Tooth Extraction Tooth extraction should only be done by a specialist dentist to ensure the proper procedure and safety. It requires careful treatment planning because extracting a tooth means permanently losing a natural tooth. The most common cause is severe tooth decay that cannot be repaired. Other reasons for tooth extraction include:
1) Tooth Decay: Tooth decay occurs when bacteria in the mouth combine with food particles and saliva, forming a sticky substance called plaque or bacterial biofilm. This plaque gradually builds up on your teeth and grows with the sugar from food or drinks. The bacteria turn sugar and starch into acid, which gradually destroys the minerals in the tooth enamel, creating a small hole that enlarges over time. As the tooth structure is damaged, it progresses deeper into the tooth tissue, reaching the pulp. Without treatment, the decay spreads, becoming larger and deeper, eventually causing pain and leading to tooth loss.
2) Tooth Extraction with Orthodontic Treatment: For patients undergoing orthodontic treatment, tooth extraction may be necessary to create space for aligning the teeth properly. The dentist will plan which teeth need to be extracted and how many, based on the patient’s dental condition. This may also include extracting the last teeth or wisdom teeth to prevent future issues with neighboring teeth and to ensure proper alignment of the teeth in the future.
3) Gum Disease: Gum disease is a common oral health issue that can affect individuals of all ages. It is caused by inflammation of the gums due to bacteria or microorganisms that accumulate on the teeth. Poor brushing habits lead to the buildup of plaque and tartar on the teeth and between the teeth, which irritates and inflames the gums. If left untreated, gum disease can progress and lead to infection in the bone that supports the teeth, potentially resulting in tooth loss.
4) Abscess or Pus at the Root of the Tooth: An abscess or pus at the tip of the tooth root occurs when bacteria reach the dental pulp and infect the root tip, located deep within the tooth. This results in pus accumulation in the jawbone and causes swelling and pain. If left untreated, the infection can spread to neighboring teeth and potentially damage the bone around the tooth root.
5) Accidents: Dental accidents, such as severe impacts to the teeth, can cause the tooth to break, leaving insufficient tooth structure to repair with a filling or crown. If the tooth fractures down to the root, it may be necessary to extract the tooth. In such cases, tooth extraction is required to prevent further complications.
Wisdom Tooth Extraction A wisdom tooth that cannot fully emerge into the mouth and may be partially erupted or fully embedded in the jawbone. The most commonly affected teeth are the lower third molars, which may emerge in a vertical, tilted, or horizontal position, often in close proximity to neighboring teeth. The need for surgical removal or extraction arises when the impacted wisdom tooth causes pain, infection, damage to adjacent teeth, or other complications.
1) To Prevent Pain from an Impacted Third Molar: When a third molar (wisdom tooth) cannot emerge properly due to crowding from adjacent teeth or obstruction by the jawbone, it creates pressure in the jaw area. In some cases, the tooth's root may press on or interfere with the nerve canal or blood vessels in the jaw, causing potential damage to these structures. Delaying removal can lead to serious complications, including damage to the nerve and blood vessels. For upper wisdom teeth, if left untreated for too long, the sinus cavity may descend, leading to the risk of creating a perforation between the oral cavity and the sinus.
2) To Prevent Gum Inflammation Over the Tooth: The gum tissue covering an impacted tooth can trap food particles underneath, making it difficult to clean. Bacteria that accumulate in this area can cause the gums to become inflamed, painful, and swollen, potentially leading to pus and a foul odor. If left untreated, the infection can spread to areas beneath the chin or under the tongue, causing the bacteria to spread throughout the body, which is extremely dangerous. In some cases, if the gum inflammation is severe and the opposing tooth grows long enough to irritate the gum, it can intensify the pain.
3) To Prevent Decay of Neighboring Teeth: The space between the impacted wisdom tooth and the adjacent second molar is difficult to clean, which can lead to food particles becoming trapped and causing decay in both teeth. In severe cases, both the wisdom tooth and the neighboring molar may need to be extracted to prevent further dental damage.
4) To Prevent Bone Resorption: The pressure exerted by an impacted wisdom tooth attempting to emerge can damage the bone around its root and the roots of neighboring teeth. If the neighboring tooth is not yet decayed, delaying wisdom tooth extraction may lead to the loss of the bone surrounding both the impacted tooth's root and the neighboring tooth's root. This can potentially affect the vitality of the neighboring tooth as well.
5) To Prevent Cyst or Tumor Formation: If a wisdom tooth is left untreated for a long time, the tissue surrounding the impacted tooth may enlarge and form a cyst, which can grow without symptoms. Eventually, this may lead to the destruction of neighboring teeth and the bone around the area. Often, individuals may not realize this until they notice facial asymmetry or one side of the jaw being larger than the other. If detected early, prompt surgical removal can prevent further damage to the jaw and help maintain facial symmetry. However, if the cyst or tumor is very large, a portion of the jawbone may need to be removed, potentially altering the appearance of the face in that area.
6) To Prevent Jawbone Fracture: An impacted wisdom tooth embedded in the jawbone can cause the surrounding bone to become thinner, creating a weak spot. If the jawbone in that area experiences an accident or impact, it is more likely to fracture easily due to the weakened bone structure caused by the impacted tooth.
Surgical Procedure with Orthodontic Treatment This is a surgical procedure to reposition the jaw, combined with orthodontic treatment to correct facial abnormalities and malocclusion. The treatment is divided into two parts: correcting the structure of the jaw and fixing the bite. It is typically recommended for individuals with abnormalities in both the upper and lower jaw, such as a short or long midface, asymmetrical chin, or a protruding chin. For these cases, orthodontics alone may not be sufficient, and surgery is necessary to place the upper and lower jaw in a more suitable position. The treatment plan involves collaboration between an oral surgeon and an orthodontist to achieve the best outcome.
