In this article, we’ll discuss the topic of tooth extraction. We’ll cover what constitutes a simple versus a complex extraction, how long the procedure might take, and the importance of the dentist's experience and qualifications when a tooth extraction is necessary.
Additionally, we’ll address some pressing questions like, "What am I paying for?" and "Why is it so expensive?" Fortunately, the list of conditions that require tooth extraction isn't very long. Modern dentists generally strive to preserve teeth for as long as possible. However, miracles don't always happen (you can read more about that here), and sometimes tooth extraction becomes unavoidable.
What is important to know about tooth extraction?
A precise understanding of when a tooth extraction is necessary can aid in preserving your tooth. For instance, one of the main reasons for extraction is advanced decay. If a patient doesn't visit the dentist in time, the roots of the teeth affected by infection and inflammation will eventually deteriorate. Restoring such teeth or placing a crown becomes pointless as they will no longer fulfill their function.
Moreover, decay can not only affect the teeth but also reach their roots. Root caries, or decay below the gum line, is a direct indication for extraction. Such a tooth cannot be saved.
Another common reason for extraction is depulped teeth that aren’t covered by crowns. These teeth, often due to pulpitis, have thin walls and can break under chewing pressure. If there is a vertical fracture 7 millimeters below the gum line, such a tooth should be extracted.
Destruction of the interradicular septum, which can lead to cyst formation, is another reason for extraction. Treating teeth with large cysts is usually not advisable because it is difficult to predict whether the condition will improve or worsen. Therefore, to avoid risk, it’s better to extract such a tooth, especially if it is near an implant, which could also be affected.
Tooth perforation, which occurs as a complication of root canal treatment, might also require extraction. If the perforation happens at the bifurcation area (where the roots begin to divide), tooth extraction is inevitable. If only the root below this area is damaged, the perforation can be sealed, and the tooth might have a chance to be preserved.
Tooth shifting caused by the absence of an antagonist can lead to cyst formation or bone loss. In this case, even prosthetics can be difficult, and the tooth needs to be extracted.
Wisdom teeth, especially those that are impacted or poorly positioned, often require extraction. In cases of regular decay, wisdom teeth are extracted rather than treated.
In our clinic, we do not extract teeth at a patient’s request for the purpose of placing implants or removable dentures as a preventive measure. We do not extract teeth without medical indications!
Ease or Complexity of Tooth Extraction
There are two main types of tooth extractions: simple and complex. Complex extractions are further divided into second and third degrees of difficulty depending on the tooth's position.
Simple extractions involve teeth with 3rd and 4th degrees of mobility, which often occurs with periodontal diseases. Such an operation usually does not require complex manipulations and can be performed even by a less experienced dentist.
Complex teeth, or teeth of the second category of difficulty, may be immobile or “red” (resorcinol), which are difficult to remove due to their strong attachment to the bone and brittleness. This requires careful and meticulous extraction to avoid damaging the bone tissue.
Extraction of wisdom teeth, especially lower ones that often do not erupt or grow abnormally, falls into the third category of difficulty. Such extractions can lead to pain, swelling, and other complications due to the anatomical positioning of wisdom teeth.
Extraction of Milk Teeth
The extraction of milk teeth is performed to remove them from the alveolus. Children’s teeth go through three stages of development: milk, transitional, and permanent. It is better to extract milk teeth when their roots are completely dissolved to avoid shifting of the remaining teeth.
Modern methods and equipment make the extraction of milk teeth practically painless for young patients.
Extraction of Impacted Teeth
Impacted teeth, which require intervention from an orthodontist or surgeon, are usually removed using a complex method. This may require general anesthesia and an incision of the mucosa to access the tooth. If the tooth is large, it is divided into parts before removal.
Time Differences
The time needed for tooth extraction varies depending on the complexity of the case. A simple extraction can take a few seconds, whereas a complex extraction, especially of wisdom teeth or resorcinol teeth, can take between 15 minutes to several hours.
The timeframe depends not only on the tooth's complexity but also on the doctor’s experience. Tooth extraction can take different times with different specialists. It’s important that the procedure is performed well, regardless of the time spent on the extraction.
