Step 1: Numbing the tooth: Tooth extraction begins by administration of anaesthesia for the tooth, gum and bone tissue surrounding it. This process looks to numb the tooth and surrounding areas, a necessary step before the tooth is removed.
Step 2: Extraction of the tooth: When tooth is extracted, what happens is that the tooth is pulled from its socket (in jawbone The tooth is normally firmly encased in the socket and held in place by a ligament. To remove the tooth, the doctor enlarges the socket before he can separate the tooth from the ligament, then out of the socket. The bone that encases the root of the tooth is relatively spongy. Rocking the tooth back and forth against the socket walls therefore causes the bone to expand. Eventually there would be enough space and the tooth is separated from the ligament with tools to grasp or apply pressure on the tooth and remove it, such as extraction forceps and elevators.
Step 3: Closing the space vacated by the tooth: Removing your tooth will leave the socket open. Your dentist may perform the following steps to enhance proper healing:
- Remove any infected or pathologic tissue by scraping the walls of the socket
- Round off any sharp bone edges
- Evaluate the socket for any sinus complications (for removal of upper molars)
- Rinsing out the socket to remove any tooth fragments or loose bone.
Step 4: Controlling bleeding
The dentist places a folded gauze over the site of tooth extraction and ask you to bite down on it to create firm pressure which will control bleeding. You may be required to maintain firm pressure on the gauze for about an hour.
In certain circumstances, stitches may be placed to close the extraction site and control the bleeding. For example, in cases of multiple teeth removal, surgical extractions, or for patients on blood thinning medications.
These stitches may need to be removed at a follow up appointment.
Step 5: Surgical Intervention (if suggested by the dentist):
In cases where standard extraction methods are insufficient or deemed inadequate due to various factors such as severely broken down teeth, roots with abnormal curvature, bulbous roots, multiple roots, curved roots, thin roots, teeth with large restorations, have crown or bridge treatments, or obstructions like hard bone impeding the extraction, or if the tooth is unable to be removed by normal extraction methods, surgical intervention may be required.
Step 5.1: Sectioning of the Tooth: If the tooth's structure presents challenges for straightforward removal, such as large size or intricate root configuration, the dentist may opt for sectioning. This involves dividing the tooth into smaller segments using specialized instruments like dental burs and elevators. Sectioning facilitates safer extraction by allowing the dentist to manage each segment individually, reducing the risk of trauma to surrounding tissues.
Step 5.2: Bone Removal: In situations where dense bone or anatomical obstacles hinder access to the tooth, the dentist may perform bone removal. Delicate reshaping of the bone using surgical drills and burs allows for better visualization and extraction of the tooth.
Step 5.3: Closure and Post-operative Care: Following surgical extraction, the dentist ensures proper closure of the surgical site, often by suturing soft tissue flaps. This promotes optimal healing and reduces the risk of complications. Patients receive detailed post-operative instructions to support a smooth recovery, including guidance on oral hygiene, pain management, and dietary considerations.
Step 6: Post-operative Follow-up: Patients undergoing surgical tooth extraction typically require a follow-up appointment for evaluation of healing progress and removal of sutures if necessary. During this visit, the dentist addresses any concerns or complications, providing further guidance on post-operative care as needed.
Please note that the decision to pursue surgical tooth extraction is based on individual circumstances and may involve additional costs, typically ranging from $650 to $1250 (before GST), reflecting the complexity of the procedure and the specialized techniques required.