ORAL SURGERY

What are extractions?

Removing teeth is more correctly termed ‘Exodontia’

A tooth can be compromised and cause pain because of…

  • Decay (a breakdown of the tooth surface and tissues by acids produced by bacteria)
  • Trauma or fracture of the tooth
  • Wear or tooth surface loss (from grinding, erosion, abrasion etc)
  • Significant gum disease
  • Heavily filled or crowned tooth (which can devitalize / die as a process of attempting to save it)

Extractions may be conducted when one of the above problems leads to…

  • Intolerable sensitivity when eating, drinking or when air is drawn over the tooth
  • A fracture or crack that has compromised the structural integrity of the tooth
  • Significant discomfort, which occurs as the pulp becomes inflamed, heralding the probable progression to death of the pulp
  • Pulp necrosis (death of the pulp tissues) leading to the formation of an abscess

The aim of an extraction is to relieve discomfort, prevent the risk of, or remove a source of infection. Occasionally teeth may need to be extracted for one of many other reasons e.g. creating space for orthodontic treatment, fracture of the jaw involving those teeth, irreversible resorption of the root of a tooth or ahead of some cases of planned chemo- or radiotherapy.

The relief of discomfort that this procedure provides (and advances in treatment techniques and equipment) now mean that patients feel comfortable choosing this treatment option.

What is the procedure for having a tooth extracted?

The treatment usually involves 1 visit to the dentist following diagnosis (and radiograph)

Single visit (around 30 to 40 minutes in length)

  • You will be asked to rinse your mouth for 2 minutes using a solution that will reduce the bacterial load in your mouth
  • Your dentist will make you comfortable by anaesthetising the tooth to be prepared
  • The area will be gently checked to ensure it is entirely numb before proceeding
  • Extracting the tooth will involve the application of careful pressure, which is all you should feel (you will also be aware of some unusual sounds)
  • After the tooth is removed you will need apply pressure to the site to stop any bleeding and this is done by biting down onto a cotton pack for a few minutes
  • You will be issued with some aftercare instructions (an example of these instructions can be found in the ‘information’ section or by clicking here)

How much should I pay for a simple extraction?

This is very dependent on the skill and qualifications of the dental surgeon and the procedure to be conducted. In the private arena the cost of a ‘simple’ extraction by an experienced clinician should range from £100 to £150. The charges for surgical or more complex extractions may be in excess of this and you may need to be referred by your dentist to another dental surgeon or specialist for this type of treatment.

Remember to clarify costs and obtain an estimate. Once you have carefully discussed your needs and been advised of the options available to you, all good dentists should issue you with a written quote for treatments, usually printed at the reception desk.

Some dental surgeries will offer 0% finance packages or accept payment through insurance plans.

As with everything in life, it is possible to seek out individuals who are willing to use cost-cutting techniques to offer ‘budget’ options (for those in whom short-term expenditure is the predominant factor influencing choice). You should always feel comfortable with your dentist and trust them implicitly, so choose your clinician carefully. Speak to family and friends to find out who they would recommend. You can check a dentist’s or doctor’s credentials using the respective governing council websites (General Dental Council and General Medical Council).

What is a Surgical Extraction?

Most teeth can be extracted, intact, using the simple principles of moments and levers. This technique is appropriate where the shape of the root of the tooth (i.e. its morphology), the remaining tooth above the gum line and the surrounding tissues and anatomical structures are favourable.

In some situations, it may not be possible to remove the tooth in this ‘simple’ manner and a more technical approach is required.

As with any extraction, a surgical extraction should not cause any discomfort, but the procedure may take longer. The post-operative healing will differ very little from a ‘simple’ extraction, although you will need to return to your dental surgeon a few days later to ensure everything is healing well and to remove any sutures that may have been placed. Almost all patients feel fit enough to return to work the next day, although it is often advised that extreme physical exertion is avoided for 24 to 48 hours post-operatively.

Examples of the types of situation that may require a ‘surgical’ rather than a ‘simple’ extraction include…

  • ‘Impacted’ wisdom teeth
  • Teeth with large and/or oddly-shaped roots
  • Extraction of a tooth where placement of an implant is planned
  • A heavily decayed and/or badly broken-down tooth
  • Very dense bone
  • Proximity to very important and delicate anatomical structures
  • Other pathology exists (e.g. cyst)
  • Difficult access with ‘conventional’ techniques