It may so happen that damaged, unhealthy or obstructive teeth pose a threat to a person’s oral or general health, in which case, tooth extraction is required. There are two types of tooth extractions: simple and surgical. The method of extraction used depends on factors like the severity of the patient’s symptoms, the condition of the tooth, the location beneath the gum line, the shape of the tooth’s roots, and the number of roots the tooth has.
Simple extraction involves the use of a device called an elevator to break the tooth ligament and widen the tooth socket, thereby loosening the tooth. A specialized extraction forceps, resembling pliers, is then used to manually grip and lift the loosened tooth out of its socket without injuring the root structure or surrounding tissue. With simple extraction, no bone is removed and stitching is not necessary. This is the procedure of choice for teeth that are easy to remove. Such teeth are fully erupted. i.e., the visible portion of the tooth (the crown) has fully emerged through the gum bed, making the tooth easy to grasp with a forceps. Typically, simple extraction is done using only a local anaesthesia and is performed by a general dentist.
Surgical extraction is a more complex form of tooth extraction that is usually performed by an oral surgeon. With this type of dental extraction, an incision is made in the gum and a drill is used to remove surrounding tissues and bone. The tooth may also need to be sectioned (split into pieces) to reduce bone loss and facilitate easier removal. Stitches are often necessary. Surgical extraction is performed on teeth that are more difficult to remove, for example: teeth with brittle roots that might fracture; impacted teeth; teeth that have broken off at the gum line; or teeth with unusually large or curved roots. Surgical extraction is almost always done while the patient is under general anaesthesia.
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