If a tooth is badly broken or decayed, it may need to be removed. This process is called extraction. The presence of an abscess may also require removal. In cosmetic dentistry, a tooth may be removed to relieve overcrowding. Extraction is a dental specialty that is generally performed by an oral surgeon. A tooth is positioned in its socket and held by ligaments. When an extraction is performed, the surgeon grasps the crown of the tooth with a pair of dental forceps, then cuts the ligaments, opens the socket, and pulls out the tooth. Once this happens there will be bleeding at the site. The patient is given gauze pads and instructed to bite down. This will stop the bleeding.
Once the anesthetic has worn off the patient will feel pain. The surgeon will prescribe a painkiller. Usually this is acetaminophen. The patient is always instructed to avoid aspirin and ibuprofen as these two painkillers may prevent the blood from clotting. Patients are also advised to avoid rinsing the mouth or drinking through a straw for at least twenty four hours as these practices can dislodge the clot. But then they are instructed to rinse the mouth with warm salt water to encourage prompt healing that requires from seven to ten days.
Once the extraction site has healed, it is time for an implant or a bridge. A bridge is a false tooth with a metal frame that attaches to the neighboring teeth. A bridge can contain one or more artificial teeth. In order for a bridge to be fitted the neighboring teeth must be strong and healthy. The artificial tooth or teeth in the bridge can be constructed with porcelain covers to match the color of your natural teeth. Once a bridge is installed, meticulous dental hygiene is required to prevent gum disease. It is particularly important to clean the area between the bridge and the gum. This is done by flossing but the floss is run through a special device called a floss threader that drags the floss under the bridge.
A dental implant is also an artificial tooth. But instead of using a metal frame to anchor it to the adjoining teeth the implant is anchored to the jawbone. To prepare an implant, the dentist makes an impression of the tooth that is to be replaced. The tooth is then extracted. The dentist makes an incision in the gum to reach the bone and then drills a hole in the bone. After this a metal screw known as an implant fixture is placed into the hole. The gum is folded back over the implant fixture and left for four to six months to settle into the bone. During this time the bone tissue will grow around the implant fixture to provide a secure base for the artificial tooth. In the interim the area is filled with a temporary denture.
Once the implant fixture has integrated with the bone, an incision is again made in the gum and a metal cylinder known as an abutment is attached to the implant fixture. The gum is then left to heal which usually requires about one month. Then the dentist makes an impression of the abutment. Using the two impressions an artificial crown will be constructed and cemented onto the abutment. In order to have a dental implant, the patient must have sufficient bone structure to support the screw.
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