Sunday, November 6, 2011

The Tooth about Pulling Teeth



Its been a while since I had posted I apologize, I'll keep more regular update as much as possible!

"Pulling Teeth" or dental extractions get a lot of bad press just like root canals. The term "hard like pulling teeth" makes it seem like its a long painful process. Lets delve into what goes into a dental extraction so you understand the basics shall we?

DOES IT HURT TO HAVE YOUR TEETH EXTRACTED? Lets get the most pressing question out. No you should not feel pain during the actual extraction. Just like how root canals get a bad repuation, the history of pulling teeth being painful came from a time when our anesthetics were not as good as they are today. You should be completely numb during the time of the extraction and you should always ask for more anesthetic if you feel a sharp pinch. Don't worry after the initial pinch from getting numb you should not feel a 2nd, because the gums numb a lot more easily than the tooth.

Now for the confusing part.... where you won't feel pain, you will feel a lot of PRESSURE. Anesthetic cannot remove the pushing feeling of trying loosening and finally removing tooth. I'll go into whats actually happening next.

HOW DOES A DENTIST REMOVE A TOOTH? The term "pulling" a tooth is actually very misleading because there is very little pulling of the tooth. In fact if you were to attempt to pull your own tooth -- and you literally took a pair of pliers and pulled on the tooth, you would find that it does not come out unless you bench 250. Why is this? Because a tooth is held into your jaw by tiny fiber ligiments that attach directly into the bone. So basically the tooth is glued into the bone. If you want to remove something that glued shut, you don't just grab it and yank, you'll destory it and some of it will probably still be stuck! You want to loosen up the glue until its much weaker and then tease it our gently. This is how dentists remove teeth.

The process of extracting a tooth involves two things: loosening up those fibers and expanding the jaw bone. Bone is actually a little flexible (especially the upper jaw) and by wiggling the tooth or wedging an instrument between the bone and the tooth will allow it to "give" a little. While its wedged this is where you'll feel a lot of the pressure I was referring to before.

WHY ARE SOME TEETH HARD TO PULL? Okay, so while 90% of all teeth come out without much fuss, theres still 10% of them that put up a fight. So if your dentist is taking more than just 15 minutes getting your tooth out you probably have one or more of these:

- Highly decayed tooth below the gum line: nothing to grab on to, nothing to wedge against
- Very dense and unflexible bone: particularly common in african americans and the lower jaw
- A tooth that had a root canal and highly decayed: its brittle so it tends to shatter
- Curved roots - Try getting a crow bar out of cement and you'll understand
- Long Roots - More root = more fibers

WHAT DOES THE DENTIST DO WHEN TEETH DON'T WANT TO COME OUT? Okay STOP reading if you don't like details. At this point the dentist has realized this tooth is not going to simply loosen and come out, so he has to go to plan B. Usually plan B consists of moving the gums out of the way to see better, cutting the tooth into a few pieces so hes not trying to tackle all of it at once, or removing some of the jaw bone around the tooth so he can gain some extra tooth to lean on. Bottom line is you will be a little extra sore after the procedure is done.

WHAT IF THE TOOTH DOESN'T COME OUT? Now we're into the 1% probability range. Very rarely the dentist cannot get the tooth out because its either fused into your bone of the piece is so small, but when it does happen the dentist will usually choose to leave it in. Why? Because the damage he would need to inflict to you in order to get that little piece out is much worse than everything up to that point. What will happen? Either a) the body will just pretend its a piece of bone and intergrate it into your jaw, or b) you body will just gradually push it out until it comes out on its own.

TIPS for getting a tooth pulled:

- Take Ibuprofen 600 mg 4x a day 2 days prior to treatment (if you don't have health problems taking Ibuprofen. This will decrease pain and soreness during and after the treatment.

- If you feel any pain, ALWAYS ask for more anesthesia, don't "tough it out"

- Give yourself a few days to recover just to take it easy

- Don't feel that its going to be a big deal. Most of the time its a fairly simple procedure with minimal discomfort

Jeffrey Chung DDS

7 comments:

  1. Asking for a stronger dosage of anesthesia is not a bad thing, but the amount should be properly moderated by the attending dentist. Don't hesitate to tell your dentist if you can still feel a bit of pain during the procedure. After all, the purpose of applying anesthesia is to have a totally painless procedure. If the dosage is not enough, feel free to ask your dentist for more.

    George Quirk

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  2. This blog post is very informative and I cant help to stop myself to reading all. how to pull a tooth without the help of a dentist. It is really a painful to pull a tooth by yourself. This post is the best i ever had.

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  3. this is very true i been up all night with pain in my right side of face so i tried pliers and let me tell you that's a horrible idea so I'm taking some pain meds to make it till later so dentist can handle this

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  4. I have huge pain on the side of my whole face and tooth area , my tooth broke off a whole back I just left it as is and the root is just there it will be normal every other day but the pain hits randomly and it hits hard will they fill it or will it be pulled ? :(

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  5. This is a very well written post. I have a front lateral incisor that is broken into a 3rd on the back (tongue) side. I have been trying to pull it with pseudo dental tools to no avail. No health insurance and no money=NO HELP!
    I hate this country with a passion....Your teeth are not part of your health you know.

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  6. Tooth extraction is a pain full procedure, you really need a good dentist to have safely removal of your teeth, I have my family dentist in Gilbert who is very good at it.



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  7. For adults teeth extraction experience dependent on the doctor and the their teeth condition when my mom went for her tooth extraction in Newmarket she had a slight pain but our family tried his best to avoid the pain.

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