the path of the radiation beam, they might need to be removed. In addition, the oncologist may suggest removing teeth that are at risk for infection, because cancer therapy will weaken the patient’s immune system and, in consequence, their ability to fight these infections.
The latter is also valid for patients that have undergone organ transplants.
Tooth extraction for orthodontic purposes. Patients who will undergo orthodontic treatment might need to have some teeth extracted to create enough room on the arch for a correct alignment. Overcrowding may cause gum disease and tooth decay, because a proper oral hygiene is difficult to maintain.
Wisdom tooth extraction. Wisdom teeth are the last teeth to erupt and they rarely integrate fully on the arch without complications. More often than not, they get stuck in unfavourable positions, causing pain, inflammation, gum irritation, infection and can sometimes have damaging effects on the neighbouring teeth as well. To prevent or eliminate these complications, an extraction is advised.

Here is what you need to know about the procedure:

After the clinical examination and considering your general and local symptoms, our team will decide whether an extraction is indicated in your case. An x-ray is mandatory before the extraction, because we need to see the actual position of the tooth (or the tooth fragments) inside the bone, the shape of the roots, the level of bone loss, extent of infection and possible implication of the neighbouring anatomical structures, like the maxillary sinuses, the mandibular nerve or the nasal cavity floor. At this moment we can tell if the extraction will be simple or complex. We may prescribe antibiotics prior to a surgical extraction, depending on your medical history and the status of your immune system.

The procedure is always done under local anaesthesia, so it will be painless. Specially designed instruments are used to elevate the tooth from the alveolar bone. Once all the parts of the tooth are removed, we need to clean the socket and probably suture the gum over the remaining hole. You will have to bite on a sterile gauze for about 15 minutes after the procedure. The sutures will be removed in about one or two weeks, during your post-extraction check-up visit or they will dissolve or fall off by themselves. That’s it!

After a Tooth Extraction

Everything that you need to know about the healing process and the instructions that you need to follow will be completely explained before and after the intervention. If, for some reason, you forgot something or you did not fully understand the details, do not hesitate to call and ask us!

Right after the extraction you may experience some local pain. Do not disturb the wound with anything, just brush your teeth as usual (a little more careful around the extraction site!) and keep your oral hygiene optimal. Swelling, a light bruise and some bleeding is also normal. Icepacks can help with swelling, so apply them for 20 minutes at a time in the first hours after the procedure.

All these symptoms are temporary, as it takes a few days to fully recover. You will have to reduce or avoid physical activities like sports, heavy lifting or strenuous work for a few days. Generally, the first 48 hours are the most difficult. After that, the symptoms begin to recede and you will feel better and better with time. Take the medicine prescribed by our doctors exactly as they indicated and follow their instructions for a rapid recovery.

You will not be allowed to eat for about two hours after the extraction, so be sure to have a meal before your appointment. Eat soft foods that are cold or at room temperature on the day of the surgery, to avoid irritating the area of the extraction. Refrain from smoking for at least 72 hours to reduce the risk of toxicity and infection.

Wisdom tooth extractions

The last permanent tooth to erupt on the arch is the third molar or the wisdom tooth. This happens usually between the ages of 17 and 25. There should be two molars for each arch (upper left and right and lower left and right), but not everyone has them. Some patients have no wisdom teeth, while others can have any number between 1 and 4.

More often than not, these molars do not have enough room to fit on the arch and end up stuck inside the bone (this is called an “impacted wisdom tooth”) or pressing the other teeth, causing pain, overcrowding, gum inflammation and creating spaces that are difficult to keep clean. Considering these risks, sometimes extracting them will be recommended, before causing any damage. The best way to predict the outcome of a wisdom tooth eruption is through regular check-ups and periodical dental x-rays. Our doctors will assess the position of the wisdom tooth, its possible trajectory and find whether an eruption without complications is possible.

If a wisdom tooth extraction is indicated in your case, here is what you need to know:

The procedure is done under local anaesthesia, so you do not need to worry about feeling pain. If you struggle with high anxiety regarding the intervention, you should know that in our clinic it is possible to opt for sedation anaesthesia (also called “sleep dentistry”).
The removal of your wisdom tooth is similar to a tooth extraction, but you should expect some additional steps, with the purpose of creating access. This is done with specially designed instruments and burs.
After the procedure, the surgeon will likely suture the gums over the extraction site and ask you to bite on a sterile gauze for about 15 minutes. The sutures will either fall by themselves or will have to be removed in a week or two.
You will receive instructions that you need to follow in the next few days and you will also be given medication for pain management and to prevent infection.
Brush your teeth as usual, just be careful not to disturb the wound with anything.
If you rinse with water or mouthwash, be sure no to do so excessively.
Bruises, some bleeding and swelling can appear. Icepacks can help, apply them for 20 minutes at a time in the first hours after the procedure.
The recovery will take a few days. In this time, you will be required to avoid physical activities like sports, heavy lifting or strenuous work. You will not be allowed to eat for about two hours after the procedure, so be sure to have a meal before your appointment. Eat soft foods that are cold or at room temperature on the day of the surgery, to avoid irritating the area of the extraction. Refrain from smoking for at least 72 hours to reduce the risk of toxicity and infection.