Mary Sturk, Author at Adam Brown Dentistry

Tooth Extraction Explained at Carolina’s Dental Choice

Mary Sturk2020-07-16T16:56:44+00:00April 17th, 2019|Dental Insurance, Dental Trends, Oral Health|

Our team at Carolina’s Dental Choice knows that the word “extraction” can cause anxiety and even fear in some people. Many of us have had this procedure done, sometimes multiple times, and the reason a tooth needs to be extracted varies from patient to patient.

What Is Dental Extraction?

A dental extraction (also called exondontia or informally, tooth pulling) is the removal of teeth from the socket (dental alveolus) in the alveolar bone. Extractions are performed for a wide range of reasons, but most commonly because a tooth is unrestorable due to decay, periodontal disease, or dental trauma.

Tooth decay is the softening of your tooth enamel and refers to the damage of the structure of the tooth caused by acids that are created when plaque bacteria break down sugar in your mouth.

Periodontal diseases are infections of the structures around the teeth, which include the gums, periodontal ligament, and alveolar bone.

Traumatic dental injuries most often occur as a result of an accident or sports injury. The majority of these injuries are minor, such as chipped teeth. Occasionally though, a tooth will dislodge or even get knocked out completely.

Extraction Procedure

Typically, when undergoing a tooth extraction procedure, your dentist will numb the area with a local anesthetic before the procedure.

Common forms of local anesthesia are Novocaine and more popularly, Lidocaine, which is injected after the dentist numbs the area with an external numbing agent. Here are all the common forms of anesthesia:

Local Anesthesia—this is when medication is injected into the mouth to numb the area to be treated and block the nerves that transmit pain. This type of anesthesia is commonly used during fillings, treating gum disease, or preparing teeth for crowns.
Sedation—this method is usually administered by inhaling nitrous oxide, also known as laughing gas. It can also be administered orally in the form of a pill taken prior to the dental procedure. This form of anesthesia is commonly combined with a local anesthetic to help relieve anxiety and reduce pain.
General Anesthesia—this is the strongest form of anesthesia available for dental procedures and involves intravenous medications that produce a temporary loss of consciousness. General anesthesia is usually only used during oral surgery procedures.

You may have also heard of I.V. sedation and wondered if it were for you. Intravenous (I.V.) sedation has become more common and works well for those with fear of the dentist and dental procedures. It is also ideal for patients whose fear of dentistry has led to a large amounts of dental work needing to be completed. I.V. Sedation is also used for outpatient procedures, like colonoscopies. Referred to as “twilight sleep,” you will wake with little or no memory of the procedure. Anesthesia is given via the I.V. and recovery requires someone take you to/from the procedure.

If the extraction involves an impacted tooth, the tooth may be broken into pieces before it is removed. An impacted tooth is a tooth that, for some reason, has been blocked from breaking through the gum. Sometimes a tooth may be only partially impacted, meaning it has started to break through.

Your dentist will perform x-rays and thorough examinations before this stage and will explain the procedure and any other possible options. Often, with impacted teeth, there are no symptoms and only an x-ray will discover it.

Another reason teeth are extracted, especially in youth and young adults, is to make room in the mouth before planning to straighten remaining teeth. Teeth may also be extracted if they are so poorly positioned that they cannot possibly be straightened. A less common reason to extract a tooth is as a cheaper alternative to filling or placing a crown on a decayed tooth.

If you or your child has a condition where a tooth extraction might be called for, please call Carolina’s Dental Choice at (704) 289-9519 to schedule an appointment.

The number of Americans missing at least one tooth is more than 120 million, so it’s not at all unusual to be missing one or more teeth for a variety of reasons, including those listed above.

What’s the deal with Wisdom Teeth?

One of the most common procedures is the removal of the “wisdom teeth.” What is this procedure and why do these teeth often need to be removed and what are the benefits? According to www.mayoclinic.org:

Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth — the four permanent adult teeth located at the back corners of your mouth on the top and bottom.

If a wisdom tooth doesn’t have room to grow (impacted wisdom tooth), resulting in pain, infection, or other dental problems, you’ll likely need to have it pulled. Wisdom tooth extraction may be done by a dentist or an oral surgeon.

For many, the first use of dental anesthesia is during extraction of wisdom teeth (the four hindmost molars that come in during young adulthood), which can cause issues including moving other teeth around.

To prevent potential future problems, some dentists and oral surgeons recommend wisdom tooth extraction even if impacted teeth aren’t currently causing problems.

Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.

Many people develop impacted wisdom teeth — teeth that don’t have enough room to erupt into the mouth or develop normally. Impacted wisdom teeth may erupt only partially or not at all.

An impacted wisdom tooth may:

Grow at an angle toward the next tooth (second molar)
Grow at an angle toward the back of the mouth
Grow at a right angle to the other teeth, as if the wisdom tooth is “lying down” within the jawbone
Grow straight up or down like other teeth but stay trapped within the jawbone

Problems with impacted wisdom teeth. You’ll likely need your impacted wisdom tooth pulled if it results in problems such as:

Pain
Trapping food and debris behind the wisdom tooth
Infection or gum disease (periodontal disease)
Tooth decay in a partially erupted wisdom tooth
Damage to a nearby tooth or surrounding bone
Development of a fluid-filled sac (cyst)

Preventing future dental problems. Dental specialists disagree about the value of extracting impacted wisdom teeth that aren’t causing problems (asymptomatic), because it is difficult to predict future problems with impacted wisdom teeth. However, here’s the rationale for preventive extraction:

Symptom-free wisdom teeth could still harbor disease.
If there isn’t enough space for the tooth to erupt, it’s often hard to get to it and clean it properly.
Serious complications with wisdom teeth happen less often in younger adults.
Older adults may experience difficulty with surgery and complications after surgery.

What to expect after a Dental Extraction

Immediately after an extraction, be sure to follow your dentist’s instructions. You may receive a prescription for a mild pain killer or antibiotic, but in most cases, over-the-counter medications will manage pain. Do not eat solid foods or smoke for 48 hours. Stick with soft foods like yogurt, soups, mashed potatoes, and smoothies (avoided fruit seeds). The soft tissue takes about 3-4 weeks to heal.

Keep an eye out for any signs of acute bleeding, pain, or swelling. This could indicate an infection.

Beware of Dry Socket

Dry socket (alveolar osteitis) is a painful dental condition that sometimes happens after you have a permanent adult tooth extracted. Dry socket is when the blood clot at the site of the tooth extraction fails to develop, or it dislodges or dissolves before the wound has healed.

Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot also provides the foundation for the growth of new bone and for the development of soft tissue over the clot.

Exposure of the underlying bone and nerves results in intense pain, not only in the socket but also along the nerves radiating to the side of your face. The socket becomes inflamed and may fill with food debris, adding to the pain. If you develop dry socket, the pain usually begins one to three days after your tooth is removed.

Dry socket is the most common complication following tooth extractions, such as the removal of third molars (wisdom teeth). Over-the-counter medications alone won’t be enough to treat dry socket pain. Your dentist or oral surgeon can offer treatments to relieve your pain.

Signs and symptoms of dry socket may include:

Severe pain within a few days after a tooth extraction
Partial or total loss of the blood clot at the tooth extraction site, which you may notice as an empty-looking (dry) socket
Visible bone in the socket
Pain that radiates from the socket to your ear, eye, temple, or neck on the same side of your face as the extraction
Bad breath
Unpleasant taste in your mouth

When to see a doctor. A certain degree of pain and discomfort is normal after a tooth extraction. However, you should be able to manage normal pain with the pain reliever prescribed by your dentist or oral surgeon, and the pain should lessen with time.

If you develop new or worsening pain in the days after your tooth extraction, contact your dentist or oral surgeon immediately.

Expected Costs

The cost of a dental extraction can vary depending on your dentist’s fees and the scope of work. In some instances, extractions (such as wisdom teeth that are impacted) may need to be handled by a dental surgeon under anesthesia.

According to Member Benefits, who tracks the cost of dental work throughout the country, the cost of dental extraction (per tooth) can range from $75-$300 for a non-surgical extraction, and upwards of $650 for a single surgical extraction. Additional costs could include x-rays and exam fees.

If you have dental insurance, it will take a bite (no pun intended) out of your bill. Depending on your policy, it may cover up to 50% of the cost. At Carolina’s Dental Choice, we work with a variety of Dental Insurers, as well as, Medicaid. Our staff will help you understand the costs involved and file the insurance paperwork for you. If you don’t have insurance, we offer an In-House Dental Savings Plan that allows patients to receive treatment at a discounted price.

Carolina’s Dental Choice also welcomes new patients. Whether you have just moved to the Monroe/Charlotte area, are transferring your care from another practice, need to establish care with a dentist, or find yourself suddenly in need of dental service, we look forward to partnering with you for the benefit of your oral health.

As we’ve explored, the reasons for a dental extraction are varied. There is no need to be in pain or discomfort, or even embarrassment, if you feel you need help with dental issues. Our staff is ready to help you find solutions for your dental needs.

The 411 on 3D Imaging at Carolina’s Dental Choice

Mary Sturk2018-11-05T14:28:46+00:00November 5th, 2018|Dentist Office Monroe NC|

3-D Imaging Device-New Advances in Imaging Making a Difference

3D head Scanner, 3 dimensional digital device, Charlotte NC, Carolina"s Dental Choice

The X Factor

Wilhelm Conrad Röntgen (1845-1923) was a German mechanical engineer and physicist, who, in 1895 produced and detected electromagnetic radiation in a wavelength range known as X-rays or Röntgen rays, an achievement that earned him the first Nobel Prize in Physics in 1901. (Wikipedia). He demonstrated that the rays could pass through human tissue, yet not bone and teeth. Bone and teeth would appear as “shadows” and he learned to make images from these. Like Pierre Curie, Röntgen refused to patent his discovery, instead wanting society as whole to benefit from his work, he even donated his Nobel Prize money to his university.

X-rays are a form of energy, similar to light and radio waves. X-rays are also called radiation. Unlike light waves, x-rays have enough energy to pass through your body. As the radiation moves through your body, it passes through bones, tissues and organs differently, which allows a radiologist to create pictures of them. The views these images are on photographic film or on monitors similar to a computer display.*

X-ray examinations provide valuable information about your health and help your doctor or dentist make an accurate diagnosis.*

The use of x-rays in dentistry of a living person in the United States took place in 1896. Advances in dentistry and the availability of the equipment grew and x-rays became part of the normal dental routine in the 1950s.

3-D Imaging

3-D imaging has become more popular as machines have become more advanced and more available in the medical community. Popular for ultrasounds, mammograms, and other uses, they are helping doctors and dentists better diagnose health issues, while making it easier on the patient. This is truly technology changing lives.

Dental CBCT (3-D) systems have been sold in the United States since the early 2000s and are increasingly used by radiologists and dental professionals for various clinical applications including dental implant planning, visualization of abnormal teeth, evaluation of the jaws and face, cleft palate assessment, diagnosis of dental caries (cavities), endodontic (root canal) diagnosis, and diagnosis of dental trauma. (www.fda.gov)

Also known as, dental cone beam computed tomography (CBCT), and described by as “a special type of x-ray equipment used when regular dental or facial x-rays are not sufficient. Your doctor may use this technology to produce three dimensional (3-D) images of your teeth, soft tissues, nerve pathways and bone in a single scan.” Adding, “this procedure requires little to no special preparation.” *

More about Cone Bean CT:*

Cone beam CT is not the same as conventional CT. However, dental cone beam CT can be used to produce images that are similar to those produced by conventional CT imaging.
With cone beam CT, an x-ray beam in the shape of a cone is moved around the patient to produce a large number of images, also called views. CT scans and cone beam CT both produce high-quality images.
Dental cone beam CT was developed as a means of producing similar types of images but with a much smaller and less expensive machine that could be placed in an outpatient office.
Cone beam CT provides detailed images of the bone and is performed to evaluate diseases of the jaw, dentition, bony structures of the face, nasal cavity and sinuses. It does not provide the full diagnostic information available with conventional CT, particularly in evaluation of soft tissue structures such as muscles, lymph nodes, glands and nerves. However, cone beam CT has the advantage of lower radiation exposure compared to conventional CT.

At Carolina’s Dental Choice, we use Planmeca 3-D imaging device to help diagnose our patients. Not all damage and disease is visible during a routine dental examination. We strive to limit our patients exposure to radiation. That’s why we make the process quick and painless!

The 3-D Planmeca imaging device is the newest X-ray procedures. Instead of using standard X-ray film, 3-D digital images are produced on the computer screen where we can view them, store them or print them. 3-D imaging take a fraction of the time and uses less radiation.

This technology offers up a profound representation of anatomy, thus offering new possibilities for diagnosis and treatment. These advances assist with many forms of dentistry, including: endodontics, periodontics, orthodontics, implantology, dental and maxillofacial surgery.

The benefits for the patient include:*

Cone beam CT scans provide more information that conventional dental x-ray, allowing for more precise treatment planning.
CT scanning is painless, noninvasive and accurate.
A major advantage of CT is its ability to image bone and soft tissue at the same time.
No radiation remains in a patient’s body after a CT examination.
X-rays used in CT scans should have no immediate side effects.
Non-invasive, there is no need to bite down on a mold or piece of plastic.

Benefits for the dentist include:*

The focused x-ray beam reduces scatter radiation, resulting in better image quality.
A single scan produces a wide variety of views and angles that can be manipulated to provide a more complete evaluation.
Surgical planning for impacted teeth.
Accurate placement of dental implants.
Determining bone structure and tooth orientation.
Locating the origin of pain.
Planning orthodontic issues.

What can you expect?

Like traditional x-rays, you’ll be asked to sit very still. While seated, the x-ray source and detector will sweep around you in unison providing a 360-degree rotation (or less, as needed). This typically takes 20-40 seconds for a full scan, and less if the scan if for a specific area only.

Jewelry, eyeglasses, dentures, and other metal objects may affect the images and should be removed in advance. You might also be asked to remove hearing aids and any removable dental work and piercings.

This is a painless procedure and results are quickly available for treatment planning.

The 3-dimensional digital device at Carolina’s Dental Choice combines three different types of 3-D data with one X-ray unit! This will save our patients time and additional discomfort associated with traditional X-ray units. As with all procedures, we’ll work with you and determine if your dental insurance covers this technology.

*Radiological Society of North America, Inc.