Sunday, November 6, 2011

The Tooth about Pulling Teeth



Image result for dental extractions cartoon
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

33 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

    ReplyDelete
  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.

    ReplyDelete
  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

    ReplyDelete
  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 ? :(

    ReplyDelete
  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.

    ReplyDelete
  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.



    ReplyDelete
  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.

    ReplyDelete
  8. Tooth extractions are done for loosen tooth/teeth(because of gum disease), infected tooth or badly decayed tooth.

    Tooth Extractions in Whitby

    ReplyDelete
  9. Tooth extraction and various other dental concerns can be easily be eliminated by booking an appointment with most successful Dentist in Westboro and witness one of the best dental hospitality.

    ReplyDelete
  10. In simple sense a dental implant is a root analog. Implant were to be placed in bone, the bone would heal right up against the surface of the implant and rigidly locking it in place - a process known as osseointegration. Burlington dentist take proper precautions during such surgery.

    ReplyDelete
  11. Interesting read!! its very imp to have one teeth checked at regular interval!! better be safe than sorry!!

    regards,
    Dentist Mumbai

    ReplyDelete
  12. This comment has been removed by the author.

    ReplyDelete
  13. Tooth Extraction Saskatoon perform tooth extractions for patients only in the most extreme cases.

    ReplyDelete
  14. It is amazing how strong teeth are. They can withstand about 200,000 pounds of pressure per square inch. That's what a five hundred pound bite from a jaw translates into when it's concentrated on the contact edges of teeth. Little wonder "pulling" teeth is an misleading term. williamguthriedds.com

    ReplyDelete
  15. Sometimes the only way to cure an ailing tooth is to remove it completely.
    Tooth Extractions Houston

    ReplyDelete
  16. This comment has been removed by the author.

    ReplyDelete
  17. Our Dentist In Newmarket performs tooth extractions treatment to the patients only in the most extreme cases. Davisview Dental can provide a variety of innovative smile enhancement procedures from teeth whitening to full mouth reconstructions.

    ReplyDelete
    Replies
    1. Mr: Margalit Gavrilov:
      visited your website and it is very good and simple website and you offered good service in canada for Dental implants.
      I would again visit for more update asap.

      Dental implants Wirral in Manchester

      Delete
  18. In severe but rare cases, wisdom teeth that are impacted can actually develop cysts that have the potential to weaken or damage the bone in the jaw; in these situations, extraction will be necessary.
    Tooth Extraction Orangeville

    ReplyDelete
  19. Many dentists recommend the extraction of impacted wisdom teeth. While the teeth may not initially cause physical discomfort it create inflammation and irritation as they continue to emerge.

    Tooth Extraction in Vaudreuil

    ReplyDelete
  20. The procedure of extraction or removal of a tooth can occur due to many reasons, which may vary from the need to carry out other dental procedures or because the teeth maybe severely damaged.

    Tooth Extraction dentist

    ReplyDelete
  21. I lost my teeth during an accident and had to fix dentures in mouth. But the dentures were very irritating and I used wear them only at the time of eating. Then the second time I did dentures it fit well causing less irritation. Dont know whether it was experts at Dentzz

    ReplyDelete
  22. Just thinking about tooth extraction gives me the shivers, but knowing exactly what to expect (especially as far as pressure goes - thanks for really explaining what that means) makes me feel a lot better about my upcoming wisdom tooth removal. And, I've had friends laugh at me for asking for so much anesthesia in little operations, so I'm glad to hear a dentist sanction the practice of asking for more, even if there's only a tiny bit of pain! I think too many people try to tough it out because they think their dentist will think they're being wimpy, when it apparently that's not the case. Thanks for this article, Jeffrey! http://aqdentureservice.com

    ReplyDelete
  23. i have a tooth that me and my dentist are talking about removing then pushing the rest of my teeth over into that spot, i was wondering if its possible after two year of having a root canal,i believed the tooth is infused to the bone now.

    ReplyDelete
  24. i have a tooth that me and my dentist are talking about removing then pushing the rest of my teeth over into that spot, i was wondering if its possible after two year of having a root canal,i believed the tooth is infused to the bone now.

    ReplyDelete
  25. i have a tooth that me and my dentist are talking about removing then pushing the rest of my teeth over into that spot, i was wondering if its possible after two year of having a root canal,i believed the tooth is infused to the bone now.

    ReplyDelete
  26. Hi, I am in extreme pain, and my dentist won't remove my tooth, reason 1, my tooth is that big that the xray Couldn't catch it all, 2, I could pass out or bleed too much that it could be dangerous, so I've to suffer more less, 3 weeks now actually. Is there anything I can do or anybody I can see to help me with this??

    ReplyDelete
  27. That part about it not hurting to get dental work is BS. Novocaine doesn't work well on me and I feel PAIN when they reach a nerve. It is horrible amd dentists act like it shouldn't hurt. So I am years overdue for a dental checkup and have 2 teeth that are painful. There has te be some better way. The stupid shots don't wor k.

    ReplyDelete
  28. That part about it not hurting to get dental work is BS. Novocaine doesn't work well on me and I feel PAIN when they reach a nerve. It is horrible amd dentists act like it shouldn't hurt. So I am years overdue for a dental checkup and have 2 teeth that are painful. There has te be some better way. The stupid shots don't wor k.

    ReplyDelete
  29. If you can find a dentist you trust, you're very lucky, because even the holistic ones are not always trustworthy. My most recent dentist, Dr. Thomas Gent at Sola Dental, talked me out of my root-canaled molars and botched the replacements. I ended up with massive gum and bone loss and now will likely lose most of the rest of my teeth! I am suing him and he is under investigation with the state dental board. Do not spend your money and threaten your health! I was just fine with root canals. My health really went downhill after all the surgeries, antibiotics, and corrective surgeries. It’s taken two years and I am always depressed. I was disfigured for 18 months. What I wouldn't give to still have those root canaled teeth that caused me no problems!

    ReplyDelete
  30. Hi, i just got a recommendation to get my "8's"/Wisdom tooth removed. All 4 of them. I went to mu dentist and he attempted to extract the upper right tooth. He tried to shank and shake to get this tooth out, but this did not work. I do remember a burning smell and the sound of the cutting thing (im sure at this point he tried to cut around the bone or tooth. After many trial, id say 45mins of trying, he gave up and told me he quit. He explained that firstly it was a bad day to do it(Tuesday rather than Friday) and also he assured me since i am of African descent/Zimbabwean, my bone was much more dense and he decided not to continue with the procedure. Then sent me home right away. I am here, 12hours later, im excruciating pain. My whole right side is throbbing and my ears are almost burning. The tooth is still there, its very fragile feeling, cracked, fructured and sometimes i feel little pieces in my mouth. I am not sure if it is tooth or cut bone, i assumed it might have been chips of the tooth, since there is a big hole on the outer cheek side of the tooth, just by the gum area. The hole is circular like, with sharp edges on the opening lining. It feels very pressured when i try bite or apply any pressure on it. I am very anxious and in pain, i have the antibiotics, Ibuprofen 600 and a prescribed mouth wash i got before the surgery assuming we would be successful in removing all 4. However, i am thinking of going to the emergency room now(4am-ish), and see another dentist tommorow morning to get second opinion, then go see my dentist who did the surgery, since we organized an appointment for tomorrow to do cleaning. I feel very uninformed, botched, and confused -i have been struggling to make ends meet, then just lost my job that was paying or my insurance (insurance will be deactivated June 6th). I thought we would get the procedure over and done with whilst i am covered, but i feel like i will have to make more visits to get the tooth fixed, atleast the one that got tempered with. I do not mind keeping the other 3, speaking of which he tempered with another lower tooth, assumably to see if it was looser than the upper one. Im sooo confused, i have 1.5 days left of insurance coverage, im financially struggling and the only thing i can hold on to is that i spent lots of money on appointments, x-rays e.t.c, i went through a painful procedure, i still have all my wisdom teeth in and pushing against my other teeth, i have partially crushed tooth with a hole on it and professional advice from my dentist that i am black African thats why i have to go through all this. Please help with informing if this is usual and what i could do. I feel lost and afraid that there could be more to this. I am pretty much holding on to 1400 with my savings included, and i planned on paying 500 for my rent and atleast have something, until i land my next career job. I mean, i can do odd jobs inbetween, but i just dont think i will have enough money to afford more dental appointment, especially after the 6th of July. I am writing this not to ask for money or tell my problems, i just hoping to get some informtion and asmuch information as i can get to know what is going on and what i can do, maybe that can save me a dental appointment, because my confidence is slightly low right now. Im sure there are many great dentist and oral people out there, its just that my experience has been very unpleasant and i feel unheard and like im nothing but a experimental cashcow!

    ReplyDelete