Dental extraction

A dental extraction (also referred to as tooth extraction, exodontia, exodontics, or informally, tooth pulling) is the removal of teeth from the dental alveolus (socket) in the alveolar bone. Extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become unrestorable through tooth decay, periodontal disease, or dental trauma, especially when they are associated with toothache. Sometimes impacted wisdom teeth (wisdom teeth that are stuck and unable to grow normally into the mouth) cause recurrent infections of the gum (pericoronitis), and may be removed when other conservative treatments have failed (cleaning, antibiotics and operculectomy). In orthodontics, if the teeth are crowded, healthy teeth may be extracted (often bicuspids) to create space so the rest of the teeth can be straightened. Extractions could be categorized into non-surgical (simple) and surgical, depending on the type of tooth to be removed and other factors. A comprehensive history taking should be performed to find out the pain history of the tooth, the patient's medical history and the history of previous difficult extractions. The tooth should be assessed clinically i.e. checked visually by the dentist. Pre-extraction radiographs are not always necessary but are often taken to confirm the diagnosis and hence appropriate treatment plan. Radiographs also help in visualising the shape and size of roots which are beneficial in planning the extraction. All this information will aid the dentist in foreseeing any difficulties and hence preparing appropriately. In order to obtain permission from patient for extraction of tooth the dentist should explain; other treatment options available, what is involved in the dental extraction procedure, the potential risks of the procedure and the benefits of the procedure. The process of gaining consent should be documented in clinical notes. Before extracting a tooth, the dentist would deliver local anaesthetic to ensure the tooth and surrounding tissues are numb before they start the extraction.