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Thanks to excellent narcotics pulling a tooth today is no longer painful. Its removal usually takes only a few minutes. Patients have to wait much longer for the anesthetic to reach their full effectiveness. Many are also worried about the anesthetic injection. Many a patient develops a veritable phobia.

No matter what the situation is, hardly anyone is pleased about the announcement of his doctor that a tooth is beyond saving. This is because the gap that has been created is usually associated with dental prostheses. It also takes some time for wound healing to complete. So it's worth taking the half-yearly recommended check-up. A regularly conducted examination book also has a favorable effect on the costs of dentures.

Overview of this article

When do teeth have to be pulled?

Various reasons make a tooth extraction necessary. Typical indications include severe loosening of the teeth due to periodontitis, dental fractures, teeth with advanced infections (eg abscesses) and wisdom teeth with difficult tooth breakage.

Teeth are also pulled in the context of orthodontic treatment or to compensate for a strong asymmetry. Often the removal of strongly carious teeth is necessary, if neither crowns or bridges would hold on it. Under an older crown or filling, tooth decay develops more frequently. If it is noticed too late and there is too little substance for a new filling, tooth loss is also imminent.

In adolescents, all wisdom teeth are often pulled because the jaw is too narrow to provide enough room for the molars. The resulting gaps are not filled, because the large number of molars in the human dentition is a remnant of the Stone Age. As a result of changing eating habits, we no longer need them all today.

How does a tooth extraction work?

If tooth-preserving measures can no longer achieve anything, the tooth must be extracted. For this, the tooth is first anesthetized locally, which triggers more anxiety in many patients than the pulling itself. Actually, it is only one or two small punctures for injecting the anesthetic fluid. After a 15-minute exposure, the anesthesia has reached its optimum level so that the tooth can be pulled.

For this purpose, the dentist first dissolves the periodontal tissue and some gums from the tooth. Then the affected tooth is loosened with a pair of pliers and then completely removed. Depending on how firmly he sits in the jaw, the doctor must spend relatively much strength. The resulting noise the patient perceives very clearly. Although they are not painful, they are sometimes perceived as unpleasant.

The resulting gap is filled with a tampon containing a hemostatic drug. Sewing is required only for a very large wound. The patient should not eat for two hours after treatment. For faster wound healing, it is desirable that he put pressure on the pad. Working people get a sick leave for one or more days after a tooth extraction.

Special situations in tooth extraction

A large molar is associated with a relatively large amount of bone and gum, which may require a gum section that is later sutured. Usually, however, the wound closes itself and soon fills with new tissue. After a dental accident, the doctor can fill the gap created after drawing with an artificial tooth root (titanium implant). This is later supplemented by a dental crown. If the patient is planning dentures restoration, the gap is only restored after completion of the healing with a temporary and then with a crown or bridge. Several months may pass before the first impression is made.

Normally, extractions require local anesthesia. Even in children, general anesthesia is not administered, even if all molars are pulled at once. General anesthesia would require the presence of an anesthetist. It is only indicated in patients with extreme dental fear and is then taken over by the health insurance. Nevertheless, it is also only a slight drowsiness sleep anesthesia. If parts of the tooth root are left in the jaw during extraction, they are removed by a second procedure with local anesthesia.

Avoid complications after tooth extraction

If a molar is to be pulled, it usually causes problems and pain. Many patients therefore feel relief when the "culprit" is eliminated. If no nerves were injured, the healing is unproblematic, because the saliva accelerates them. Since every person reacts differently to pain, the consequences of tooth extraction are also perceived very individually. Against the wound pain the doctor prescribes a common painkiller. If inflammation has already occurred in the jaw, an antibiotic is indicated.

Until the anesthesia dies down, the patient must not drive. After extraction, there is always swelling and sometimes bruising, which can extend over the entire face. The best prevention of major swelling is cooling. Patients already get a cooling pad in the practice to cool their face as early as possible. On the day of the tooth removal, they should not drink alcohol or smoke. The longer they give up the stimulants, the faster the healing process, because tobacco smoke and alcohol affect the process negatively.

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