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    (Sunday by one day prior appointment)

    DENTAL EXTRACTION

    Dental extraction is the removal of a tooth from the mouth.

    The Most Common Reasons For Extraction Are:

    • Severe tooth decay or infection (acute or chronic alveolar abscess).
    • Extra teeth which are blocking other teeth from coming in.
    • Severe gum disease which may affect the supporting tissues and bone structures of teeth.
    • In preparation for orthodontic treatment (braces)
    • Teeth in the fracture line
    • Teeth which cannot be restored endodontically
    • Fractured teeth
    • Supenumerary, supplementary or malformed teeth
    • Teeth which cannot be restored endodontically
    • Cosmetic teeth of poor appearance, unsuitable for restoration
    • Receiving radiation to the head and neck may require extraction of teeth in the field of radiation.
    • Reduced cost compared to other treatments
    • Extractions are often categorized as "simple" or "surgical".

    Simple & Surgical Extractions

    Simple extractions : are performed on teeth that are visible in the mouth, usually under local anaesthetic, and require only the use of instruments to elevate and/or grasp the visible portion of the tooth. Typically the tooth is lifted using an elevator, and using dental forceps, rocked back and forth until the periodontal ligament has been sufficiently broken and the supporting alveolar bone has been adequately widened to make the tooth loose enough to remove. Typically, when teeth are removed with forceps, slow, steady pressure is applied with controlled force.

    Surgical extractions : involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line or because they have not erupted fully. Surgical extractions almost always require an incision. In a surgical extraction the doctor may elevate the soft tissues covering the tooth and bone and may also remove some of the overlying and/or surrounding jawbone tissue with a drill or osteotome. Frequently, the tooth may be split into multiple pieces to facilitate its removal.

    Wisdom teeth are the last teeth to erupt in the mouth. Technically they are called the 3rd molars, because they erupt behind the 2nd molars in the mouth. We have 4 wisdom teeth, two in the upper arch and two in the lower. The wisdom teeth are the ones least needed for good oral health. They may not erupt or emerge from your gums until your late teens or early twenties - if they erupt at all. Most often they are impacted or trapped in the jaw-bone and gums, usually because there is not enough room for them in your mouth.

    There are 5 possible ways in which wisdom teeth may cause problems :

    Gum disease : Most people are aware of the pain experienced during the eruption of these teeth. This generally happens because these partly erupted teeth are difficult to keep clean, and the accumulated food particles cause the gums around the tooth to get infected. Such an infection is felt as swelling and pain around the area. Sometimes the tooth is trying to erupt, but has not yet broken through the gums. When the upper tooth bites down onto this gum, pain can be caused.

    Impacted : It sometimes happens that there is not enough space in the mouth for these teeth to erupt. In such cases they may try to erupt in an abnormal direction, or may get locked into the jaw. This locking is known as impaction.

    Decay : A wisdom tooth may decay unnoticed, as they are the most difficult teeth to keep clean, being so far back into the mouth.

    Crowding : An impacted or erupting wisdom tooth can push on adjacent teeth, causing them to become crooked or even damaging them structurally.

    Cyst : If the sac that holds the crown of the wisdom tooth remains in the bone, it can fill with fluid, forming a cyst that can destroy surrounding bone.

    The picture above shows an impacted wisdom tooth. The swollen gums are depicted in red, while the decayed portions are shown in black. It also shows the erupting wisdom tooth putting pressure on the adjacent tooth in front, which if allowed to continue for a longer time, could result in crowding. The position of the wisdom tooth also makes it difficult to keep that area clean, leading to decay and gum infection.

    Dr.Arora will do your oral examination and take x-rays. We may also need to know your medical history, as extraction of an impacted tooth usually is a minor surgical procedure. But the surgery is a minor one and the patient is back to work in a day or two. The x-rays show the type of impaction and thus helps the dentist plan your treatment. Due to unavailability of space in the jaws, the impacted wisdom teeth grow in many different directions, commonly at an angle. The complexity of surgery depends on the type of impaction, as shown in the picture.

    TMJ (Temporo mandibular joint) Disorder & Headache :

    TMJ plays an important role in jaw functions such as talking, chewing etc. It can be felt by placing fingers just in front of ears and opening and closing mouth. The most common causes of TMJ disorder are grinding or clenching of teeth, emotional and physical stress and tension, fracture or dislocation of TMJ. TMJ patients experience one or more of the following –limited jaw movement, locked jaw, clicking noise fom TMJ, pain when chewing, pain around ear n cheeks, headache, muscle spasms. The most common treatment methods are use of occlusal splint (night guard), awareness and behaviour modification therapy (jaw exercises), relaxation n stress management, physiotherapy. In conjunction with other nonsurgical treatments, medications that may help relieve the pain associated with TMJ disorders

    Operculectomy :

    It involves removal of the gingival tissue covering an erupting tooth Sometimes, the gingival tissue over the erupting tooth doesn’t get uncovered totally as the tooth remains submerged in the mouth. It becomes a place where food and bacteria accumulate causing inflammation and pain. So, the gingival tissue is removed to allow the tooth to erupt normally.

    Jaw Fracture :

    A broken jaw is a break in the jaw bone. A dislocated jaw means the lower part of the jaw has moved out of its normal position at one or both joints where the jaw bone connects to the skull (temporomandibular joints).

    The most common cause of a broken or dislocated jaw is injury to the face. This may be due to a assault, accident or recreational or sports injury etc. The general procedure for treating a fractured mandible is first to immobilize the jaw and set the break - this is called "reduction." Often, a surgeon can set the bone simply by manually repositioning it . n more complex mandibular fractures, setting the bone might require "open reduction." This means surgically exposing the bone and re-positioning the fractured pieces with the use of small screws and plates that are attached directly to the bone. These plates and screws then act to stabilize the jaw during the healing process, as the bones grow back together.

    Prognosis in most cases, the outlook is very good, especially when the fracture is treated promptly and properly. In rare cases, when the fracture is ignored or healing is poor, long-term complications can include facial deformity, long-lasting facial pain, pain or limitation of movement at the jaw joint and a bad bite.

    Apicectomy :

    It is the removal of the root tip and the surrounding infected tissue of an abscessed tooth. This procedure may be necessary when inflammation and infection persists in the area around the root tip after RCT or RC retreatment.

    Once the tooth is completely numb, the gum is lifted to expose the underlying bone and root tip of the tooth. The root tip and all surrounding infected tissue are removed. A retrograde filling may be placed at the root tip. The gum is repositioned and stitches are placed.

    Complete healing of the bone and the root tip typically occurs in a few months. An apicoectomy is usually a permanent solution, and should last for the life of the tooth.