A molar tooth was removed, what should I do? Molar tooth removal technique

Many people are afraid to have teeth removed due to fear of pain. In fact modern medicine allows this procedure to be carried out in sufficient time comfortable conditions, and sometimes even completely painless. Let's take a closer look at this issue and decide once and for all whether it hurts to pull out a tooth.

Today, dentists give preference to tooth-preserving technologies. However, situations arise when deletion cannot be avoided. Experts highlight following reasons forcing the doctor:

process of destruction in which there is no help conservative methods treatment;
lack of effectiveness medicinal methods in the treatment of periodontitis of multi-rooted molars;
3-4 degree of mobility of diseased teeth;
extra teeth (this happens);
displacement of the dentition;
orthodontic treatment (for example, installation of braces);
preparing the patient's jaw for the prosthetic procedure.

Severe destruction - serious reason to delete

Why does pain occur?

The intensity of pain is influenced by the following factors:

Psychological mood. It's important to remember that local anesthesia makes the removal procedure completely painless (relevant for both molars and breasts). Before visiting the dentist, you need to calm down and set yourself in a positive mood.
Localization. Removing front teeth is much less painful than removing back teeth. This situation is due to the fact that the former are less firmly fixed in the jaw and are smaller in size. The most painful thing is to remove a wisdom tooth.
The number of tooth roots - the more there are, the more painful the procedure.
Pain threshold. As you know, each person has his own limit of perception painful sensations. Some patients may not feel anything at all during the removal process, and some feel discomfort even after anesthesia. But it will be just discomfort, not pain.

The number of roots affects the intensity of pain

Removal is stressful situation for the body, however, like any other surgery. Even those with a high pain threshold will not be able to withstand the operation unless the removal is preceded by the administration of a general or local anesthetic.

Oksana Shiyka
Dentist-therapist
Currently, the removal process, although unpleasant, allows you to avoid having to endure pain. The type and dose of anesthesia is selected for each visitor dental clinic individually.
Anesthesia methods
Even in the last century, dentists practiced... But today dentistry has stepped far forward and can offer a wide variety of methods and dosages of anesthesia, adapting to individual characteristics patient.
Doctors of modern dental clinics resort to in the following ways pain relief:
topical anesthesia, in which the mucous membrane of the area where the affected tooth is located is treated with a local anesthetic solution;
infiltration anesthesia, which means injection under the mucosa;
conduction anesthesia, in which an anesthetic substance is injected directly into the nerve;
general anesthesia, which is recommended if other methods of pain relief are ineffective or if the patient is allergic to local anesthetics.

Application anesthesia Injection anesthesia General anesthesia
Oksana Shiyka
Dentist-therapist
Different methods have different effectiveness. However, in any case, no doctor will perform tooth extraction without anesthesia.
The video shows the process of administering local anesthesia:
How does deletion work?
Surgical removal takes place in several stages:
To begin with, the affected tooth and nearby tissues treated with an antiseptic for disinfection purposes.
Anesthesia is performed.
The dentist places forceps on the root to loosen the affected tooth. The socket expands, causing it to separate from the strong ligament.
Now the tooth can be easily removed. Then the edges of the resulting hole are compressed using cotton balls, and the wound quickly fills with blood clots.

Oksana Shiyka
Dentist-therapist
The operation goes very quickly. However, in some cases it becomes necessary to cut the tooth into several fragments and remove it piece by piece. This is usually caused by the complex structure of the root system or the unusual shape of the bone element.
The video simulates the removal process:
During the first 2 hours, you must refrain from eating food, and for the first 2 days, from drinking alcohol. You should also rinse your mouth a day after surgery. This must be done before meals and before bed. If you follow all the recommendations of your doctor, then after two weeks the wound will heal and you can forget about its existence forever.
Oksana Shiyka
Dentist-therapist
It should be noted that the operation is quick, but sometimes it becomes necessary to cut the tooth into several fragments and remove it piece by piece. This is caused by the complex structure of the root system or the unusual shape of the bone element.
Some features
To answer the question of whether it is painful to remove a molar tooth, it is worth highlighting the features of the operation:
Removal is resorted to in case of complete destruction of the crown by a carious process, in case of a root fracture, or the development of purulent inflammatory processes in the acute form etc. The attending physician makes every possible effort to maintain dead tooth. However, if there is a strong inflammatory process or the root part is damaged, then it is advisable to pull it out.
Is it painful to have a molar pulled out? As for painful sensations, they are practically absent thanks to anesthesia. Pain syndrome begins to appear a few hours after the operation, but if the doctor did everything correctly, then it will not bother you much.
As you know, wisdom teeth do not bring practical benefit and are among the rudimentary. If they are not positioned correctly (as happens in most cases), when they erupt, a person experiences severe pain, increased body temperature, inability to chew food consumed normally and talk. Therefore they are often removed. As for painful sensations, there are much fewer of them if a wisdom tooth is pulled out lower jaw.
Is it painful to remove a tooth root? As is known, those affected by infectious processes force the dentist to remove the roots of the teeth. The procedure can be further complicated by the fact that its upper part is almost completely destroyed, which makes it impossible to tear them out with forceps. The dentist will have to make an incision in the gum and drill out some of the bone tissue. While the operation is underway, you will not feel anything thanks to the anesthesia, but when it wears off, prepare for unpleasant sensations.

Removal during pregnancy
Every woman knows that during the period of bearing a child, any surgical intervention on the body is contraindicated. Whenever aching pain it is recommended to treat them by rinsing, ointments, etc. You can resort to removal only in an extreme situation, for example, when a cyst has formed. It is important to remember that you should not pull teeth in the first and third trimesters of pregnancy. Be sure to inform your dentist about your situation so that he can select the most appropriate anesthetic.
In the video, dentist Dmitry Solovyov explains whether it is possible to remove teeth during pregnancy:
Today, tooth extraction is prescribed only when it is absolutely not amenable to any treatment. The anesthetics used will make the process quite tolerable. If stitches were applied after surgery, you must visit your doctor 5-8 days after the procedure to remove them. In this case, you should follow all the recommendations of a specialist in oral care during the postoperative period.

In what cases may it be necessary to remove the root of a tooth, or part of it (for example, resection of the apex);
Why “rotten” tooth roots should be removed as soon as possible and what can await you if this is not done on time;
In what cases can tooth roots be preserved (for subsequent prosthetics) and by what methods is such preservation implemented?
Typical clinical situations when a tooth root needs to be removed (and what is useful to know if, for example, a significant piece breaks off from a tooth while eating);
Methods for removing tooth roots, ranging from simple to complex and traumatic (using a dental chisel and hammer);
What to do if, after tooth extraction, a root or small fragments remain in the socket...

Sometimes the crown part of the tooth is so badly destroyed that only the root of the tooth, eaten away by caries, remains - in such cases, the question usually arises of removing these “rotten” remains. There are often annoying injuries: for example, while eating, a piece of a tooth may break off, and the chip (or crack) sometimes goes deep under the gum - in this case, the removal of the tooth root may also be necessary.

It’s a different story when the tooth is outwardly more or less functional, but the condition of its root (or roots) is far from normal - there are cysts and granulomas. Then the dental surgeon may suggest resection of the root apex or even amputation of the entire tooth root. We will also talk about this a little further below...

Fortunately, in some cases it is not necessary to remove the root of a tooth, and you can limit yourself to its treatment followed by prosthetics or restoration of the crown of the tooth. However, it should be understood that tooth remnants ("thoroughly rotten" roots) that are severely destroyed by the carious process should be parted with as quickly as possible and without regret, since their preservation does more harm to health than good.

Let’s start with this – let’s see why, in fact, it is necessary to remove damaged tooth roots as soon as possible...

Why should rotten, destroyed remains of tooth roots be removed?

From the point of view of a dentist, the situation is when a patient walks for years with a completely destroyed rotten tooth, looks like this: to this person don't feel sorry for yourself. The fact is that in such cases the roots of the teeth need to be removed urgently(see example in the photo below).

The reason is simple: rotten roots are a breeding ground for infection, and the more of them there are in the mouth, the more pronounced the problems are, and they are far from being limited to constant unpleasant smell from the mouth. These porous “rotten things”, like a vacuum cleaner, absorb bacteria and food particles. In addition to rotting food, the remains of the tooth also contain plaque that is difficult to remove and almost always supra- and subgingival tartar, which is why the gums begin to suffer.

In almost 100% of such cases at the top rotten roots an inflammatory process is observed, accompanied by loss of bone tissue, and a granuloma or cyst is formed. Simply put, there is a purulent sac hanging at the top of the root, which is just waiting in the wings to break through to form a “flux.”

The photo below shows an example of extracted teeth with cysts on the roots:

Against the background of the vital activity of microorganisms, the human immune system is forced to constantly expend its resources to fight the infection in order to somehow compensate for this problem (frequent illnesses may occur).

If such a tooth root is not removed, sooner or later a moment comes when the body’s forces can no longer prevent the spread of infection - an acute inflammatory process will occur, often accompanied by significant swelling. The favorite phrase of such patients: “The root was rotting for so many years, it didn’t hurt, and then suddenly the cheek suddenly swollen, and as always, at the wrong time.”

Note

And how, one might ask, should a dentist painlessly remove a tooth root for such a patient with gumboil, for whom the slightest touch to the gum causes severe pain? After all, anesthesia is almost always done in the projection of the tooth roots onto the gum, and at that moment a significant amount of pus accumulates there. The surgeon has a choice here: somehow try to inject the anesthetic as painlessly as possible, cut the gum, releasing the pus, and send the patient home, and after a few days, when he feels better, calmly remove the destroyed tooth root.

Or you can remove it here and now, but in this case there is a very high risk that removing the root will be painful.

As you can see, there is no point in delaying the removal of rotten tooth roots - they must be removed, and the sooner the better.

In what cases can tooth roots be preserved, and by what methods is this implemented?

Suppose that in your oral cavity you have a tooth (or even several), which can hardly be called a full-fledged tooth due to destruction, but it also hardly falls under the category popularly called “root”.

For example, for a long time were on dead teeth large fillings, which for some reason fell out, and all that remained of the tooth were “horns and legs”: one or two walls or remnants of the walls of the tooth. Or, for example, while eating, a significant piece broke off from a molar, leaving only a “stump” with sharp edges.

Is it necessary to remove the roots of the tooth in such cases, or is it still possible to come up with something to preserve them with subsequent prosthetics of the crown part?

So, today there are many so-called tooth-preserving techniques - the main ones are divided into conservative and conservative-surgical.

Conservative methods of tooth preservation do not include surgical interventions, and preservation of the root (tooth stump) is carried out by preparing the canals (if necessary) and restoring the coronal part suitable method, for example, using restoration with a light-curing material using a pin, or an inlay and a crown.

A conservative-surgical method may be required when there is an inflammatory process at the apex of the tooth root: after filling the tooth canals (most often with dental cement), resection of the root apex is performed on the same day or delayed. This operation is usually performed under local anesthesia and can be performed on both single-rooted and multi-rooted teeth. The operation is generally simple and usually takes 15-30 minutes.

However, sometimes with an inflammatory process at the apex of the root or even the roots, it is possible to do without surgical procedures - if it is possible to carry out treatment by introducing an anti-inflammatory drug into the canal(s), then the dentist puts the drugs on certain period(from 2-3 months to 1-2 years) while waiting for bone restoration around the root apex. If there is significant bone loss, the doctor will high probability will still choose a conservative surgical method - either as the only way to save the tooth, or in order to reduce the treatment time (not a year, for example, but 1-2 months).

Note

Resection of the apex of the tooth root is carried out in several stages. At the first stage, preliminary preparation takes place (history collection, especially for allergies, treatment of the surgical field) and anesthesia (most often with articaine drugs).

The second stage involves the beginning of the operation itself: creating access to the apex of the root through an incision in the gum, peeling off the soft tissue, sawing out a special small “window” in the bone and identifying the problem root.

At the third stage, a part of the root with a cyst or granuloma is cut off with a drill, after which drugs are put into the wound to stimulate the growth of bone tissue and accelerate healing. The wound is sutured. Prescription of drugs for home treatment(including painkillers) allows you to minimize possible painful sensations and allows the patient to return to their normal life in a matter of days.

Much less popular techniques to prevent the removal of the entire tooth are hemisection and root amputation.

During hemisection, the affected root is removed with part of the rotten crown of the tooth, and healthy roots with the remaining intact crown part are left for prosthetics.

Amputation of the tooth root, unlike hemisection, does not involve excision of the coronal part: only the root (the entire one) with the cyst or granuloma present on it is removed.

This is interesting

Exclusive options for preserving a severely damaged tooth are coronoradicular separation and tooth replantation (for example, if the tooth was knocked out due to mechanical impact).

Coronoradicular separation is carried out in relation to large molars, when in the area of bifurcation or trifurcation of the roots (where the roots branch) there is a focus of inflammation that cannot be treated. The tooth is cut into two parts, and the affected tissue between the roots is removed. Subsequently, each tooth segment is covered with soldered crowns to restore the lost function of the dentition.

Tooth replantation - simply put, is the return to the socket of a tooth that, for one reason or another, was previously removed from it (on purpose, or, for example, was accidentally knocked out by an impact). It sounds incredible, but it's true. Today, such operations are rarely performed, usually in cases where the tooth is brought to the dentist having just been knocked out.

In Soviet times, when they were not available modern methods preservation of complex destroyed roots, similar methods were more or less popular for various options unsuccessful conservative treatment. For example, a dental surgeon could first carefully remove a tooth, and a dental therapist would carry out intracanal treatment with filling and (sometimes) resection of the root apex (amputation, hemisection). The prepared tooth (or part of it) was fixed back into the socket in its original place using splinting, excluding it from the bite for several weeks.

Due to the technical complexity and not always justification, today the method of dental replantation is used only in exceptional situations.

In what cases will the root have to be removed?

If none of the tooth-preserving techniques can be applied, then the roots of the tooth must be removed.

Below are the most common situations in dental practice that involve the removal of tooth roots:

At complex fractures tooth (for example, with a longitudinal one - see the example in the photo below);
Against the background of serious inflammatory processes near the root (large cyst, periostitis, osteomyelitis, abscess, phlegmon);
Destruction of the crown part of the tooth is significantly below the gum level;
Root mobility grade III;
Atypical position of a destroyed tooth (various dental anomalies).

And some others.

However, as noted above, not every tooth fracture requires removal of the remaining roots. A splinter can break off both from a living tooth and from a dead one, that is, previously depulped, and dead ones are more vulnerable in this regard, since they become fragile over time. So, if the root is not badly damaged and has a solid base, then the tooth is restored using the usual methods: the canal is treated (if the tooth was alive) and the coronal part is restored using restoration or prosthetics.

There are nuances regarding the roots of wisdom teeth: many patients are in a hurry to get rid of such teeth as soon as possible - the reasons may be different:

Sometimes the hygiene of wisdom teeth is difficult and they are rapidly destroyed due to caries;
Erupted wisdom teeth can cause displacement of the remaining teeth in the dentition, which often leads to malocclusion;
Sometimes figure eights lead to regular cheek biting, that is, to chronic injury to the mucous membrane, and this is dangerous with the risk of malignant formations.

And so on. However, before you rush to remove figure eights, it is worth taking into account the fact that there are cases when even a seemingly severely damaged wisdom tooth is important for removable or fixed prosthetics. Not all people can afford dental implants to “throw away” even such teeth.

Therefore, in certain situations, a dentist can preserve the roots of a wisdom tooth by carrying out full endodontic treatment and restoration of the tooth (for example, with an inlay), followed by using it as one of the supports, for example, a bridge.

From the practice of a dentist

In fact, most dentists rather tentatively adhere to the list of indications for removing a tooth or its roots. The fact is that over the years of work, a practicing doctor has formed his own opinion about the possibility of saving a tooth in a given clinical situation (often this is the result of numerous trials and errors).

So, for example, an inexperienced orthopedic dentist may insist on preparing the roots of a certain tooth for a future bridge prosthesis, to which a competent and experienced dentist-therapist, suppose, refuses, justifying this by the mobility of the root (or roots), destruction of the interradicular septum, or obstruction canals due to the resorcinol-formalin treatment method carried out many years ago, or a significant inflammatory focus at the root apex. Even one of the reasons listed is quite enough to abandon such an undertaking.

In addition, there is such a thing as the “functional value of a tooth”: even if the root of a tooth can technically be restored in an accessible way, this does not mean that without a detailed analysis of the entire clinical situation it is worth taking on it immediately. Will the tooth be able to function in the future? normal mode? If not, then there is little point in saving it. For example, this applies to the roots of teeth that are outside the dentition, or wisdom teeth that do not have antagonists (that is, they are therefore unable to perform a chewing function).

Methods for removing tooth roots: from simple to complex

For some patients of the old Soviet school, the doctor’s message about the need to remove the root of a tooth almost causes panic. Typically, this reaction is associated with a number of the following fears:

“My lower left molar has fallen apart, they said I need to pull out the roots. Believe me, this is terribly painful, I recently went through this myself. And they also told me that I wouldn’t feel almost anything, they consoled me so that I wouldn’t be too afraid. This is terrible, I burst into tears right in the chair, they even gave me a sedative. My jaw was cut and gouged a whole hour, the doctor was already sweating all over. The pain is wild, despite three injections..."

Oksana, St. Petersburg

Fear of dental office often leads to the fact that a person can walk for years with rotten remains of a tooth in his mouth: he looks in the mirror - the root has not yet completely rotted and does not hurt, which means he can still be patient. All this time, the remains of the tooth will be subject to increasing carious destruction, which in the future may further complicate the process of root removal.

Meanwhile, if you don’t wait until the last minute, it will be quite easy for a dental surgeon to remove the roots of a tooth using forceps with cheeks specially adapted for this. Even if the roots are partially covered by the gum, no incisions are made. Moreover, the roots that have disappeared from sight have an access line, that is, the gums cannot completely close the “rotten spots” even over the years, so the dental surgeon can only open them a little with a trowel and remove them with forceps. This usually takes about 3-10 minutes.

The photographs below show the removal of a tooth, the crown part of which has been destroyed almost to the level of the gum:

From the practice of a dentist

In patients in mature age(from 40 years and above) removal of rotten tooth roots in the vast majority of cases does not present any particular difficulties, since against the background of alveolar atrophy, decreased height of the septa and the inflammatory process near the roots, the body seems to “reject” these roots itself, so their mobility is often present in a varying degree. Practicing doctors know well that the older the patient, the better, since removal along with anesthesia almost always takes a matter of minutes - to the delight of the patient and the doctor.

Now a few words about chiseling tooth roots using a chisel and hammer. There are difficult cases when there is a tandem of 2-3 or more roots, that is, there is a full-fledged partition between them, and the patient’s age is relatively young, the bone tissue around the roots is full. In other words, there is clearly no gift for the dental surgeon.

In such cases, forceps rarely help in solving the problem, and professional dentist takes up... No, not a chisel and a hammer. Currently, the professional dentist prefers modern approaches to remove such roots: sawing out using a drill and removing the roots separately using an elevator and (or) forceps. This is especially true for sixth teeth and wisdom teeth.

Photo of a tooth whose roots were separated by a drill before removal:

Then in what cases do they still resort to a hammer and chisel?

Extremely rare, in dense villages middle zone Russia (figuratively speaking) uses this technique - moreover, it is used as the main one, since the dental surgeon either does not know about removing roots using a drill and chisels even teeth with an almost complete crown, or he does not have a drill available (from the poor equipping the offices is all happening).

Regarding pain during the procedure: when removing the roots of a tooth, absolutely the same anesthesia is used in terms of quality and technique as when extracting teeth with a crown part. If a dentist uses an outdated anesthetic in his work and, moreover, does not have a professional command of anesthesia techniques, the result will be disastrous, especially for the patient.

Note

A fairly actively discussed topic among people is whether it is possible to remove a decayed tooth yourself using pliers? There are even terrifying (from a professional point of view) examples of removal with this tool. Firstly, in many cases, a diseased tooth, even if it has deep carious destruction, should not be removed, but can be successfully treated by a dentist. Secondly, removal requires anesthesia, and without it the pain will be very severe. Thirdly, with such tooth extraction at home, there is a high risk of introducing an infection into the wound with the subsequent development of complications. And this is not to mention the fact that many daredevils can simply crush or break off part of a tooth with pliers, leaving roots and fragments in the hole.

About situations when, after a tooth is removed, its remains remain in the socket

Patients' fears often concern not only the fear of removing tooth roots, but also the prospect of possible tooth remains left in the socket due to the doctor's carelessness (for example, a broken off root with a cyst or fragments). Indeed, in practice, not very experienced specialists sometimes encounter similar precedents. Interestingly, a number of these dentists are firmly convinced that everything will be fine, and tell their patients: “Don’t worry, over time the root will come out on its own.”

What happens if the tooth root was not completely removed by the doctor?

During a complex tooth root removal, the dentist often finds himself in a situation where the apex of the root (tip) breaks off, and increased bleeding from the socket obscures the view for further action (in other words, the socket is completely filled with blood and it is difficult to see anything in it). The professional can either work blindly, relying on his experience, or postpone the appointment, competently explaining to the person what to do and when to visit him again to complete the work.

But if the doctor does not have much experience in tooth extraction, or fundamentally prefers the tactics of “non-intervention” (sometimes in order not to waste his time), then he advises the patient to simply wait until the root “comes out on its own.” They say, don’t worry, the problem will resolve itself.

Dentist's opinion

The practice of leaving a broken tooth root in the hope that everything will be fine is vicious. Indeed, in many cases a root or fragment left behind can long time do not disturb, but over the years the wound simply does not heal completely - something like a canal or fistulous tract remains, and the root gradually moves to the surface of the gum. This can take a very long time (up to several years), and there is nothing good for the owner of such an incompletely removed tooth: infectious process at the top of the root continues its negative impact on the body.

The worst thing happens in cases where the root apex remains with a granuloma or cyst. Problems arise either immediately in the form purulent inflammation on the gums (“flux”), or delayed, but they will almost certainly occur (can happen even after 10 years). The most unpleasant situation is when the left root is pulled in by the gum and new bone is formed around it, that is, the remainder of the tooth lies in a kind of capsule that separates it from healthy tissue. How long it will take before all this makes itself felt is not important, but the later you go to the dentist, the more likely it is that if an exacerbation develops purulent process(periostitis, osteomyelitis, abscess, phlegmon) assistance will be provided in the hospital on the operating table.

Thus, if the tooth was not completely removed (after the tooth was removed, a fragment of the root remained in the socket), then it is advisable to take measures to complete the work begun by the doctor, and this should be done in the near future. This will allow you not to leave an inflammatory focus on for many years, despite the assurances of the attending physician to wait until everything goes away on its own. In such cases, it can be useful to contact another dentist without leaving a time bomb in your jaw.

After tooth extraction, it may turn out that its roots will be completely removed, but at the gum level you will find some small fragments at home. Moreover, the dentist can state from the image that there are no roots in the socket, but will not pay due attention to the gingival margin. The point here is that a tooth destroyed by caries often crumbles during removal, and single fragments connected to the gum are not removed by a dental surgeon for a number of reasons:

Poor vision due to bleeding of injured tissues;
Doctor's carelessness;
Negligence.

If this debris remains in the hole (even small pieces carious tooth), then the risk of developing alveolitis increases to a certain extent - infectious inflammation accompanied by pain, swelling, increased body temperature, general malaise and others unpleasant symptoms. That is why a competent dentist not only removes all the roots of the tooth, but also examines the wound for the presence of small tooth fragments, pieces of bone (if the removal was difficult), and filling material.

A clean wound, as a rule, heals much faster and more comfortably than a contaminated one, which is why it is so important to promptly consult a dentist and clean the hole if anything foreign is noticed in it.

Is it possible to remove a tooth root yourself?

Today on the Internet you can often see video reviews about how people remove their own teeth at home. Moreover, there are not only video reviews where adults and, to put it mildly, tipsy men independently pull out their dilapidated teeth, but there are also examples self-removal baby teeth in children.

Let's see if it's worth experimenting with this?

Not only does it not look very attractive from an aesthetic point of view (people are writhing in pain, blood literally runs down their fingers), but the main concern is, first of all, the lack of sterile conditions during the procedure. There is no need to talk about the professional component at all: if the removal of a more or less whole tooth is still possible after the tenth time (provided that the crown part does not crumble into fragments), then teeth destroyed to the root are practically impossible to remove on their own.

Therefore, “pulling out” teeth at home (including loose milk teeth) is not worth even trying.

Interesting video: removal of the roots of two teeth followed by suturing the wound

An accessible description of the instruments used in tooth extraction

A visit to the dental clinic is a big deal for many people, especially if we're talking about about the removal of tooth roots.

Modern medicine allows this procedure to be performed without pain, discomfort and complications.

In what situations is surgery necessary?

There are often cases when teeth break, fall out, and the root remains inside the gum - this is the main indication for its removal. Leaving the root if the tooth is destroyed is dangerous, as over time inflammation may begin and pus may appear.

The presence of a root can be determined by the following symptoms:

with “twitching” at the site of a fallen or extracted tooth;
characteristic sharp (pressure while eating);
swelling of the soft tissues of the gums;
redness, inflammation;
suppuration and

It is necessary to remove the root as soon as one of the listed symptoms manifests itself. You should not put off visiting the dentist, as this may lead to serious consequences, up to blood poisoning.

The spine is small, but removed

Tooth root removal is a surgical procedure that should only be performed by a specialist. The complexity of the operation is due to several factors:

tooth size;
the condition of the tissues around it;
gum defects (if any);
placement inside the gums.

It is also important to take into account contraindications, since they influence the choice of removal technique.

The main contraindications are:

acute respiratory infections and acute respiratory viral infections;
mental disorders in the acute phase;
CNS diseases;
recovery period after hypertension or heart attack.

In some cases, according to a doctor's indication, root removal is performed in a hospital setting.

In most cases, the dentist will suggest, despite the fact that the process of removing a completely destroyed tooth, in which only the root remains, will cause virtually no negative sensations - this is also a feature of the operation.

Difficulties during the operation may arise if the root is removed after the crown has broken or the root is deep in the hole.

Pulling out twisted and thickened roots is also called difficult. In other cases, the dentist’s work in this area is considered easy.

Preparing for surgery

Preparation for the operation is carried out according to general scheme: examination of the oral cavity and the immediate area in need of special attention dentist

At this stage, a choice is made - it must take into account age characteristics, presence/absence of diseases, body characteristics, for example, allergies to medications.

Also at this time, the doctor who will carry out the intervention selects the necessary instrument.

Immediately before surgery, the dentist examines the gum tissue to determine whether there is any suppuration.

The information obtained during the examination allows us to draw up detailed plan future work. The operation is performed by a doctor wearing gloves and a mask.

After this comes the turn hygienic treatment oral cavity to prevent bacteria from entering the wound.

Sometimes, before proceeding with root removal, the doctor must first remove plaque or plaque located near the operation site.

Then the patient should rinse his mouth or Eludril, this way you can achieve maximum sterility - up to 90% pathogenic microorganisms and bacteria die, which significantly reduces the possibility of infection of the wound.

If complex removal is required, then an additional stage of hygienic treatment is the treatment of the facial skin with alcohol, as well as a solution of Chlorhexidine bigluconate.

After this, a sterile towel or a special cape should be placed on the patient’s chest so as not to stain the clothes.

Pain relief is part of the preparation for tooth root extraction. Drugs should be selected carefully, taking into account the person's health status. Sometimes it is necessary to make a preliminary incision in the gum, especially if the root is deep in the hole or is not visible during visual inspection.

What tools are used?

To carry out the operation, they are used the following types tools:

syringes;
elevators of various types;
drill.

Based on which instruments will be selected for the operation, certain working methods are selected.

For a successful procedure, it is necessary to perform a detachment of the circular ligament of the tooth or a syndesmotomy. It is carried out regardless of the chosen technique. In addition, the choice of method depends on where exactly the removal is required.

Then use one of the following methods:

Pulling out roots with forceps on upper jaw produced by a tool with straight ends. If it is necessary to remove the roots of molars, then bayonet-shaped wide forceps are used, or as they are also called universal, since they are used to extract roots anywhere on the upper jaw.
Rotation technique or rotation should be used if the operation involves removing the root of a single-rooted tooth, or if the roots of multi-rooted teeth are located separately. If the roots are connected, they must be dislocated.
The root removal technique is also successfully used on the lower jaw. with tongs. In most cases, beak-shaped forceps are used. The removal technique is similar to the actions for removing the roots of the upper jaw.
Extracting tooth roots elevators- another technique widely used in dentistry. She also assumes that the first stage of the operation will be a syndesmotomy. Then working part the elevator is carefully inserted between the root of the tooth and the wall of the alveolus of the gums and all necessary actions aimed at removing the root. In the case when it is necessary to carry out dislocation, the elevator is used as a lever.

The photo shows tooth root removal using forceps.

Removal methods - there are three main ones

Modern dentistry carries out several types of operations to extract tooth roots.

So, what methods do modern dentists use to remove tooth roots:

Hemisection or partial removal of the tooth and root. It is performed in most cases on molars located on the lower jaw. The technique allows you to completely eliminate the development pathological processes. The affected root with the adjacent crown or upper part of the tooth must be removed. After this, the teeth and roots located next to the root being removed are filled.
Amputation or complete removal root This technique is used when it is necessary to perform surgery on the upper jaw. First, you will need to completely expose the roots of the teeth if they are poorly visible or located deep inside the jaw. This means that the doctor peels off the mucous tissue on the gum. After this, the root is cut off using a drill and removed from the hole using universal forceps. At the final stage, the space is filled with a special medical staff- osteoplastic material.
Cystectomy or removal formed on the root of the tooth. The operation is carried out as follows: it is necessary to expose top part root, then identify the cyst and remove it. Finally, the doctor fills the resulting space and adjacent tissues with osteoplastic material.

Removal of the tooth root and subsequent suturing of the sockets - visual video:

Modern methods of root removal are performed under local anesthesia. Sometimes special treatment is carried out, but this is done only in a hospital setting and if the person is undergoing treatment for the underlying disease.

Therefore, the operation is painless for the patient.

Special cases

Sometimes root straightening takes place under unusual conditions.

Special cases are usually called:

root extraction if the tooth is destroyed;
the presence of gum disease, for example.

Special situations should also include the presence serious illnesses, For example, diabetes mellitus or epilepsy, where the use of certain types of pain relief is strongly discouraged.

In addition, children under 12 years of age may need to remove the roots, in which case the operation also takes place in an unusual manner.

Thus, root extraction is a painless operation that does not take much time and does not require long recovery after her. A variety of techniques will allow you to perform dental intervention taking into account all the characteristics of the body, so you should not postpone your visit to the doctor.

Molars (molars, premolars) perform the function of grinding food and are located next to the fangs. An adult has 8–10 molar units on each jaw. The crown has the shape of a cube; there are 3 or more tubercles on the chewing surface, separated by grooves. Molars and premolars have from 1 to 3 roots; wisdom teeth have up to 5.

Reasons for deletion

Molar tooth extraction is performed in as a last resort if there is no way to cure it. The procedure is performed by a dental surgeon. What are the main indications for removal?

During exacerbation chronic diseases, the presence of gum inflammation, disorders nervous system removal is not recommended. Extraction is contraindicated in the first trimester and last month pregnancy. Able to alcohol intoxication the doctor has the right to refuse treatment of the patient.

The surgeon decides to remove the root unit after examining x-ray and examining the patient.

Surgical procedure

Removal is performed using special tools. For the extraction of premolars (small molars growing behind the fangs), S-shaped forceps with wide cheeks are used, for molars - beak-shaped forceps with spikes that go between the roots.

Before the tooth is pulled out, an injection of anesthetic is administered. The patient does not feel pain during the procedure. The forceps are then applied to the base of the crown to obtain a tight grip. Afterwards, it is gently rocked and dislocated from the hole. In this case, the ligaments that hold the tooth in place are torn. alveolar process.

If the crown is severely destroyed and only the root remains, removal is performed using an elevator. This is a device made of a metal rod and handle, which operates on the principle of a lever. The instrument is inserted between the root and the wall of the socket and the remains of the tooth are pushed out. If it is not possible to extract the root in this way, the dentist peels off the mucous membrane, drills the root into pieces at the junction with a bur, and removes the separated pieces one by one.

In case of retention (units hidden in bone tissue) of wisdom teeth, complex operation. After removing the mucous flap, the dentist cuts out a section of the jaw bone. Then the tooth germ is removed and the wound is sutured.

After extraction, a deep hole is formed in the gum, which is filled with a dense blood clot that performs protective function from the penetration of bacteria. Gradually, the clot turns first into fibrous and then into bone tissue. This process takes about 2 months.

Postoperative care

Leaving the surgeon's office, the patient receives the doctor's recommendations on what to do at home after the removal of a molar. All appointments must be strictly followed to prevent infection of the socket and fast healing.

Complications after removal

Sometimes the tooth will collapse completely, leaving only the root and purulent remains in the gum. How is removal done if the disease brings a person discomfort or even severe pain?

How to remove tooth roots?

Tooth root removal can be varying degrees complexity. In some situations, the procedure can be carried out quickly and simply, but in another case you will have to try hard, because there are complications in the form of surrounding bone tissue.

Methods:

Removal with forceps. The first step is to separate the gums. This is done in order to capture the part above the edge of the hole on each side. Next, the root is grasped tightly with forceps. If complications of the procedure occur during the process, the dentist can peel off the periosteum and mucous membrane from the edge of the socket.
Removal of a tooth root located in the upper jaw. For this process, special forceps are used. They differ in their shape. It depends on the tooth that has to be pulled out. For example, bayonet-shaped forceps are only for large molars. Fangs and incisors are removed with another instrument. They pull out with rotational movements, as if they are twisting something. If the root is rejected, the doctor decides to saw the bottom to separate the roots.
Removal of a tooth root in the lower jaw. Their removal is the easiest, because they are short in this part of the jaw and do not sit deep in the gum. Curved forceps are suitable for the extraction process. However, with this method of removal, the main difficulty is extracting the fang.
Removal by elevator. This tool is used when it is not possible to carry out the procedure with forceps, the tooth is not grasped, and the root located deep in the hole is not extracted. If you continue to manipulate the forceps, you can injure the oral mucosa, bone tissue. The elevator provokes rupture of periodontal fibers that hold the tooth root. After this, the problem area is picked up firmly with forceps and removed.

After the process, you must carefully examine the extracted root. This is necessary to make sure that there is nothing else left in the hole.

Treatment of the tooth socket

After removal, it is necessary to treat the wound. The doctor, as a rule, suggests that the patient rinse the mouth with a special substance. This is a 2% sodium bicarbonate solution. In other cases, the dentist places a gauze pad on the wound, considering rinsing unnecessary.

After the operation, the person must firmly press the gauze to the wound with his teeth. After a quarter of an hour, when the bleeding has completely passed, the tampon is removed. During the day, you should not apply mechanical pressure to the wound.

Eating is allowed approximately 4-5 hours after the procedure. To avoid causing bleeding again, the patient should not drink hot drinks. You should rinse your mouth with tincture medicinal herbs. These are calendula, oak bark, chamomile.

Washing the wound is done after each meal for 3 days, when the wound is completely healed.

How to rinse the socket correctly so that the water formed on the socket, which prevents infection from entering the blood, does not wash out? This happens if the patient performs the procedure too intensively.

This leads to bleeding, inflammation of the socket and other complications:

On the first day, do not rinse your mouth, but use baths. IN oral cavity The solution is drawn up, kept for up to 5 minutes, and spat out. You should not drink or eat for an hour after this.
Ask your doctor exactly when to rinse and for how many days after surgery. If the procedure is prescribed by a specialist, perform it very carefully so as not to harm the clot.

What is the best way to rinse:

miramistin;
saline solution;
a solution of salt and soda, in a ratio of 50/50;
decoction medicinal plants(sage, chamomile, calendula, eucalyptus);
solution of potassium permanganate in low concentration;

Does it hurt?

In modern times, almost all procedures are performed under anesthesia. However, many patients who want to remove a tooth root are tormented by the question: does it hurt? How will I feel during the process?

In this case, there is no need to cut the root; the doctor can take on the rest of the tooth.

Before the operation, local anesthesia is given by injection with an anesthetic drug. If there are remains above the root that you can grab with forceps, no one will cut the gum. Even if there is an incision, the patient will not feel any pain. It will be much more painful when the root becomes inflamed and an infection appears in the mouth, which subsequently spreads to the remaining teeth.

In general, removing a tooth root is no more painful than removing a whole tooth. In the first hours or even days after removal there will be discomfort, bringing discomfort, but this problem is solved.

Be sure to pay close attention to choosing a specialist. Experienced doctor will carry out the procedure painlessly and without dangerous consequences.

Possible complications

The occurrence of alveolitis is facilitated by traumatic root removal, the absence of a clot in the wound, and reduced immunity.

After the removal procedure, complications may arise due to the fact that harmful microbes and infection enter the unhealed wound.

They cause inflammation:

Alveolitis. If a blood clot does not form at the healing site, the socket remains defenseless against bacteria. Because of them, an inflammatory process develops. The main symptom is pain after removing the remains, which occurs after a few days. Other signs include: swelling of the gums, inflammation of the edges of the socket, fever, and general deterioration of the condition. Sometimes symptoms manifest themselves in pain when swallowing, enlarged lymph nodes.
Socket bleeding. One of the common consequences. It does not necessarily occur immediately after the extraction procedure, but also after a couple of hours, even days. The following factors can provoke: use of adrenaline; non-compliance with specialist recommendations; injury to the hole; associated diseases.
Paresthesia. A rare but common complication in dental practice. Key Feature is numbness of the tongue and cheeks.
Displacement of neighboring teeth.
Injuries that occurred during the operation.

Side effects:

Trauma to the oral cavity.
Tooth fracture.
Jaw fracture.
Removal of a piece of alveolar ridge.

When is tooth extraction necessary?

Often, the problem area is removed in advanced cases. These include:

Significant destruction due to.
Inflammatory process, associated with the tooth itself or the area around it.
Mechanical destruction.
Crack in the root zone.

These are the main indications for which surgical intervention is prescribed.

Removing a tooth is completely painless. It's important to choose good specialist, who has enough experience to carry out the procedure. Removal occurs using several methods, at the discretion of the doctor, depending on the complication.

If the operation is performed incorrectly, consequences in the form of dental diseases may occur. After the removal procedure, it is important to properly treat the hole to prevent infection.