Complex Dental Extractions

Tooth decay is still a problem, even in the developed world and can lead to serious and life-threatening complications.

The microorganisms can spread from just within the tooth to the surrounding bone supporting the tooth and then to soft tissues in the face.

Infected teeth need to be treated

Due to the nature of human tissues, there are potential tracks within the skin and adjoining tissues through which the infection can spread rapidly and reach a critical state. This can be more dangerous in people with other pre-existing diseases which affect their immunity, therefore, it is prudent to have these teeth treated promptly by your dentist. In cases where they cannot be saved, they should be removed promptly.

Simple extractions

Most extractions are done under local anaesthetic and involve a needle. A lot of care is taken to make this least painful. Once your gum and teeth are numbed all you should feel is pushing and pressure. Very rarely in the presence of pus or active infection, the anaesthetic may not work very well.

Your surgeon may decide to peel the gums if the teeth are brittle or broken down, in which case you require stitching. Stitches should dissolve and heal away without any problem.

Be on a soft diet and take painkillers, like simple paracetamol or ibuprofen, which are quite useful. Some people may need codeine which is available as co-codamol over the counter. Maintain your oral hygiene as normal.

Immunocompromised patients

Patients who are unable to mount a normal healing response which is preceded by inflammation to any surgical procedure can be termed immunocompromised. There are a host of conditions which can lead to this situation and can result in delayed or even non-healing areas where surgery is carried out in your mouth and may require treatment in the hospital depending on the severity.

Conditions that can compromise healing

• Smoking.
• Diabetes.
• Radiotherapy for head and neck.
• Steroid treatment for various medical conditions.
• Immunosuppressive therapy for different types of cancer.
• Chemotherapy.
• Blood disorders.
• Treatment of osteoporosis.

Precautions that need to be taken

Meticulous maintenance of oral hygiene with careful consideration of the surgical alternative should be the first step. Your surgeon will discuss the options available and the pros and cons of each of these options. If you should have a tooth removed or a similar surgical procedure undertaken then the risks involved will be explained. Antibiotic cover for such procedures may be useful in preventing complications.

Oroantral communication

Many upper molar teeth are located in close relationships or even within the maxillary sinus cavity. This is a hollow cavity within the upper jaw and has direct communication with your nose. It is directly under the orbit(eye shell). Before removal, the risk of causing communication to the sinus cavity will be discussed by your surgeon. Many times they may heal without causing many symptoms. In some situations, patients may experience fluid running through the nose or even pain in the cheek. The close relationship also makes one prone to dislodgement of root into the sinus cavity.

In the event of such complications, your surgeon may opt to close the defect by another simple procedure. If a root fragment needs to be removed or the defect is large and not amenable to be treated by simple procedure then a treatment under general anaesthetic may be necessary.

For more information regarding this treatment

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