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TOOTH EXTRACTION IN IRAN

Perpetual teeth like any other organ in the body are created to live with the human for the rest of their life. However, other organs do not need continuous care and attendance like teeth. Teeth are apt to many problems due to their functions, alignment, and because of aging. Dentist tries to treat these problems and finds solutions for them. However, some of these problems require tooth extraction, such excessive tooth damage as a result of decay, or impacted teeth, etc. But, tooth extraction as minor surgery, is subject to strict rules, and needs exact evaluation for every patient, because the oral cavity is full of microorganism, to avoid following infection or other complications that ensue the surgery.

TOOTH EXTRACTION CAUSES

The main causes for tooth extraction include:

  • Excessive tooth damage that cannot be treated as a result of severe decays
  • A mobile tooth due to periodontal cause or periapical abscess of the tooth, whose treatment has failed.
  • Overcrowding teeth, which deform the alignment of the teeth or according to orthodontist request (tooth extraction for brace).
  • Milk teeth.

Many secondary factors require tooth extraction such as malposed teeth, supernumerary teeth, the teeth near a tumor, some cases of radiation treatments, jaw fractures, etc.

THE TOOTH EXTRACTION PROCEDURE

The steps of tooth extraction are generally as follows:

  • The evaluation of the case of the tooth and if it can be repaired or not. If the decision is to extract the tooth, the dentist evaluates the patient’s health and asks whether he/she has any high-risk disease that requires the approval of their diseases specialist. This is mostly the case of tooth extraction in cancer patients or patients of cardiac diseases who may need special consultations, while some tests may be needed for the diabetes patients such as (blood glucose rate).
  • Local anesthetic: Tooth extraction under local anesthetic is sufficient for most of the patients, while some special cases may need tooth extraction under sedation or tooth extraction under anesthesia. However, the special anesthetic can be used for patients of cardiac disease, hypertension or pregnant women.
  • The assistance prepares the instruments for extraction and suture in a tray. After that, the dentist strip the tooth of the gingival tissues, and luxate the tooth with an elevator, then he/she applies the forceps on the crown of the tooth, and continues to luxate the tooth with buccal and lingual movement until the tooth is removed of its socket.

Most non-surgical extractions need no stitches, and tooth extraction medication may be only over counter painkillers. However, tooth extraction hurts more at night because more blood comes to the site of extraction when the patient is sleeping or leaning down.

Tooth extraction for kids may need some preparation by their parents and the dentist. However, in a tooth extraction and implant, the dentist may put the  dental implant  directly after the procedure, while the tooth extraction membrane aims to replace the vacuum of the extracted tooth by bone tissue instead of a tooth extraction with bone graft.

SURGICAL TOOTH EXTRACTION

The oral surgeon makes an incision in the gum on the targeted area to reach the tooth. If the access is not sufficient, he/she may remove some of the bone tissue and extract the tooth. Then to avoid tooth extraction infection symptoms (swelling, fever, pain and so on), stitches, antibiotics and analgesics are necessary after surgical extraction. Surgical extraction includes the impacted tooth, and non-erupted tooth, as well, abnormal wisdom tooth extraction, and tooth extraction under the gum, in addition to fractured roots, etc.

CONTRAINDICATION FOR TOOTH EXTRACTION

There are many local contraindications related to the site of extraction such as non-treated infection, nearness of malignant tumor, severely exposed area to radiation, proximity to the site of jaw fracture.

Tooth extraction systemic contraindication may include pregnancy during the first and last trimester, uncontrolled diabetes, bleeding disorders, cardiac dysrhythmias, hypertension, cerebrovascular accidents, lymphoma, uncontrolled leukemia, some kind of chemotherapy and radiation for tumor treatments, etc.

TOOTH EXTRACTION AFTERCARE: WHAT TO EXPECT

After biting on the gauze pad for half to an hour, the blood clot is forming. You may need a rest for 1-2 days for tooth extraction recovery. Maintain a soft diet, avoid using a straw after tooth extraction and keep your head above your heart level when you are lying down or sleeping. On the following day, you may rinse your mouth with a salt solution for a few days.

Some tooth extraction pain and swelling are expected. Take your medicine exactly to avoid infection. Generally, symptoms will disappear within a few days, but tooth extraction healing time may need about ten days.

COMPLICATIONS AND RISKS DURING AND AFTER TOOTH EXTRACTION

The tooth extraction process is a minor surgery. Although it is generally a simple and safe procedure, like any other surgery, it has some complications and risks that may need more precaution during the process itself and strict tooth extraction instructions and tooth extraction care to lessen or prevent ensuing problems.

Some pain, bleeding, oozing, swelling, is expected, but, most of tooth extraction complications are temporary ones and diminish within a few days.

Infection is the most common complication after the process. Tooth extraction care and medicines are necessary to lessen and control it.

Dry socket may develop after three days as a result of dislodged clot. It causes severe pain to the patient and needs a special treatment in the dental clinic.

Some tooth extraction risks are accompanying the procedure as a result of ankylosis and applying an excessive force. These risks include:

  • Injury to the soft tissue
  • Maxillary tuberosity fractures that often happen through the removal of some difficult third upper molar
  • Opening through the maxillary sinus
  • Nerve injury might happen if the needle passes through the nerve during anesthetic or during bone removal, which may sometimes cause paresthesia in the lips.

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