How to pull out a bad tooth at home. Self-extraction of a tooth: how to do it right? How to calm down and tune in the right way

In absentia determine the indications for removal of molars not possible, this requires an examination by an experienced dentist. Extraction recommendations are:

• purulent periostitis with the impossibility of outflow of exudate through the root canal, abscess, phlegmon;
• purulent-inflammatory diseases of the periodontium, cystic formations, the presence of a tumor;
• longitudinal axial fracture of the dental crown, pulp exposure;
• destruction of the crown, excluding its reconstruction;
• incorrect position of the tooth, as a result of which the mucous membrane is injured or it is impossible to install an orthopedic prosthesis;
• diseases in which destructive changes occur bone tissue;
• advanced inflammation paranasal sinuses nose, sinusitis

Molar tooth extraction procedure

Exist the following contraindications to delete:

• exacerbation of cardiovascular disease preinfarction state, angina pectoris, arrhythmia, hypertension);
• acute respiratory viral diseases (including influenza and tonsillitis);
• general diseases of the body kidney failure, pancreatitis, infectious hepatitis);
• damage to the nervous system;
• the presence of neoplasms, hemophilia, leukemia, radiation sickness;
• first and recent months pregnancy;
• inflammatory dental diseases(gingivitis, stomatitis);
• exhaustion of the patient's body, dystrophy;
• alcohol intoxication.

Only a doctor has the right to decide on removal, carefully weighing all the pros and cons.

How the removal process works (video)

Before removing a diseased tooth, the doctor must X-ray, which allows you to determine the location of the roots. Removal takes place with an anesthetic injection.

The doctor carefully separates the gum, grabs the tooth with forceps and begins to pull out, swinging or scrolling it, depending on the number of roots. After that, you can pull out the tooth from the alveoli. The extraction of the lower and upper teeth is not much different, the upper molars are somewhat more difficult to capture correctly.

In more advanced cases doctor can share dental crown into pieces with a drill and tear them separately. This method helps to protect the jaw from damage.

Unambiguous indications for extraction in children are:

1. the presence of a granuloma or cyst of the tooth root.
2. inflammation of the tooth root, mandibular nerve.
3. complete destruction of the crown.

Possible consequences and complications

Extraction, like any operation, can cause backlash organism. If the cheek is swollen, the throat hurts, there is a sharp throbbing pain in the hole, the likelihood of an inflammatory process is high.

Early complications:

• fainting, shock, collapse;
• fracture, dislocation of the jaw;
• perforation maxillary sinus(when removing the upper molar or premolar), falling root fragments into the gum;
• trauma, dislocation, fracture of an adjacent or opposite tooth;
• severe bleeding, hematoma formation.

Late complications:

• inflammation of the alveoli (alveolitis);
• inflammation of the peripheral nerves (neuritis);
• limitation of jaw movement (muscle contracture).

At timely handling to a specialist, the consequences of removal can be minimized.

Is it possible to remove at home

It is dangerous to remove a tooth on your own, at home it is difficult to ensure sterility, anesthetize the gums, monitor the complete pulling out of the root, prevent blood loss and other complications. Most without risk to health, you can only remove a very loose tooth.

Usually loose baby teeth are removed at home for children. It is important at the same time to remove food debris, to disinfect the oral cavity well. It is necessary to tightly grasp the tooth with fingers wrapped in sterile gauze, loosen it well and only then pull it. If after the second attempt it was not possible to pull out the tooth, entrust this difficult manipulation experienced dentist without risking your health.

If the tooth easily comes out of the hole, it is necessary to firmly press the gauze pad to the wound to stop the bleeding, hold for 30-40 minutes. You should refrain from eating for two hours.

When any unpleasant discomfort it is advisable to consult a dentist as soon as possible in order to prevent the development of complications.

Finally, I would like to remind you: simple preventive measures will allow you to keep your smile snow-white, and your teeth healthy and strong for many years.

How to pull out a tooth at home without pain, so as not to harm your health and not provoke complications - preparatory stage and carrying out the procedure in different ways.

Tooth extraction requires preparation and skill

Preparation for the procedure

Pulling teeth at home is dangerous, there is a high risk of infection in the wound or bleeding.

Rules for everyone to follow:

1. Find out the condition of the problem tooth. If it wobbles when you touch it with your tongue, it makes sense to try to pull it out of the socket of the jaw. In the case when the tooth is firmly held in the gum, it is better not to extract it yourself.
2. Disinfect the oral cavity - clean with a paste, rinse with an alcohol-based antiseptic.
3. Anesthetize. Maximum painless procedure You can do it if you drink a strong analgesic 20 minutes before the start. For children, it is better to use external agents (gel), which are rubbed into the gums and begin to act after 30–50 seconds.
4. Wash hands with soap and dry with a towel.

Rinse your mouth with an antiseptic before the procedure.

It is important to prepare mentally. A person must decide for himself whether he can quickly and sharply pull out a tooth, and whether he has enough willpower.

Pulling out at home requires the following items:

• containers for spitting blood clots (deep plate, small basin, bucket);
• hygiene items - gloves, napkins from a bandage folded several times, gauze, cotton wool or cotton pads (at least 10 pieces), hydrogen peroxide and alcohol;
• gel for local anesthesia- Asepta, Dental, Denton, Kamistad;
• analgesics (for an adult) - Ibuprofen, Analgin.

How to extract a tooth without pain at home?

At home, you can pull out both a milk tooth for children and an indigenous adult.

This applies to:

• fangs;
• chewing (“five”, “six”, “seven”);
• anterior incisors;
• rotten areas.

The main thing is to strictly observe the basic rules of such a procedure at home and monitor sterility.

Extraction of a milk tooth for a child

Children are most afraid of doctors, especially dentists. For this reason, pulling out milk incisors or canines occurs at home. There are ways that help not to injure the baby and protect the child from stress as much as possible.

Pulling without thread

In order for a loose tooth to fall out faster, you need to loosen it with your hands and quickly pull it out. If the child is not given, you can tell him a fairy tale about the tooth fairy or come up with a game in which he himself must gradually loosen the diseased incisor. Fascinated by the new activity, the baby will endure the removal process more calmly and in the future will be less afraid of such procedures.

Before extraction, the milk tooth must be loosened

Thread method

You will need a strong thread 20–30 cm long. One end must be tied to the base of the incisor (fang), and the other must be picked up. At this time, it is important to distract the child with an interesting story, a toy (something like - a helicopter or a car will take a tooth, and in return bring a gift), do flick hand on yourself. It is important to pull yourself, without tying the thread to doors or other objects, as older people like to advise.

It is important not to touch the skin and gums with a rope, otherwise you can injure soft tissues, provoke open wounds and bleeding.

You need to pull the thread yourself, and not tie it to doors and other objects

After the end of the procedure, the child should thoroughly rinse the mouth (possible with Chlorhexidine) 3-5 times a day for a week. Immediately after removal, apply a cotton pad or gauze pad to the wound. Eating is allowed after 2-3 hours. It is better to start with liquid food (vegetable and fruit purees, yogurt, kefir).

Extraction of molars

Permanent teeth are more difficult to remove on their own than milk teeth. The root is deeply attached to the bone tissue, and even a loose canine or incisor is not easy to pull out painlessly. In order to avoid undesirable consequences (infection in the wound, trauma to neighboring teeth, inflammation), removal should be carried out if the tooth is loose and almost fell out by itself.

1. Depending on the placement of the object to be removed (front incisor, canine, chewing), it must be wrapped with gauze on both sides.
2. The procedure should be carried out slowly, gradually loosening the tooth, and periodically trying to pull it out of the gums. Slow movements ensure safe extraction of the injured area without splinters.
3. Apply a swab soaked in an antiseptic to the wound and firmly squeeze the jaws.

The molar tooth must be gradually loosened before removal.

During the procedure, blood may ooze from the injured area. You need to wipe it with a gauze napkin, pre-treated in an antiseptic solution.

To avoid swelling and bleeding, the mouth should be rinsed after extraction of the tooth. disinfectant, and to the cheek for 5-7 minutes (you can’t take longer, otherwise you can catch a cold sore spot) attach cold compress. Eating is best done after 4-5 hours. This will allow the wound to heal a little, and will not provoke re-bleeding.

Wisdom tooth extraction

Wisdom teeth or "eights" are very difficult to remove, as they have deep roots and are inconveniently located on the jaw. To pull it out to someone, and even more so to oneself, is unrealistic. Even if you follow the instructions correctly, you can seriously harm your health - crumble a tooth, leave fragments of the root in the gum, break the bone tissue of the jaw. All this can lead to severe inflammatory and purulent processes. Therefore, wisdom teeth should be extracted only in a hospital from highly qualified specialists.

Regardless of which tooth needs to be extracted, it is important to remember that pulling should only be done when it is very loose. Under no circumstances should you use forceps, pliers, otherwise you can damage the gum or break the root, leaving part of it inside.

Possible Complications

Extracting teeth at home is always dangerous.

Failure to follow the basic rules of manipulation can cause serious consequences:

• infection and inflammatory processes, which are accompanied by redness and swelling of the soft tissues;
• prolonged bleeding;
• increase in body temperature;
• the presence of a root fragment in the gum or a crack in the jaw;
• suppuration of the wound, the appearance bad smell from mouth;
• pain syndrome, which gradually increases.

If the tooth is removed incorrectly, it is easy to infect

If after self-extraction of a tooth there are discomfort, important immediately . Otherwise, you can provoke blood poisoning or severe inflammation in oral cavity.

To pull out a tooth with virtually no pain at home is possible when it comes to milk teeth or molars, but very loose. If you follow specific recommendations, you can quickly get rid of unpleasant discomfort in the mouth. It is impossible to carry out the procedure completely without pain, but it is quite possible to reduce discomfort as much as possible. It is impossible to remove fangs or incisors, as well as “eights”, firmly seated in the jaw socket, otherwise irreparable harm to health can be caused.

• How can you transfer the procedure of tooth extraction with minimal loss to your health, nerves and wallet;
• Why teeth sometimes have to be removed and what indications the dentist-surgeon is guided by, passing the appropriate verdict;
• In what situations is it better to wait a little with the extraction of a tooth or not even remove it at all;
• What are the stages of the procedure and what awaits you in the dentist's office;
• Is it possible today to remove teeth without terrible forceps, without pain and with minimal trauma;
• How difficult and lengthy can be the removal of problematic teeth - impacted, semi-retinated, resorcinol-formalin and even ordinary molars, but with specific roots;
• How can the patient help the attending physician so that the tooth extraction goes smoothly;
• What to do if you need to urgently remove a tooth at night, on weekends or holidays;
• Is it possible to remove teeth in hospitals today for free and what is often hidden behind the cheapness of the service ...

Tooth extraction (extraction) is considered a dental operation and involves surgical intervention. In other words, when you go to extract a tooth, you go exactly to surgical operation, and therefore, this procedure should be taken with all responsibility.

Next, we will consider many nuances that will help an ordinary unprepared person go through this test with minimal loss to the nerves, wallet and health (mistakes and negligence of the patient can lead to very serious consequences).

On a note

Situations are different: sometimes a tooth has to be removed urgently, sometimes it is planned, but in both cases the question immediately arises: which dentist is more appropriate to contact? Which doctor can most competently and painlessly remove a tooth?

Someone can immediately say without hesitation that you need to contact a dentist-surgeon. On the one hand, this is the correct answer, but in practice things may not be so simple. The fact is that in clinics, hospitals and even in private dentistry often there is a situation where one dentist works for mixed reception. That is, it treats (preserves) teeth that can still be saved, and also removes “bad” teeth, professional cleaning teeth, and in addition, the same doctor is also engaged in prosthetics of missing teeth. In total, we get 2-3 or more specialties “in one bottle”. Is it worth contacting such a specialist?

Of course, everything depends on the professionalism of the doctor and his experience, but in practice, most dentists focus on one area of ​​work, having significantly less experience in other areas. For example, there are dentists at a mixed reception who devote a lot of time to dental treatment, but the removal is not very high quality. Here much still depends on the complexity of the work ahead. But after an hour and a half of torment, during which the doctor cuts, drills and even chisels with tools, it is unlikely that any of the patients would like to hear that, they say, the tooth is too complex and cannot be removed (it happens).

That is why it is best to remove a tooth from a dentist-surgeon who specializes only in this manipulation in its various forms.

In addition, there are also maxillofacial surgeons - relatively speaking, they are even higher in level than dental surgeons. These specialists are not limited in their work to “pulling out” teeth (even the most difficult ones), but can also help with injuries. maxillofacial region, dangerous complications periodontitis (periostitis, osteomyelitis, abscess, phlegmon, lymphadenitis), congenital and acquired deformities, TMJ diseases, tumor processes, etc.

For example, with significant problems with opening the mouth, when it is necessary to remove a wisdom tooth with diffuse swelling of the face and neck, dislocation of the jaw or fracture, it is worth contacting maxillofacial surgery.

Why do teeth sometimes have to be removed?

Before performing a tooth extraction, the dentist determines the indications for this in advance, that is, weighs all the pros and cons. There are such clinical situations when a tooth can be considered controversial - this means that a dentist, even taking into account the available indications, cannot unambiguously say whether it is worth the risk of saving it, or still remove it from harm's way.

It is not uncommon for situations when in one clinic they offer to immediately pull out a bad tooth, and in another they undertake to save it.

On a note

Sometimes, in order to recognize a tooth as subject to extraction, a council of dentists of various profiles gathers: a therapist, surgeon, orthopedist, orthodontist, periodontist.

How to explain such uncertainty in dental practice?

In life, as you know, everything is not as simple as it may look in books and textbooks. The indications and contraindications for tooth extraction that exist today were developed back in Soviet times by reputable scientists, and most of of them has moved into modern protocols that guide dental surgeons in their practice. However, they may not always be suitable for a specific clinical situation, and there are a number of reasons for this:

• Improving equipment, instruments and methods of dental treatment increases the chances of saving teeth, sometimes contrary to existing protocols;
• At the same time, thanks latest methods diagnostics and modern approaches in dentistry, a dentist alone or collectively may decide to extract a tooth, even if there are indications for its preservation.

The following are examples of the main indications for tooth extraction:

1. Failure of endodontic treatment in the periapical region inflammatory focus(in other words, when a cavity with pus has formed on the root of the tooth, and healing procedures have no effect)
2. Emergency cases - sick teeth, which are the source of an active microbial process, not subject to treatment and provoking diseases such as periostitis, osteomyelitis, abscess, phlegmon, lymphadenitis, sepsis, etc.;
3. Technical difficulties associated with curved or hard-to-pass canals, leading to the impossibility of conservative treatment, as well as perforation of the tooth cavity or root wall;
4. The location of the teeth, leading to permanent trauma to the oral mucosa or tongue;
5. Tooth mobility of the third degree and its extension due to bone resorption in periodontitis or periodontitis;
6. Location in the fracture line (teeth that interfere with the reposition of fragments and are not subject to conservative treatment);
7. Complete destruction of the tooth crown when it is impossible to use the root for orthopedic purposes;
   
8. Supernumerary teeth interfering with prosthetics or causing injury soft tissues that violate the aesthetics and chewing;
   
9. Protruding teeth with the loss of the antagonist, as well as those that interfere with the creation of a functional prosthesis;
10. In case of bite anomalies, according to orthodontic indications, even teeth that are not affected by caries can be removed;
11. Some types of root fractures as a result of mechanical trauma.

Wisdom teeth are a separate category, which a number of dentists recommend removing in urgently, and other doctors suggest trying to keep them, even at some risk of complications.

On a note

There are situations when orthodontic treatment (for example, on braces) cannot be started without the removal of wisdom teeth, even if they have completely erupted and do not interfere with the bite.

The same ambiguous situations often arise in relation to the preservation of teeth, for example, when it is impossible to pass root canals, perforate the wall, or break off an instrument in the canal. In one clinic, the extraction of such a tooth may be recommended, and formally this falls under the indications, while in another dentistry they may offer to save the tooth with the help of the latest technologies(for example, a microscope plus removal of instrument fragments from the canal using ultrasound).

In other words, when removing teeth, it is very important individual approach, common sense and medical logic, combined with the experience and professionalism of a doctor. And not a simple old-fashioned method of chopping from the shoulder, which took place in Soviet times, not from a good life: a tooth is badly damaged - under the forceps, there is no third channel - under the forceps, a slight edema appeared in the area of ​​​​the transitional fold in the projection of the tooth root - also urgently "Tear out" without waiting for periostitis.

Such antediluvian tactics (which, unfortunately, are still sometimes found in some polyclinics by patients tired of the flow and low salaries of doctors) are currently unacceptable and fraught with negative consequences in patients.

Situations when you can wait a little with the extraction of a tooth or not remove it at all

Despite the variety of options for tooth extraction noted above, there are also many situations when problem tooth it is better not to delete or wait with it.

The most common situation is related to pediatric dentistry, when parents of babies with a carious lesion of a milk (temporary) tooth strongly demand that the tooth be pulled out, accompanying this with something like this: “It will fall out anyway - why treat it?”.

This logic is too straightforward and does not take into account the fact that the change of teeth should normally occur at an appropriate age: symmetrical groups of teeth gradually become mobile and in many cases fall out on their own. If the tooth is removed prematurely (even a year earlier), then there is a high risk of malocclusion and the development of anomalies in the eruption of permanent teeth.

In other words, with the early removal of milk teeth (especially multiple), future permanent teeth they can literally “spread” in different directions, or even not erupt in a single or group version. No sane parent needs such a prospect, therefore it is better now to save the child from surgical intervention by curing caries or its complications, rather than later investing effort and money in correcting the bite and the child's psyche.

On a note

However, there are clinical situations where acute conditions, health threatening and the life of the baby, require immediate removal temporary tooth. Or when the tooth can no longer be saved even with modern methods of treatment.

As for the impossibility of cooperation between a child and a doctor at the stage of dental procedures: there is not only treatment and extraction of teeth under anesthesia, but also various forms superficial sedation and premedication, allowing the procedure to be carried out as comfortably as possible and to minimize the possibility of a child's fear of a white coat in the future.

Cases when a person wants to pull out an innocent tooth are quite common in adult dentistry, especially among men and women over 45-50 years old. This is largely due to old memories of the remnants of Soviet dentistry, when a tooth, at any opportunity (even with caries), was sent under forceps. Until now, such categories of citizens often get an appointment, especially in budget (free) dentistry with requests or even demands to remove a tooth in case of caries or pulpitis.

For example, a tooth began to hurt from cold, hot, sweet, or night pains of a aching nature had just begun, and the patient was already negatively disposed to the treatment of the tooth. The motives can be different: from “love to pull out teeth” (quickly, inexpensively and there is no terrible drill with its sound) to 100% certainty that after treatment the tooth will still have to be removed (the negative experience of past decades, when teeth were treated for a long time, but in the end, I still had to apply for removal).

So, what is important to keep in mind: modern dentistry has long crossed out these prejudices. Now, not only with caries (even deep) and pulpitis, but also with most periodontitis, the teeth are treated remarkably, and they do not need to be rushed to be removed at all. And even if the tooth, it would seem, has broken at the root, it is not yet a fact that the root will need to be removed, since it is quite possible to restore the functionality and aesthetics of the tooth with the help of a root inlay and a crown.

Stages of tooth extraction: how it all happens in most cases

After the decision to remove the tooth is made in accordance with the indications, the stage of preparation for the procedure begins.

The photo below shows an example of a broken anterior tooth to be removed:

The nature of the preparation depends on the characteristics of the future manipulation (under or without anesthesia, with or without premedication), but the most basic steps include:

1. Collection of anamnesis (especially allergic status);
2. Psychological preparation of the patient (many are afraid, so it is important for the doctor to calm the patient and set him up in a positive way);
3. Medical preparation of the surgical field (rinsing the mouth with antiseptics, treatment of the injection site).

On a note

It is recommended to sign up for tooth extraction in the morning, when you and the doctor are still full of energy. If anesthesia or sedation is not planned, then it is better to eat well before the procedure - this way you will have more strength, and the blood will clot better.

If it is possible to remove a tooth with forceps, then the removal is called simple, and it is carried out in several stages:

In some cases, sutures may be required.

To remove the tooth was not painful, both domestic anesthetics (for example, Lidocaine) and imported ones (drugs of the articaine series) can be used. The most effective today are recognized as "artikain", however, it is also very important correct technique anesthesia - much depends on the level of professionalism and experience of the doctor.

Today in dentistry there are different variants anesthesia during the extraction of a diseased tooth. During conduction anesthesia, a group of teeth is “frozen”. A good example is the torusal or mandibular technique: during its implementation, the patient does not feel the lip, the tip of the tongue and the cheek on the corresponding side.

Infiltration anesthesia is done in the projection of the tooth root onto the gum: in this case, freezing occurs only in the removal zone: this is almost always enough for everyone upper teeth, as well as the lower ones - from the first to the fifth. For 6, 7 and 8 lower teeth infiltration anesthesia will not be enough, so a torusal is done. If this conduction technique is not done or done poorly, then during the removal of the lower large molars it can be very painful.

Of the modern methods, intraligamentary anesthesia (intraligamentous) can also be noted. It is done with a special syringe and has a lot of advantages (does not cause facial numbness, comes on quickly, lasts for 20 minutes, which is enough for most outpatient removals).

For difficult removals, anesthesia is sometimes used. A characteristic difference complex removal of a tooth from a simple one, in addition to the time it takes, is the use of a drill (for sawing a tooth into pieces, cutting out a bone), screws, ligatures and some other specific tools (sometimes a tooth is literally split into pieces with a chisel and hammer).

The photo below shows an example of a tooth sawn into three parts using a drill before removal:

On a note

It is not always possible for a dental surgeon to determine in advance whether a tooth extraction will be difficult or simple. In many cases, the doctor can only roughly guess which tooth should be expected to have difficulties, and which one will almost “jump” out of the hole during removal.

Sometimes a specialist immediately sees potential complex tooth(resorcinol-formalin, semi-retinated, retinated, with specific roots) and warns the patient in advance that the procedure will be difficult and slow.

“The day before yesterday I removed the lower wisdom tooth. It was a real nightmare ... For more than an hour they sawed a tooth, hollowed it out with a hammer, broke out the roots, almost broke the jaw. They cut the bone and turned everything there completely. The most terrible feeling is when the doctor tried to break out a tooth several times, I thought that he would dislocate or break my jaw. All four roots of the tooth stuck out in different directions, so it was removed badly. Now half of my face is swollen, the pain is terrible, I can’t swallow normally and open my mouth. The doctor said that he had not seen this for a long time ... "

Natalia, Moscow

Option to remove teeth without "terrible" forceps: ultrasound technique

In order to minimize tissue injury during tooth extraction, and therefore to speed up and make the subsequent healing process more favorable, there is a so-called atraumatic method of tooth extraction. Such removal could be classified as complex, but the application additional funds(drill, periotome, etc.) in this context, on the contrary, simplifies the procedure, reduces it in time and makes it minimally traumatic.

Suppose the patient has a severely damaged upper sixth tooth (at the level of the gum or even under the gum), however, the roots do not exist independently, but are connected into one whole. With the help of a drill, the crown part of the tooth in the middle is carefully sawn out: in this case, each root becomes independent. Periotome allows you to quickly and accurately remove them without damaging the septa, walls of the alveoli, as well as the gingival margin.

The photos below show the individual stages of the atraumatic method of removing three teeth at once with a preliminary cut:

On a note

If, however, only forceps are used in this case, then the cheeks of the forceps would have to be advanced deep under the gum in order to “loosen” and “dislocate” the soldered roots. In 50% of cases it will work, but with varying degrees breaking off the outer and inner wall holding the root. After such root removal, uneven or sharp bone tissue remains, creating new problems for both the doctor and the patient.

Often with forceps removal complex teeth cannot be carried out at all, and the result is only a waste of time and useless “biting” with forceps of both the alveoli and the roots.

Atraumatic tooth extraction can also be accompanied by the use of ultrasound. It is this technique that modern clinics are currently actively using as a "know-how". The piezosurgical apparatus allows, using an ultrasonic scalpel, to separate the periodontal ligaments that hold the tooth bloodlessly and remove it from the hole.

The main advantages achieved by tooth extraction using ultrasound:

• Bloodlessness;
• Acceleration of work;
• Antiseptic effect;
• No overheating;
• Help in the removal of complex teeth (impacted, semi-retinated, dystopic, resorcinol-formalin).

This type of atraumatic tooth extraction is ideal for subsequent immediate implantation, when the implant is installed immediately in a fresh hole.

Features of the removal of potentially problematic teeth (impacted, semi-retinated and resorcinol-formalin) - should we be afraid?

To remove impacted and semi-retinated teeth (i.e., not erupted or erupted only partially and largely hidden in the jaw bone), as well as resorcinol-formalin teeth (that is, previously treated with resorcinol-formalin paste and become brittle because of this), the doctor can apply as anesthesia, if there are indications for it, and local anesthesia.

Most often, these teeth are removed under local anesthesia.

The picture below shows an impacted wisdom tooth:

From the practice of a dentist

Some budget dentists (especially in small towns and villages) who work on a mixed basis (therapy plus surgery) are afraid to remove teeth from this category. Seeing a semi-impacted or, moreover, impacted tooth (according to the picture), they can immediately refuse to remove it and send the patient to maxillofacial surgery at the nearest regional clinic or dental center. The motivation for this can be both unwillingness to mess with these teeth (the procedure may take 1-2 hours of painstaking work), and the fear that the lack of experience and tools will not allow you to remove all the roots - which means that the exhausted patient will still have to be sent to another a more qualified dentist.

Stages of complex tooth extraction:

1. Preliminary preparation (premedication, treatment of the surgical field, etc.)
2. Anesthesia (general or local);
3. Creation of access to the removed tooth;
4. Instrumental technique to improve the conditions for the "dislocation" of the roots of the tooth;
5. Extraction of roots;
6. Hemostasis;
7. Preservation of the hole to prepare for implantation (according to indications);
8. Suturing (according to the situation);
9. Appointment of recommendations.

Creating or improving access to a tooth involves the use of elevators, a periotome, trowels, a drill with a set of burs and cutters, and (rarely) chisels and a hammer. After partially creating access to the tooth to be removed (gingival retraction, flap detachment), the tooth is removed with an elevator, and if this is not possible (as with impacted ones, for example), then the alveolus bone is sawn with cutters in the projection of the tooth location. At the same time, cooling is applied to the area being prepared, since the bone tissue should not overheat, otherwise necrosis will develop.

When the tooth to be removed becomes visible, the surgeon can immediately begin to use elevators to “pick up” it. Often, the tooth can be sawn (or split) into pieces to make work easier.

On a note

How long can such a complex removal take? Depending on the complexity of the procedure, the availability necessary tools and the experience of the doctor, the procedure can take from 10 minutes to 2 hours.

After extracting the diseased tooth and removing the granuloma or cyst (if any) from the hole, suturing is performed and recommendations are made. In a number of situations, the well is preserved before subsequent implantation so that there is no atrophy bone walls. For this, natural bone substitutes are used, or synthetic (inorganic bone matrix).

After a complex tooth extraction, the doctor must prescribe home treatment for maximum comfort postoperative period and prevention of alveolitis, which may include drugs of various directions:

1. Painkillers (Ketorol, Ketanov, Nise, etc.) for pain relief in the first days after surgery;
2. Antibiotics and sulfa drugs(for liquidation bacterial infection in the maxillofacial region);
3. Antihistamines (to reduce swelling and other manifestations of the inflammatory response);
4. Preparations for rinsing and treatment of the removal area (gels, ointments) with anti-inflammatory, wound healing, analgesic, antiseptic and antibacterial action.

On a note

Generally speaking, the list of recommendations that exists in the arsenal of Russian dentists is huge, and each dentist adheres to his list of necessary postoperative treatment. Someone prescribes the same thing to each patient, while someone has an individual approach (which is the most correct).

But it should be borne in mind that some dentists may not say anything at all to the patient, even as parting words or advice. If you had a tooth removed and were not given recommendations, be sure to ask for them, or find out from another doctor, as this helps to avoid unnecessary anxiety and very unpleasant complications.

How to help your doctor so that a tooth extraction goes smoothly

Despite the fact that anesthesia is used in dentistry before tooth extraction, there is always a risk that the procedure may not go as smoothly and painlessly as we would like. Often this is due to the fact that the patient is not ready for the procedure and behaves not quite correctly.

Let's see how to prepare for tooth extraction, in order to at least help a good doctor to carry out the manipulation without any problems.

Firstly, surgical intervention on a “neglected” tooth, when the stage acute process reached its climax (because of the pain you can’t even touch the root, a “flux” has arisen) is tolerated in many cases much worse than the planned removal of a “calm” tooth. Moreover, in this context, it does not matter which particular tooth will have to be removed: the root (six, seven, eight) or some front tooth is to be removed.

It is not difficult to imagine what unforgettable emotions a patient (as well as a doctor) can experience when you have to remove a diseased tooth or its remains against the background of periostitis and other purulent complications when anesthesia almost does not work, and any touch on the tooth causes hellish pain. But the tooth needs to be loosened! At the same time, there is still a risk that the rotten crown part may break off, and you will have to separately “pick out” the roots ...

It is interesting

Often anesthesia is done in the projection of the root of the tooth, when pus is everywhere under the gum in this area. At the same time, the “sufferer” demands from the dentist-surgeon that everything be absolutely painless: “Give a strong injection, doctor, if only it doesn’t hurt!” However, it is immediately clear that where the pus is located, a priori they are “not happy” with the new solution: there is nowhere to put the existing exudate.

A bad doctor, as a punishment for such a patient who walked too long to the doctor's office, will simply inject the entire portion of the anesthetic at a time, and in terms of sensation, the procedure will be similar to removing a tooth without anesthesia, when there are already "sparks from the eyes" from pain. A normal surgeon will gradually inject the gum with an anesthetic in 2-4 stages, release milliliters of purulent fluid to eliminate pain during the administration of the drug and try to achieve stable anesthesia for painless tooth extraction.

So the patient's excessive patience before going to the doctor can give rise to a lot of problems. Therefore, if it is known for sure that a badly damaged tooth is to be removed, then it is better to get rid of it as planned: make an appointment and, in the absence of contraindications, once and for all end the problem before the tooth gets sick.

For tooth extraction ideal option will sign up for the morning:

There are a few more practical advice, which help the patient to safely endure the procedure for tooth extraction:

1. Before removing a tooth, you should eat well (unless anesthesia or sedation is planned). A well-fed person copes with stress better, faints much less often and blood coagulates better, which is important after the procedure;
2. Do not take alcohol for courage. The risk of edema and prolonged bleeding in drunk people it is increased, not to mention inappropriate behavior;
3. In case of great fear of the procedure or fear, you can resort to sedatives(Tenotene, tincture of valerian, motherwort, Corvalol, etc.) 20-60 minutes before surgery, depending on the activity of the agent. In this case, the choice of the drug must be coordinated with the attending physician or district physician and have an idea of ​​​​the measure (especially regarding alcohol tinctures, since their reception can smoothly turn into alcohol intoxication);
4. Good to have positive attitude. If you are initially set up for a successful outcome of the procedure, then almost always the removal goes well, and the healing time is as short as possible. How more people tells himself that nothing will work out and the more he winds himself up, the more anxiety he causes to himself and the doctor, sometimes simply because of anxiety wrong actions(use of unnecessary ointments, rinses, dangerous folk remedies etc.);
5. When planning complex operations(removing difficult impacted tooth, all wisdom teeth at once, etc.) it is recommended to consult with your doctor about starting anti-inflammatory, painkillers and even antibiotics before the intervention.

If the tooth is deemed unusable, then in emergency cases it is removed urgently. But there are situations when the patient is going to apply for a planned tooth extraction - in these cases, it sometimes makes sense to postpone the procedure.

1. SARS and acute respiratory infections in the active period;
2. Painful and heavy periods;
3. Cardiovascular diseases, when their treatment is accompanied by the intake of certain drugs (for example, anticoagulants - Warfarin, Xarelto, etc.);
4. Pregnancy (on some terms - an exclusively individual approach);
5. acute diseases ( acute appendicitis, acute pancreatitis and etc.).

It is not difficult to guess that after the disappearance of many of these conditions, you can safely consult a doctor about scheduled removal tooth.

What to do if you need to urgently remove a tooth at night, on weekends or holidays?

You can often observe panic among residents of large cities and metropolitan areas, when a badly damaged tooth suddenly starts to hurt on weekends or holidays. That is, emergency surgical care is required, and a person is squeezed within four walls and does not know where to go for a tooth extraction and what, in general, to do.

Meanwhile, no matter what day it is (Sunday, March 8, New Year or other holiday), since there is a 24-hour emergency service in cities dental care with the duty schedule of dental surgeons. It is enough to contact the regional dental clinic or a regional hospital with a department of maxillofacial surgery.

But not only in large cities there is an "ambulance" in dentistry. Even in the district center at night, on weekends and holidays, as patients say, it is possible to “pull” teeth after a preliminary call to the post. It usually looks like this: you call ambulance or to a medical assistant's post, you will find out the possibility of urgent tooth extraction. The specialist contacts the duty dentist, and he comes to the office within an hour to help you (if on holidays the dentist keeps his appointment according to the schedule until a certain time, then at night he most often has to be called).

As for the private sector, everything is much simpler here. There are dentists that are open 24/7. Doctors in such clinics work in 3-4 shifts, and are ready to remove a tooth at any time when required.

On a note

The night shift is popular not only with people caught off guard by pain, but also with late-night parents of toddlers who have toothaches. In addition, many people employed in business have free time only after 22:00, and some even after 00:00.

Is it possible to remove teeth in hospitals today for free?

But what about those people who do not have money to extract teeth in a private clinic? Moreover, the price for such services today varies, depending on the region and the complexity of the procedure, from 500 rubles. up to 20,000 rubles

Some may even be surprised high price- to pull teeth for 20 thousand rubles for one pulled out tooth? Isn't it too expensive?!

On a note

The fact is that 20 thousand rubles is also not the maximum for tooth extraction, since there are complex clinical cases requiring an increased investment of time and materials.

Usually, an additional mark-up is made for the following types of removal (the following are the wordings from the price lists of the clinics):

• "Atypical tooth extraction" (that is, complex);
• "Laser" (using a laser scalpel);
• "With the use of ultrasound";
• "Without tongs";
• "In a dream" (anesthesia or superficial sedation).

The list can be continued and expanded. Moreover, for example, under atypical removal in clinics, they often mean not only complex extractions of teeth, but also the removal of any wisdom tooth in general, even if the removal is simple. This is most often done for commercial purposes, as a kind of fear-mongering in patients about wisdom teeth allows you to set a higher price in the price list for getting rid of them.

So is it still possible to remove a tooth cheaply?

First, given the great competition, private dentistry exposes different prices for the same service, and the price can be very democratic, regardless of what kind of tooth it is: a canine (or as it is often called by patients, " eye tooth”), wisdom tooth or any other chewing. It happens that in one clinic you can remove a wisdom tooth for 1000 rubles, and in another they will offer a price of 5000 rubles.

And there, and there, the removal is paid, and the main question that confronts the patient is whether it is possible to trust a more budget option?

According to the recommendations and reviews of relatives, friends and colleagues, you can almost always find professional doctor which is good for removing teeth. Whose office wall, though not hung with dozens of certificates and letters, but who knows his job well and is attentive to the patient. There are small private offices where they can remove a tooth for 500 rubles painlessly and efficiently without cheating for coffee, magazines, leather chairs and other surroundings.

Another thing is that you need to go to such a specialist on the recommendation of trusted people, and not just go to remove a tooth in the first clinic that comes across, where they will offer the lowest cost of the service.

Is it possible to remove a tooth qualitatively, but for free?

Free cheese (especially in dentistry) can only be in a mousetrap - perhaps this is the first thing that can come to mind in such a case. However, annually free surgical care receive hundreds of thousands of citizens under the usual compulsory medical insurance policy.

The principle is as follows: a person who is attached to this institution applies to a hospital or clinic at the place of residence for the purpose of removing a tooth. He gets a ticket to the dentist, and he removes one or more decayed teeth for free using this coupon. If there is no attachment, and the coupon does not pass through the computer, then, of course, you can also remove the tooth, but for a fee.

If the dentist cannot perform the extraction (for example, we are talking about an impacted or resorcinol-formalin tooth, or there is diffuse edema life-threatening, pediatric specialization is required, etc.), then the patient has the right to receive a referral for free help, where the medical institution, the referral diagnosis according to ICD-10 and the need for this or that manipulation will be indicated.

On a note

There is also a list free drugs, which the dentist under the MHI policy can provide to the patient at the stage of assistance. This is especially true for anesthesia.

Not all hospitals (especially in villages, settlements, small towns) are regularly and in full allocated the necessary materials. Most often supplied domestic drugs for anesthesia (Lidocaine, for example), although today there are even anesthetics of the articaine series on the list under compulsory medical insurance, which, however, practically do not reach the addressee. In order to work as comfortably as possible and be able to provide high-quality anesthesia to the patient without risking his health, dentists are forced to extract a tooth for a fee, where a person pays money for " good shot". Of course, it's cheap compared to private clinic, and costs about 100-400 rubles, depending on the region.

But this does not mean at all that free tooth extraction “under lidocaine” will necessarily be painful. Free removal in many budgetary institutions can mean increased risks, starting from the fact that the anesthetic injection will be made on hastily and will not work as expected, and ending with a long queue of the same sufferers in the corridor for many hours, with the likelihood of getting a three-story obscenity from a tired surgeon for any inaccurately spoken word.

So here everyone chooses where to apply for a tooth extraction and how much he is willing to pay for this service. In conclusion, we can only note that having decided on the budget, you should not look for a clinic, but first of all good doctor- this will be a guarantee that the extraction of a tooth with high probability it will be almost painless and without any problems.

Be healthy!

An interesting video with an example of atraumatic tooth extraction by ultrasound

What to do after tooth extraction to avoid complications

Many people are afraid to extract their teeth because of 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.

To date, dentists prefer tooth-preserving technologies. However, there are situations when removal cannot be avoided. Specialists highlight the following reasons forcing the doctor:

• a process of destruction that does not help conservative methods treatment;
• lack of effectiveness medical 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, the installation of braces);
• preparing the patient's jaw for prosthetics.

Strong destruction - serious reason for removing

Why pain occurs

The intensity of the pain syndrome is influenced by the following factors:

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

The number of roots affects the intensity of pain

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

Oksana Shiyka

Dentist-therapist

Currently, the removal process, although it is unpleasant, however, allows you not to endure the forced pain syndrome. The type and dose of anesthesia is selected for each visitor to the dental clinic individually.

Methods of anesthesia

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, adjusting to individual characteristics patient.

Doctors of modern dental clinics resort to the following ways anesthesia:

• application anesthesia, in which the mucous membrane of the area where the affected tooth is localized is treated with a local anesthetic solution;
• infiltration anesthesia, which means injection under the mucosa;
• conduction anesthesia, in which the anesthetic is injected directly into the nerve;
• general anesthesia, which is recommended if other methods of anesthesia 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 do a tooth extraction without anesthesia.

The video shows the process of introducing local anesthesia:

How is the removal

Operational removal takes place in several stages:

1. To begin with, the affected tooth and nearby tissues are treated with an antiseptic for disinfection.
2. Anesthesia is carried out.
3. The dentist applies forceps to the root in order to loosen the affected tooth. The hole expands, as a result of which it separates from a strong ligament.
4. Now the tooth can be easily removed. Then the edges of the hole formed are squeezed with cotton balls, while the wound quickly fills with blood clots.

Oksana Shiyka

Dentist-therapist

The operation is very fast. 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, the first 2 days - from drinking alcohol. You should also rinse your mouth a day after the operation. This should be done before meals and at bedtime. If you follow all the recommendations of the attending physician, then after two weeks the wound will heal and you can forever forget about its existence.

Oksana Shiyka

Dentist-therapist

It should be noted that the operation is fast, but sometimes it becomes necessary to cut the tooth into several fragments and remove it piece by piece. This is due to the complex structure of the root system or the unusual shape of the bone element.

Some Features

To answer the question of whether it hurts to remove a molar tooth, it is worth highlighting the features of the operation:

1. Removal is resorted to in case of complete destruction of the crown by a carious process, with a root fracture, the development of purulent inflammatory processes in acute form etc. The attending physician makes every possible effort to save a dead tooth. However, if there is a strong inflammatory process or the root part has been damaged, then it is advisable to pull it out.
2. Does it hurt to pull out a root tooth? As for pain, they are practically absent. thanks to anesthesia. Pain syndrome begins to appear a few hours after the operation, but if the doctor did everything right, then he will not bother you much.
3. As you know, wisdom teeth do not bring practical benefits and are among the rudimentary. If they are not located correctly (as happens in most cases), when they erupt, a person experiences severe pain, an increase in body temperature, and the inability to normally chew food and talk. Therefore, they are often removed. As for pain, they are much less if the wisdom tooth is pulled out of the lower jaw.
4. Does it hurt to remove a tooth root? As you know, affected infectious processes, force the dentist to remove the roots of the teeth. The procedure can be further complicated by the fact that top part almost completely destroyed, which does not allow them to be torn out with forceps. The dentist will be forced to make an incision in the gum and drill out some of the bone tissue. While the operation is in progress, you will not feel anything due to anesthesia, but when it goes away, get ready for discomfort.

Removal during pregnancy

Every woman knows that during the period of bearing a child, any surgical intervention in the body is contraindicated. When aching pains 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 can not tear your teeth in the first and third trimesters of pregnancy. Be sure to tell your dentist about your situation so that he can select the most appropriate anesthetic.

In the video, dentist Dmitry Solovyov tells whether it is possible to remove teeth during pregnancy:

To date, tooth extraction is prescribed only in the case when it is absolutely not amenable to any treatment. The anesthetics used will make the process quite bearable. If after surgical intervention stitches were applied, it is necessary to visit the attending physician 5-8 days after the procedure to remove them. In this case, you should follow all the recommendations of a specialist in oral care in the postoperative period.

It is worth removing a tooth at home only as a last resort, if it is not possible to consult a doctor. For children, the extraction of milk teeth is natural and almost painless. Adults need to take pain medication before the procedure. Regardless of the reason for the extraction of teeth, the process in adults and children is almost the same.

It is not recommended to remove molars at home, as this can lead to complications.

• Show all

  Extraction of a child's teeth

  When a baby at the age of about six years begins to often touch the gums, complaining of discomfort, this should be regarded as the first sign of imminent tooth loss. It will not be difficult to remove it without pain during this period.

  But children do not always understand the need for the procedure and are often afraid of it. Therefore, before removing a milk tooth, a child must be interested and explained to him why this should be done. It will be useful to tell a fairy tale dedicated to the theme of the Tooth Fairy and the legend about the gifts that she leaves as a reward. This will help prepare him psychologically.

  If parents doubt that they will be able to pull out a tooth on their own, there is a fear of hurting the child, then you should contact the dentist.

  Removal with forceps

  To pull out a tooth, you need to purchase everything you need in advance at the pharmacy. You will need:

  • antiseptic for disinfection of the hole;
  • a tool that will help pull out the tooth (forceps);
  • clean gauze bandage;
  • a vessel for spitting out liquid from the oral cavity at the end of the procedure.

  You should wait until the tooth is loosened enough. This may take up to several days.

  Action algorithm:

  1. 1. Disinfect gauze with an antiseptic and wrap around the tooth.
  2. 2. Grasp it with a tool.
  3. 3. Pull out with a sharp, precise and decisive jerk. If the procedure goes quickly, then the child will not even feel pain.
  4. 4. Rinse your mouth with a special liquid.

  After removal, you need to press a sterile bandage to the hole and wait about 20 minutes.

  You can't eat anything for two to three hours after the procedure.

  A day later, you should give the child soda or brine(mixing it at the rate: 1 teaspoon of salt / soda per glass warm water) to rinse his mouth. This will help to avoid infection in the hole and the development of inflammation.

  For several days after the procedure, it is necessary to observe the child. In case of edema, swelling or formation on the gums, it is urgent to contact your local doctor.

  

  other methods

  If the considered method does not work, then you can try others.

  

  "The loop"

  Most moms and dads recommend the "Tooth Loop" technique for removing a baby tooth. This method is reliable and affordable. In addition, using the loop, the child will be able to pull it out on his own. To do this, use a thread wrapped around a milk tooth.

  Procedure:

  1. 1. First you need to find strong thread (best option- silk).
  2. 2. Tie the thread around the loose tooth.
  3. 3. In order not to injure your hands when pulling the thread, you can tie the other end to some object, for example, to a door handle.
  4. 4. It is required to pull the object to the side with force.
  5. 5. After removal, it is necessary to place the gauze, folded in several layers, into the hole, ask the child to squeeze it and wait 15 minutes.

  After that, you can remove the gauze, but you need to make sure that the child does not damage the blood clot formed in the hole.

  loosening

  To loosen a milk tooth, you can periodically offer your child to eat some hard fruit (apple, cucumber, pear).

  A weakened tooth gradually becomes loose and may fall out on its own after a while. This method does not cause discomfort and makes the procedure painless.

  Using a drill

  Its cost is quite high. But if it is at home, then this method is recommended.

  You can use a drill only if you have professional knowledge, if you have experience with the tool. In other cases, for its use at home, you need to call a specialist.

  How to remove a tooth for an adult at home?

  Unlike a milk tooth, a molar tooth has a different structure, and it is not recommended to try to pull it out at home.

  Adults usually face the need for removal when a wisdom tooth appears, the growth of which is accompanied by pain and discomfort.

  It will be possible to independently remove a tooth from an adult only with its poor stability. Before the procedure, be sure to carefully treat the oral cavity (brush your teeth and rinse with a disinfectant) and wash your hands. After that, you should drink an anesthetic drug (in tablets or suspension) and wait about 15 minutes.

  The procedure is similar to removal in children, but more effort will have to be made.

  Procedure:

  1. 1. You should wrap the bandage around the tooth and begin to loosen it with force, but smoothly, without jerking.
  2. 2. We must try to pull it out. It is necessary to pull, not pull, so you need to act carefully. Be sure to make sure that nothing remains in the hole.
  3. 3. The hole must be covered with a sterile bandage and pressed to stop bleeding. If it hurts a lot, you can apply an ice pack, it will help relieve the pain a little.
  4. 4. You have to wait about half an hour, and after that the bandage can be removed. This should be done carefully so as not to damage the blood clot formed in the hole.

  Within 3 hours, you will have to refuse to eat and drink. If you feel at the place of removal strong pain, you can apply a compress with ice on the first day, it will help relieve discomfort. In no case should you warm the sore spot.