How to remove a tooth if it has crumbled. How is the root removed, if only it remains in the gum, and the tooth is completely destroyed and crumbled? Features of anesthesia of a tooth with a rotten root

Going to the dentist's office is a challenge for many people. Patients believe that the removal of the roots is accompanied by pain, as well as the obligatory cutting and suturing of the gums. However, modern methods, tools and materials allow the operation to be performed with little or no discomfort and complications.

Do I need to remove the root of a decayed tooth?

When there is no dental crown, but the roots remain in the gum, you need to determine what condition they are in. The crown part can be destroyed both on a tooth with a nerve and on a pulpless one. If the roots of a tooth are severely damaged, it cannot be restored. The dentition is restored with the installation of an implant or bridge after the removal of fragments of the unit.

Do I need to extract teeth if they do not hurt? Patients often turn to dentists with the following symptoms: the tooth has crumbled to the ground and rotted, while the person is not bothered by pain. The forces of immunity allow for a certain time to restrain the spread of infection, but there comes a time when acute inflammation occurs, accompanied by edema. Then you can lose both the collapsed unit and the neighboring ones.

Absolute indications for removal

Amputation of a rotten root is mandatory, since it is a breeding ground for infection. The problem is not only bad breath - bacteria multiply in the remains of the unit, there is supragingival or subgingival calculus on them, which causes inflammation of the gums. Almost always, the tops of the roots are infected, which can cause a granuloma to form, subsequently leading to a flux (we recommend reading: is it possible to remove the flux on the gums at home and how?). What a broken tooth looks like can be seen in the photo.

Removal is indicated in the following cases:

• periodontal disease;
• if the tooth is loose;
• the presence of a cyst, abscess;
• caries damage;
• complex fracture of the tooth;
• the presence of fragments deeply stuck in the hole;
• atypical position of the unit.

Removing the roots of a wisdom tooth is almost always required. These are far-away molars, for which there is no way to take good care of them, so the “eights” are quickly destroyed. Wisdom teeth often provoke displacement of other units and constant inflammation due to cheek biting. Units are kept if they have grown correctly and are not too damaged. A crown is placed on the wisdom tooth or used for further restoration of the row with the help of a bridge.

When can the root be left if the tooth has crumbled?

If possible, dentists strive to save at least one root of a decayed multi-rooted tooth. It can become a support for the crown, thanks to which the unit will continue to perform its functions.

If there is a wall or only a root due to the loss of a filling of a pulpless tooth or a chipped piece of it, the remaining parts can be saved. This is done in cases where the root or surrounding tissues are not subject to pathological processes.

The dentist uses conservative and conservative surgical methods of treatment. In the first case, the root is sealed, and after therapy, the restoration of the unit is performed using a pin or stump insert. A crown is put on a metal base, which will allow the tooth to fully perform its function.

A conservative surgical technique is required in the presence of inflammation at the apex of the root canal. The operation is carried out within half an hour - the doctor cuts off the top of the root.

Sometimes, with inflammation, it is possible to avoid surgical intervention - the doctor injects an anti-inflammatory drug into the canal. The tool can be in it from 2–3 months to 1–2 years, during which time the bone near the root apex is restored. However, with a significant loss of bone tissue, specialists more often resort to a surgical method in order to preserve the remains of the tooth.

How is the root removed?

Many patients are interested in the question of how the roots are removed, because you need to prepare for the procedure not only physically, but also mentally. If the tooth is rotten, several methods can be used to extract it:

Preparing for the operation

If the tooth has collapsed, and the patient has decided on the operation, it is necessary to prepare for it. A person undergoes a complete examination of the oral cavity. Soft deposits and calculus are removed from the teeth next to the diseased unit.

Immediately before the procedure, the dentist examines the mucous membrane for inflammation or suppuration. He performs hygienic treatment of soft tissues in order to exclude the penetration of microbes into the wound that remains after the intervention. The patient rinses his mouth with Eludril or Chlorhexidine - this allows you to kill 90% of pathogens.

Before complex removal of the tooth root, additional processing will be required. The doctor wipes the patient's face with alcohol or Chlorhexidine. A cape is placed on the chest to protect clothing from possible ingress of saliva, blood, etc. It will not hurt during the manipulation - the method of anesthesia is selected at the preparation stage, based on the age, the presence of allergies and various diseases in the patient. If the root is located deep, you will need to make an incision in the soft tissues.

Required Tools

To remove a decayed tooth, doctors use several types of tools:
(we recommend reading: how to remove a tooth yourself at home?)

1. Forceps. There are different types of forceps, including separate mandibular and maxillary instruments, root extraction devices for limited mouth opening, etc.
2. Elevators. Each type of instrument (straight, angled, etc.) is designed for a separate group of teeth.
3. Drill. The device is necessary for sawing the tooth and removing the roots or their parts.

Amputation process

The operation begins with the detachment of tissue around the unit. Amputation of the tooth root is performed using certain methods of work:

The choice of root removal method is influenced by the degree of damage to the tooth and the presence of transformations in the bone tissue. If the root is rotten, and the bone is slightly deformed due to inflammation, then the extraction specialist will only need forceps. They are applied at the final stage after the separation of the alveoli and gums. When this tool fails, the doctor uses the elevator.

What to do if the tooth is rotted to the gums (more in the article: what to do if the tooth is rotted to the gums?)? In this case, a drill is used. The device allows you to cut the unit into pieces, then each piece is taken out separately. The fragments are removed with another tool. When extracting a wisdom tooth, additional devices are used (we recommend reading: tooth extraction: what it is and technique).

If the root is pulled out before its complete destruction, the operation will be simple. The procedure usually takes about 10 minutes. Extraction in people over 40 years old is quite easy, since the alveolus atrophies and a focus of inflammation forms - the body independently rejects a piece of the remaining tooth. When several roots are planned to be removed, the procedure is considered complicated.

Amputation of the subgingival part of the unit with preservation of the crown is rarely resorted to. It is carried out with the formation of a cyst or granuloma, when there is a chance to save most of the unit.

Possible consequences

Complications after extraction of a tooth or root is a phenomenon that occurs due to the lack of experience of the doctor or his negligence. If the unit fell out due to injury, it is worth taking an x-ray so that the doctor makes sure that there are no fragments left in the hole. During the procedure, the following may occur:

1. Breaking off the top of the root. Bleeding from the wound, so the fragments are not always visible. The specialist must prescribe a second removal.
2. Fragment stuck deep in the well. Part of the tooth cannot be seen without an X-ray, it is covered with epithelial tissue and does not bother you at first. Subsequently, a capsule of fibrous tissue and a fragment provokes the formation of an abscess or phlegmon.
3. Pieces of bone get stuck in soft tissues. This is a local complication, and fragments can often be removed on their own or in the doctor's office under anesthesia (without tissue cutting).

Do I need to remove the remaining fragments of the tooth? Leaving them in the wound is unacceptable, as this can lead to unpleasant consequences:

What to do if a piece remains after removal?

If a fragment remains in the gum, you should not delay visiting a doctor. The specialist will remove the residual fragments and treat the wound with an antiseptic. The operation is performed in two ways:

• when a fragment is on the surface, extraction is carried out in a few minutes with a special tool;
• if the piece is located deep, a gum incision is made to extract it.

Sometimes doctors are faced with a situation where the fragment is overgrown with gums - it is completely covered with mucous. In this case, the treatment is carried out in several stages:

Is it possible to pull out a rotten tooth root at home?

There are many videos on the Internet showing people trying to extract a tooth at home. Is it worth experimenting so cruelly on yourself? Attempts to remove it yourself can lead to unpredictable consequences for a number of reasons:

• choosing an anesthetic and correctly injecting it in the right dose into the gum is very problematic without a medical education;
• it is difficult to maintain sterility at home, so there is a high risk of infection in the wound;
• inept tissue incision can cause serious bleeding;
• without the use of anesthesia, pain shock is possible.

If the removal of a strong whole tooth can still be realized, then a rotten root will not succumb to extraction. The crown of the tooth or its subgingival part may crumble, the fragments will get stuck in the hole, decomposing and infecting the surrounding tissues. Dentists categorically do not recommend trying on their own to remove not only permanent, but even milk teeth.

In dental practice, there are cases when the crown part of the tooth is completely destroyed. And in the root system affected by the infection, a purulent-inflammatory process develops. Then an operation is scheduled to remove the residues. How the root of the tooth is removed, what instruments will be used and whether the chewing unit can be saved for subsequent prosthetics depends on the clinical picture.

Indications

You need to remove the root when:

1. Complete destruction of the coronal (supragingival) part of the unit, affecting the root system.
2. Extensive purulent-inflammatory process at the root: cyst, abscess.
3. Longitudinal axial fracture.
4. Previous incorrect extraction. Due to the negligence of the doctor, fragments remain in the hole. If they are not removed, an inflammatory process will develop. In the future, it will move to adjacent tissues.

With the complete destruction of the crown part of the tooth, its root is often subject to removal.

Important! Often, patients themselves exacerbate the situation. They start caries, do not go to the clinic to replace fallen fillings or restore broken walls. Over time, the so-called "stump" remains. Remains of food, getting into it, provoke an inflammatory process. If you do not remove a rotten tooth at this stage, then there will be serious consequences, up to sepsis - blood poisoning.

The rotting area is easily determined visually. Additionally, the following symptoms occur:

• jerking, throbbing pains;
• acute pain during mechanical action: pressure, biting, chewing food;
• gum hyperemia;
• bleeding;
• bad breath;
• purulent process;
• temperature rise.

If one or more signs appear, destroyed units should be removed.

If not the entire root is affected, its partial removal is possible.

In some cases, incomplete removal of the roots of the tooth is possible -. Such an operation is performed when only the root tip is affected: periodontitis, small cysts, granulomas. And often the coronal part remains intact. The dentist provides access through an incision in the gum and excised the affected area. Subsequently, the unit can be restored with a crown.

Tools

Removing a rotten tooth root is similar to extraction. The same tools are used for the operation:

1. Forceps. There are several forms for extracting the roots of various teeth in the lower and upper jaws:

• molars are removed with S-shaped forceps; for lower chewing units, flat and curved types of instruments are also used;
• wisdom teeth on the upper jaw - bayonet-shaped and non-closing;
• "eights" on the lower jaw - horizontal;
• canines, incisors and premolars - cranoid or straight.

2. Elevator. Consists of a handle, rod and cheek. It happens:

3. Raspator or trowel. Designed to exfoliate the gums. They also separate cartilage tissue. Subdivided into:

• costal;
• curved;
• bilateral;
• straight.

Although extraction in dentistry is considered a complex operation, the technique of its implementation has been worked out very well, and the manifestation of adverse effects is observed in isolated cases.

But sometimes it happens that during a complex tooth extraction, a small fragment of it remains in the hole. Then it is important not to start the condition and come to the doctor before the manifestation of complications.

The reasons

The circumstance when, after the extraction of a problematic tooth, a small fragment of it (usually a fragment of the root) remains in the gum, arises for a number of reasons.

Difficult case

Often, patients turn to a specialist in an extremely neglected and difficult-to-treat case, when the degree of visualization of such a unit during surgery is difficult.

The dentist can miss a small part in the hole only because of the difficulties during the manipulation. Often, a badly damaged tooth splits during extraction, and it has to be pulled out in separate parts. In such a situation, it is important to extract all the pieces, otherwise serious consequences can await a person.

Pulling out pieces of the destroyed unit on a napkin, the doctor must make sure that there are no unnoticed parts in the hole. If there is any doubt about this, an x-ray is prescribed.

But even with strict adherence to the technique of the procedure, situations with incomplete extraction due to the complexity of the case are not uncommon.

Splitting the root into many small fragments

This situation occurs with a complex fracture, often longitudinal, against the background of:

• severe inflammation (with phlegmon, cyst, periostitis, abscess, osteomyelitis);
• severe destruction of the crown, reaching the roots;
• incorrect position of the unit;
• strong root mobility.

A fragment unnoticed by the dentist does not allow the wound to heal completely, moves to the top of the hole, causing pain and discomfort from the sluggish inflammation that has begun in the oral cavity.

The danger also lies in the fact that other complications can join the inflammation, thereby worsening the human condition.

Large crown and root surface

More often than usual, pieces remain in the gum when the figure eight (wisdom tooth) is removed. Having a large root system and a massive body, the third molar is very difficult to extract even for an experienced doctor.

This tooth is most often removed because:

• growing in the wrong direction;
• has longer and more curved roots than other units;
• not fully erupted;
• roots fuse with the jaw bone.

Hard to reach location

Units located in the far part of the oral cavity are very difficult to visualize, and if problems with the anatomical structure of the oral cavity are added to this, the extraction may not be complete, and a fragment of the tooth may remain in the gum.

Crushing of an adjacent tooth during extraction

If there are two heavily damaged units nearby, then during the amputation of one of them, a fragment of the neighboring one can fall into its hole.

This can happen when an instrument accidentally presses on the crown of a nearby tooth, when for a number of reasons it is not possible to completely capture the pulled-out unit.

Symptoms

It is possible to suspect that after extraction a fragment of the tooth remained in the gum, according to the following symptoms:

• redness in the operated area, which does not go away for a long time;
• temperature increase after 3-4 days after manipulation;
• aches in the joints;
• chills;
• the appearance of an unpleasant odor;
• discharge from the hole of pus;
• pain that manifests itself even at rest;
• swelling that does not subside.

Some of these symptoms are the body's normal reaction to surgery - pain, bleeding, swelling, redness. But they should not appear for more than 3-5 days, and every day their severity should subside.

If this does not happen, but on the contrary, the severity only intensifies, and new symptoms join it, we can confidently speak of a complication during manipulation.

Important! You cannot examine the wound yourself for the presence of a fragment. Such an action can lead to infection, displacement or deepening of the fragment.

Specialist actions

If there is an assumption that a piece of the tooth has remained in the hole, you need to make an appointment with the dentist, and if for a number of reasons this is not possible, you should contact the specialists of the emergency room.

In each of the options, the doctor's actions are carried out in the following order:

1. Visual examination of the oral cavity.
2. Referring the patient for an x-ray.
3. Identification of the presence of fragments by a snapshot, determining the location and quantity.
4. Choice of debris removal technique.
5. Extraction from the gums.
6. Washing the hole with an antiseptic.
7. Application of an antibacterial drug.

Radiography in this case is the fastest and most convenient way to detect the presence of tooth fragments. How many of them and where they are located depends on how the procedure for extracting them is performed.

So, if the pieces are located close to the gum surface, they are removed using a special dental instrument. In the case when they settle very deeply, the doctor cuts the gum. Both procedures are quick and painless under the influence of local anesthesia, and in special cases, general anesthesia is used.

It happens that a person confuses a tooth fragment with a jaw bone. After extraction, usually of molars, a small, pointed edge of the bone may indeed be visible from the gum.

Its appearance is explained by the peculiarities of the anatomy of the jaw. In this situation, the dentist undermines the edge or it eventually tightens with gum tissue.

Today, the likelihood of developing such a complication is very low. If, nevertheless, the doctor has doubts about leaving a fragment of a tooth after a complex extraction, The patient is sent for an X-ray immediately after the operation.

The video shows a diagram of the extraction of fragments left after the removal of a wisdom tooth.

Possible Complications

Remains in the gum of a tooth fragment after its extraction is a rare local complication in dentistry. But if you do not take timely measures to remove it, the following consequences develop:

1. Abscess. The main cause of development is inflammation in the tissues of the gums. The process often takes on an extensive character and spreads to adjacent teeth.

   If you ignore the elimination of the problem, inflammation in a short time can affect the entire dentition, go to the periosteum and bone. A person will be tormented by severe pain, swelling, the temperature will rise.

2. Osteomyelitis(or necrotic damage to bone tissue). In addition to local symptoms in the form of pain when chewing and opening the mouth, numbness of the lips, swelling and redness of the mucosa, pain and enlargement of the lymph nodes, general intoxication, loosening of the teeth, yellowing of the eye membranes join.

   Often there is a plentiful release of pus. An unpleasant outcome of the disease awaits those patients who have brought their condition to the transition of osteomyelitis to the chronic stage.

   They have atrophic changes in the bone tissue and degeneration of the soft tissues surrounding the problem area.

3. Periostitis- the disease affects the periosteum. Obvious symptoms of the pathology are gum swelling, severe intense pain radiating to the eyes and ears, and high fever. It is possible to form a fistula through which pus will be released.
4. Pain in the neck which is neuralgic in nature. The condition develops with the development of inflammation in the lower jaw. And if a piece of the root remains on the upper jaw, inflammation affects the facial nerve.
5. Alveolitis. The inflammatory process that has developed in the hole (alveolus) of the extracted tooth is the main cause of the manifestation of the disease.

   The piece left in the wound contributes to the infection of the blood clot or its injury.

   The disease can be suspected if the gums in the wound area are swollen and reddened, the temperature rises, there is pain (increased during eating and gives to the ear), the lymph nodes are inflamed, a bitter taste is felt in the mouth.

6. Phlegmon- inflammatory process of soft tissues. The disease leads to swelling of the neck and face, followed by a change in their proportion.

   Phlegmon is characterized by severe swelling of the tongue and neck, limitation of their mobility, temperature, chills, deterioration in general well-being, the appearance of an unpleasant putrefactive odor, restriction of swallowing, speech and respiratory functions.

Even a very small fragment of the left root can lead to such serious and dangerous consequences for health. Treatment of all complications is predominantly only surgical. Without cleaning the wound, conservative therapy will be ineffective.

Postoperative period

After the dentist removes the left fragment, it is necessary to strictly follow all his recommendations. Usually the doctor prescribes for the entire postoperative period:

• taking broad-spectrum antibiotics to stop inflammation (up to 7-10 days);
• rinses and baths with solutions that disinfect the oral cavity - Miramistin, Chlorhexidine or herbal infusions (from chamomile, oak bark, sage);
• painkillers.

Also after the operation is very important:

• do not take any food for 3-4 hours;
• drinking is allowed only after 1.5-2 hours, and only plain (without gases) water;
• do not chew on the side on which the operation was performed;
• the first 24 hours do not brush your teeth, but only rinse your mouth (not intensively!);
• apply cold to the cheek to reduce swelling (on the first day every half an hour for 15-20 minutes);
• exclude spicy, sour, very hot, hard, viscous foods from the diet for the entire postoperative period;
• do not touch the hole with your finger, tongue, toothpick;
• physical activity and sports should be avoided;
• do not drink alcoholic products and, if possible, do not smoke.

Important! It is impossible to warm up (apply a warm compress) - this is dangerous by the appearance of secondary inflammation. Also, you can not visit the sauna, bath and sunbathe on the beach on a hot day.

It is considered normal if the temperature rises slightly (no more than 37.5 ° C) during the first days, discomfort and slight pain persist.

Is it possible to avoid

The success of the operation is largely determined by the experience and professionalism of the doctor. No dentist will remove a tooth without examining in detail the clinical picture of the state of the oral cavity and the unit itself.

To exclude the possibility of complications during the operation and upon its completion, the specialist needs to know the features of the root system, location conditions, find out the quality of the tissues and the degree of destruction of the supragingival part.

If a visual examination does not fully assess the complexity of the case, the patient is recommended to undergo one of the examinations - X-ray, CT (computed tomography), orthopantomography or visiography.

If there is a complex removal, the whole complex of these examinations is performed. Based on the results obtained, the dentist can clearly determine the number and structure of the root system, find out the direction of their growth and the degree of curvature, calculate the volume and duration of the upcoming manipulation, and prepare the appropriate tools.

Also performed antibiotic susceptibility testing, which is very important if the amputation will take place against the background of alveolitis or flux.

If the dentist removed a complex tooth and he has some doubts about the cleanliness of the hole, he will definitely refer the patient for a second x-ray examination after the operation is completed.

This is done in order to prevent the development of postoperative consequences associated with leaving a piece of root in the alveolus.

Important! A complete comprehensive examination of the patient before and after extraction guarantees safe and fast extraction.

Price

The total cost of extracting the left fragment from the well is the sum of the price for the following manipulations:

• radiography (orthopantomography or visiography) - about 1 thousand rubles;
• anesthesia - up to 500 rubles;
• hole cleaning - about 800 r.

Several other factors influence the final cost: the complexity of the manipulation, the scheduling of the subsequent treatment of the complication, the pricing policy of the clinic, its status and location, and the qualifications of the specialist.

In the last century, to the question of whether it hurts to remove the root of a tooth if the crown is completely destroyed, many dentists would have given an affirmative answer. Pain during and after the procedure, complications from anesthesia and discomfort haunted many patients. But today the situation has changed - a diseased tooth and its root can be pulled out absolutely painlessly.

Who will have to part with a tooth

After a tooth extraction in the doctor's office, complications are extremely rare. Much more often, sad consequences occur when it spontaneously falls out due to destruction or injury. In such cases, there are two options: restoration of dentin and enamel or removal of the tooth root.

You will have to remove the root of the tooth with the following symptoms:

• constant discomfort in the gums;
• sharp pain when chewing;
• swollen soft tissues;
• bleeding;
• the appearance of pus.

A sure sign of an inflammatory process in the gums is an increase in body temperature in the absence of symptoms of another disease.

Important! It is impossible to postpone a visit to the dentist, even if only one of these symptoms appears. Any suspicion that the root of the tooth has remained in the gum and has begun to rot should be the reason for an urgent visit to the doctor.

What are the roots of the teeth, look at the photo:

Temporary contraindications

Surgical removal of the root of a destroyed tooth is contraindicated in the period:

• relapse of a complex mental disorder;
• acute phase of ARVI;
• exacerbation of a neurological disease;
• rehabilitation after a heart attack.

Doctors of dental clinics are aware of all contraindications to extraction. But not all conditions have vivid clinical signs, therefore, in order to avoid unpleasant consequences, it is necessary to warn the doctor about the ailment.

Generalized scheme of tooth extraction

The process of extracting any tooth includes the following steps:

1. Examination and history taking (allergic status, information about the state of health and dentoalveolar apparatus).
2. Preparation of the surgical field: treatment of the injection site, rinsing the mouth with an antiseptic.
3. Anesthesia.
4. Detachment of the gums from the tooth with a trowel.
5. Loosening of the tooth with forceps.
6. Extraction of a tooth from the socket.
7. Treatment of the hole with an antiseptic.
8. Stop bleeding with tamponade.

According to this scheme, a simple removal is carried out. In some situations, for example, when pulling out a wisdom tooth or a heavily damaged molar, a complex extraction is required. Its main difference is that in addition to forceps, the dentist uses a drill for sawing bone tissue or sawing the root into pieces, a chisel, a hammer and other dental instruments.

Getting rid of a wisdom tooth is especially difficult. Due to being in the posterior quadrant of the jaw, access to it is complicated. With anatomically misplaced or crooked roots, which are often found in third molars, the dentist may be forced to make incisions in the gums, pull out the root piece by piece, and then apply stitches.

How is a decayed tooth removed?

The process of removing a tooth is a simple dental operation. The difficulty increases when you need to remove the root of a tooth that is completely destroyed. Factors requiring the intervention of an experienced specialist:

• small size of the remaining crown;
• condition of the surrounding tissues;
• the location of the remaining hard tissues of the tooth under the upper edge of the gum;
• defects of the gums, roots.

It affects the complexity of the operation and whether the position of the upper or lower jaw belongs. In the upper jaw, the walls of the holes are longer and thicker, respectively, the teeth are removed from them with great difficulty - a highly qualified dentist is needed to perform the manipulation.

Wisdom teeth, from which only the root remains, are removed in the same way as ordinary molars, but in some patients healing after such an intervention is very painful.

Examination and preparation

The procedure begins with a thorough examination and preparation of the patient. At his first visit to the clinic, the doctor will take an x-ray and examine the oral cavity.

Doctor's tasks:

• determine the condition of the tooth, assess the extent of destruction;
• clarify the presence of allergies, contraindications, inflammation;
• choose the method of anesthesia;
• draw up a plan of operation;
• prepare tools.

A drill, tongs, a set of elevators are used as tools for removing a rotten tooth root (photo).

A prerequisite is the hygienic treatment of adjacent tissues. Pulling out is possible only after the removal of stones and plaque from the molars, incisors or canines surrounding the surgical field. Immediately before extraction, the oral cavity is treated with a solution of Chlorhexidine.

Anesthesia

There are cases when the dentin is destroyed gradually, without inflammation, without the appearance of rot. In such situations, painless root removal is possible without the use of painkillers, however, anesthesia is more often used.

The choice of the drug is carried out taking into account:

• age;
• allergic status;
• the presence of somatic diseases;
• individual intolerance to drugs;
• the presence of chronic diseases: epilepsy, diabetes mellitus;
• complexity of the upcoming operation.

The patient must notify the dentist about all deviations before the procedure. In most cases, the root of the tooth is removed under local anesthesia - one or two injections for the incisors, 2 to 4 injections in the gum for the molars. But if two teeth have collapsed, or the jaw is to be opened, the patient receives general anesthesia - he will sleep until the doctor finishes pulling out the tooth.

Features of anesthesia of a tooth with a rotten root

An anesthetic injection is given to the site of the projection of the dental roots. But if the medicine is injected into the rotten area, it may not work, and the person will be hurt during the extraction process.

Treatment of patients with rotten roots is carried out in two stages. On the first visit, the dentist anesthetizes the gum, dissects it and cleanses it of pus. During the second visit, anesthesia is repeated and the doctor removes the root that has rotted inside the gum.

Removal

How to remove a tooth, if only the root remains, the doctor decides. Usually start with the use of forceps. Even if the destroyed roots remain under the gum, the holes do not completely overgrow - the dentist can gently pick up the remnants of hard tissues and easily pull them out.

If the tooth has crumbled to the very base, it is pulled out with an elevator. Having inserted the instrument between the gum and dentin, the doctor presses on the handle and performs rotational movements of small amplitude. As a result, the periodontal fibers are shifted, and the root is squeezed out of the hole.

A drill is used when hard tissues of a molar tooth need to be crushed before removal. With properly performed anesthesia, such a procedure is painless, discomfort is possible only when the gum is already healing.

Removal of inflammation

When a rotten root is removed, an inflammatory process is often detected. So that the wound is safely overgrown and does not fester, it is customary to treat it with an antiseptic. But one treatment will not provide proper prevention, so an anti-inflammatory drug is placed in a fresh hole. With it, the hole will heal faster, and the patient will be less likely to get alveolitis.

Suturing

To extract the root system, the doctor separates and lifts the soft tissue flaps; they can only be attached back by suturing. It is customary to tighten the edges of the holes with threads during double or triple removal, when a significant part of the gum has undergone preparation. This is done so that the affected area is overgrown faster and does not cause discomfort to the patient.

If fragments of the root remain in the hole

If the contraction of the edges of the wound was performed with catgut, the patient's treatment can be considered completed. If a non-absorbable material was used, the patient will have to return to the dentist for suture removal after a week. During this time, it is necessary to monitor the condition of the gums, your own feelings and notify the doctor if:

This means that small fragments of tooth tissue rot in the hole, which could go unnoticed during extraction. The doctor must prescribe the patient a second X-ray, check the quality of the operation and find out the cause of the ailment. Inaction is fraught with the development of alveolitis (inflammation of the hole), osteomyelitis, phlegmon and other serious diseases.

How is the removal of a rotten tooth root with preservation of the crown

A tooth in which only the root remains is not always pulled out entirely. For example, if an inflammatory process develops at the root apex, but the tooth itself can still be saved, the root apex is resected - partial removal.

The procedure is carried out after filling the canals, under local anesthesia. The operation is simple and lasts no more than half an hour. Its main stages:

1. Collection of anamnesis.
2. Preparation of the operating field.
3. Anesthesia.
4. Cutting the gums to access the root.
5. exfoliation of soft tissues.
6. Cutting a "window" in the bone.
7. Cutting off the inflamed area of ​​the root with a granuloma or cyst.
8. Laying in the cavity of drugs that stimulate the growth of bone tissue.
9. Suturing.

What to do after removal

After any surgical intervention, you should follow all the recommendations of the dentist, as well as:

• do not eat within 2 hours after manipulation;
• cool the soft tissues of the face in the projection of the removed root;
• stop smoking for two days;
• take prescribed pain medication;
• make antiseptic applications;
• check if other teeth are crumbling.

Sometimes, after a complex extraction, dentists prescribe antibiotics to patients. This appointment cannot be ignored - after a tooth is pulled out of the hole, a focus of infection is formed in it, which can only be extinguished with the help of drugs.

The following video schematically shows the different extraction methods for incisors, canines, molars and premolars of the mandible and maxilla.

Tooth root extraction is one of the most difficult and unpleasant dental procedures. This article provides information about the methods of root extraction, the subtleties of the operation, the complications that may arise from its incomplete extraction.

Indications

Experts distinguish the following series of main indications:

• Fractures of teeth of various etiologies.
• Development of inflammatory processes.
• Loss of integrity of the tooth (it fell apart, broke, rotted).
• The third level of root mobility.
• Abnormal arrangement of decayed teeth.
• Manifestation of characteristic symptoms of inflammation.

Important! Extraction of the root of a tooth that has collapsed is a mandatory manipulation. It is the main breeding ground for infection in the oral cavity. The presence of rotten roots at the top provokes the formation of granulomas and cysts, which can subsequently develop into a malignant tumor.

Preparing for removal

Remaining tooth root.

At this stage, the following is carried out:

• A complete examination of the oral cavity and in particular the area with the root residue. A panoramic x-ray of the jaw is taken, the soft tissues of the periodontium are checked for the presence of inflammatory processes and suppuration.
• The doctor draws up a treatment plan.
• A suitable pain reliever is selected.
• The entire set of sterile instruments is prepared.
• Hygienic treatment of the oral cavity. If necessary, plaque and calculus are removed.
• The mouth is rinsed with a solution of chlorhexidine or eludril.
• The gums are anesthetized.
• If indicated, an incision is made in the gums, followed by extraction of the tooth root.

Reference! Proper and complete preparation for the operation is the key to its successful implementation, and subsequently excluding the development of complications.

Tools: tongs, drill, elevators

Forceps elevators Drill

Tooth root extraction is a complex dental procedure that requires high professionalism from the dentist-surgeon. The correct choice of tools for its extraction is the key to a successful operation.

Extraction methods

In dental practice, the following methods are used to remove the tooth root:

• Hemisection. It is used primarily on the molars of the lower jaw. The diseased root and the crown that adjoins it, or the part of the tooth located on top, is removed. The next stage of the procedure will be the filling of the roots and teeth. This technique excludes the development of pathologies.
• Amputation. Used when surgery is required on the upper jaw. Initially, the visible section of the periodontium is separated, the root is cut off with a drill and removed from the alveoli with forceps. The manipulation ends with the filling of the hole with an osteoreplacing material.
• Cystectomy. Provides for the excision of a cyst on the root of the tooth. The procedure begins with the process of opening the upper section of the root. After removal of the neoplasm, the vacated space is filled with medical material.

All modern techniques for removing the roots of teeth are carried out with the help of local anesthetics. This avoids pain.

Further processing of the alveoli

Normally, a blood clot should form in the hole.

After root extraction, careful treatment of the alveoli is a mandatory rule. For this purpose, the hole is washed with special antiseptics, followed by the application of special anti-inflammatory drugs to the wound.

They are used not only for therapeutic purposes, but also for preventive purposes, despite the presence of an inflammatory process in the hole.

Their use promotes faster healing of the wound and prevents the development of inflammation.

Peculiarities of tooth root extraction on different jaws

There are slight differences in the methods and types of instruments used in manipulations on different jaws.

On the top - for the extraction of molars, bayonet-shaped forceps are used. C-shaped dental pliers are used to extract incisors and canines. For these purposes, rotational movements of the pliers are carried out, which ensures minimal damage to the periodontal tissues. If it is impossible to extract the tooth root with dental pliers, then a drill is used.

The rejected root is removed after preliminary sawing of the bottom of the tooth cavity. After a drill with a spherical tip, the necessary cavity is created in the inter-root commissure for longitudinal sawing of the bottom of the tooth with a fursor drill. Further, in the prepared cavity, with the help of an elevator and bayonet-shaped dental pliers, the palatine root is dislocated.

The procedure for removing roots on the lower jaw is much simpler. For these purposes, as a rule, dental pliers with curves along the edge and with thin and narrow cheeks are used. Extraction of the roots of wisdom teeth is carried out by surgeons with the additional use of an elevator.

Complications

Flux is one of the complications after tooth extraction.

Manipulation for the extraction of the roots of the tooth is quite traumatic and complex. Therefore, often due to the physiological characteristics of the body, or unprofessional actions of the surgeon, the following difficulties may arise after this manipulation:

• Infection of adjacent teeth and soft tissues.
• The spread of inflammation to the ligamentous apparatus with the gums and teeth.
• Chronic inflammation will provoke the development of periodontal disease and other dental pathologies.
• The formation of flux, phlegmon or cysts.
• Severe pain that can last for several days.
• Swelling and inflammation of the soft tissues of the periodontium and face.
• The manifestation of pain when swallowing.
• Problematic mouth opening.
• Rapid rise in body temperature.
• Bleeding gums.
• Suppuration of the alveoli.
• Loss of sensation in the jaw area.

Attention! If the slightest signs of inflammation appear after extraction of the tooth root, you should immediately visit a doctor to correct the therapeutic course and prevent the development of serious complications.

How painful is manipulation?

High-quality anesthesia makes the procedure painless.

Many patients are interested in whether it hurts to pull out the roots of the teeth? The duration of the operation depends on the clinical picture of the condition of the tooth and the root itself. Its location also plays a significant role. On average, with the high professionalism of a dental surgeon, such an operation lasts for half an hour. But, if a complex extraction of the root of the wisdom tooth is carried out, then the time of such manipulation can be delayed by 90 minutes or more.

In modern dentistry, when extracting the root of a tooth, strong anesthetics are used, under the influence of which pain is not felt at all. They are selected for any pain threshold. The effect of such drugs is enough not only for the operation itself, but also for two hours after it. Also, depending on the complexity of the manipulation, general anesthesia can be performed.

Important! The selection of anesthesia should be carried out exclusively by a doctor, taking into account the patient's state of health and his age category, as well as the complexity of the operation.

How much does it cost

The cost of tooth root removal depends on the status of the clinic and the qualifications of the doctor. As a rule, the price includes diagnostics, consultation with an anesthesiologist and, if necessary, other specialists, anesthesia, the operation itself, and the materials used.

The average cost of tooth root extraction in Moscow clinics is from 1800 to 5400 rubles.

Root removal at home

Removing the root of a tooth is a complex dental operation, it is forbidden to carry it out at home!

Despite the availability of modern methods for extracting the roots of teeth, many people are terrified of this procedure. Therefore, some of them decide to carry out this manipulation on their own at home.

For these purposes, they manage to use pliers. With his tongs, people try to grab the base of the root and thereby carry out its removal.

Naturally, such a resolution of dental pathology is unacceptable and unacceptable, since it poses a significant threat to health:

• Infection of the wound occurs, which can lead to the development of sepsis.
• Formed traumatic shock and stress shock.
• It is impossible to remove it completely. The fragments remaining in the wound rot, which contributes to the development of additional dental diseases.
• High risk of developing serious complications.
• There may be extensive bleeding.

Attention! If it is necessary to extract the tooth root, it is strictly forbidden to carry out the operation on your own, but you should immediately visit the dental clinic.

What is special about molar root extraction

Wisdom tooth root removal

Extraction of the root of the wisdom tooth refers to a number of complex and painful operations. This is due to its location, which runs along the longitudinal axis of the jaw. That is, the molars grow across the roots of the remaining teeth.

Therefore, the removal of the root of the molar must be carried out by the hands of a highly qualified surgeon. A prerequisite for this manipulation is the conduct of radiography, and in some cases, orthopantomography. The picture will clearly display the features of the placement of the root in the gum.

The doctor, based on the diagnostic results, selects the most appropriate method and tools for a successful operation. The duration of such manipulation is on average no more than one and a half hours. During this time, the patient:

• Strong anesthesia is administered, and general anesthesia may also be needed.
• Next, an incision is made in the gum tissue and extraction of the root of the tooth.
• After the alveolus is cleaned, treated with antiseptics and a special anti-inflammatory agent is applied to its cavity.
• If necessary, a drainage is installed for the outflow of purulent exudate.
• For deep periodontal incisions, suturing is performed.

Advice! To avoid the development of complications after extraction of the molar root throughout the entire recovery period, it is necessary to strictly follow all medical prescriptions and recommendations. You should also undergo a consultative examination on the third day.

Popular questions

• What are the features of the operation in the presence of overgrown periodontal tissues?

Tooth root overgrown with gum

Manipulation is carried out under general anesthesia by a surgeon in the presence of an anesthesiologist. First, a gum resection is performed, which opens access to the root and its canals. After a special tool, the root is extracted and the alveolus is treated with medication.

• What doctor does this?

Surgery is performed by a dental surgeon. If necessary, other narrow specialists may be involved for a consultative examination.

• Do I need to remove the roots with caries or treat?

The expediency of therapy for this pathology is determined by the dentist in each case individually according to the results of x-ray examination. The main indication for the extraction of the root of a tooth affected by caries is its damage by more than 50%. In other cases, treatment is carried out by installing an inlay and a special artificial crown.

• How is a cyst removed from the root of a tooth? Granuloma?

Removal of a cyst or granuloma is carried out by surgical intervention. For this, depending on the indications, the following methods are used: cystectomy, hemisection, cystotomy, laser extraction. In the presence of purulent exudate, after opening the granuloma, drainage is performed.

• Is it necessary to remove the roots of milk teeth?

Extraction of the roots of milk teeth is not recommended. Significant evidence is required for this manipulation. These experts include severe carious tooth decay, an advanced stage of periodontitis, pulpitis or fistula on the gums, the formation of a cyst on the root of the tooth, as well as inflammation and rapid infection.

• What technique is used to extract the pin from the root of the tooth?

This manipulation is carried out using ultrasound. Under its influence, it is possible to carefully loosen the structure without damaging the natural tissues of the hidden part of the tooth.

• Why is the cheek swollen after this manipulation?

The main reasons include: the complexity and high traumatism of soft tissues during the operation; the development of an inflammatory process or suppuration; unprofessional root extraction, the body's reaction to certain medications; the appearance of a hematoma due to fragile capillaries.

• How is the extraction of the root of the tooth from the maxillary sinus?

First of all, its bottom is perforated, followed by endodontic treatment. Thanks to this technique, the hard tissues of the hidden part of the tooth are gently affected during its extraction.