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Exodontia and tooth nerve
Odontectomy — surgical intervention at which extraction of tooth from a tooth socket is made. Indications for an odontectomy are defined by the stomatologist.
Are defined emergency and planned the indication for an exodontia. The doctor should extract tooth urgently at development of acute inflammatory processes of purulent character which gradually affect a bone, and also at abscesses, sinusitis, phlegmons , etc. The doctor defines that conservative treatment of tooth is impossible or that it is not of functional value. Also the odontectomy practices if very strong dentagras which are not giving in to treatment are noted. The odontectomy is carried out in case of its longitudinal change, at a change of coronal part when the pulp is bared, at impossibility of recovery of a crown by an orthopedic method or sealing.
The planned odontectomy is carried out when determining impassable root channels with okolokornevy periodontitis or cysts. Those teeth which cannot be kept mobile teeth are extracted at a periodontal disease (3-4 degree of mobility), atypically located teeth which are injuring mucous and negatively influencing functions of the speech and process of meal.
The indication to removal is the fang fracture, finding of tooth to lines of fractures of jaws, existence of tumors of a jaw. Teeth can be extracted at orthodontic and orthopedic treatment.
There is also a number of contraindications for an exodontia. It is a number of acute diseases — hypertensive crisis, a myocardial infarction, infectious diseases; bad coagulability of blood (the periods period at the woman), reception of the prepara reducing coagulability of blood, the first and last trimester of pregnancy. If hemophilia is diagnosed for the person, tooth to him is extracted only in a hospital.
Whenever possible the doctor tries to avoid an odontectomy as after its loss other teeth are gradually displaced. As a result, problems with chewing appear and not only.
Before an odontectomy the patient has to report surely to the doctor about what he takes medicine, and also to tell about chronic diseases.
If the doctor defines infection with an infection, then before an odontectomy he can appoint a course of treatment antibiotics. It is necessary to accept them strictly according to doctor's instructions.
Process of an odontectomy
Before an odontectomy the x-ray film, is made for definition of the location of fangs. As a rule, in the course of an odontectomy local anesthesia is used. During removal procedure teeth of people are felt by rather strong pressure, however there is no pain. Anesthesia effectively blocks nerves. But if pain during removal nevertheless is present, it is necessary to tell about it to the doctor who can make in addition anesthesia. Anesthesia is carried out by means of introduction of medicine by the syringe. Sometimes at his desire can also offer the patient sedatives for the purpose of removal of tension.
Initially the doctor separates a gingiva from a tooth neck by means of special tools and imposes nippers. Nippers are closed and fixed in the correct situation. The stomatologist defines further actions depending on an arrangement mi quantities of roots. Multi-rooted teeth are shaken, and single-root the doctor turns. Further tooth is taken from an alveolus. Sometimes multi-rooted teeth should be cut on part a drill and to delete roots step by step.
At non-compliance with rules of care of a hole after an odontectomy at the person to whom extracted tooth the alveolitis or a dry hole can develop. Sometimes such complication is an effect of an incomplete odontectomy which part of a root remains. The alveolitis develops for the second or fourth day after an odontectomy. Because of loss of a clot the infection gets to a hole owing to what in a hole there is a plaque, pain.
Long bleeding at people with blood diseases is sometimes noted. At heavy process of an odontectomy there can be dislocation or removal of the next tooth.
Rare complication is the mandible change which occurs if for an odontectomy the significant force is applied.
Removal of a nerve of tooth
Near fangs the pulp — the nerve terminations and vessels collected in a bunch is located. It is accepted to call a pulp a tooth nerve. The pulp causes reaction of tooth to irritants. If removal of a nerve of tooth is made, then its supply with blood and its mineralization stops. Tooth becomes "dead" and shows lower resistance to external influences. Often patients say also that at them tooth from which removed a pulp darkened.
Removal of a nerve from tooth is made if in time caries was not cured, and at the patient the pulpitis develops. The started pulpitis stage — indications to removal of a nerve. Also the pulp is removed at noticeable destruction of tooth, big carious cavity, and also at a constant and severe pain of tooth.
Earlier for removal of a nerve in stomatology arsenic which was for a certain time put in a pulp was actively used. Tooth was sealed by means of a temporary seal. How arsenic killed a nerve, the patient often felt severe pain. The subsequent cleaning of channels also often was very painful for the patient.
However this method was not safe as arsenic is a strong poison, and effects of removal of a nerve of tooth in such a way could lead to full loss of tooth.
The modern stomatology provides removal of a nerve of tooth throughout one visit of the doctor. It will be out under local anesthesia. The pulp is taken by means of special tools throughout about half an hour. Sometimes the doctor nevertheless makes the decision on installation of a temporary seal to be convinced that removal of a nerve took place successfully.
Sometimes the partial removal of a nerve practiced if the inflammation extended only to coronal part of a pulp is shown to the patient. In that case tooth is opened and cut coronal part of a pulp. This method practices more often if there takes place treatment of molars at the child as in that case tooth remains live.
After a depulpirovaniye the patient some time can sometimes feel pain which is connected with treatment process. In this case doctors recommend to apply analgetics several times. It is important to consider that at low-quality treatment inflammatory process and morbidity are resumed soon.
Removal of milk teeth
Removal of a milk tooth — very important event both for the child, and for parents. Modern stomatologists carry out removal of a milk tooth at children very easily, without pain and nervousness of the patient. But nevertheless parents have to know that it is not necessary to hurry with this procedure. There are reasons, removal of a milk tooth in view of which it is worth otstrochit a little. Roots of milk teeth gradually begin to resolve at the child approximately at three-year age. Later teeth drop out in the natural way. Existence of milk teeth is pledge of the correct prorezyvaniye and growth of second teeth. Besides, early removal of milk teeth can detain development of a jawbone.
Removal of a milk tooth is considered premature if after that the second tooth appears only in a year and more. If tooth is extracted earlier, then secondary dentition can be chaotic that conducts to malocclusion later.
But nevertheless there are also indications for removal of milk teeth. As absolute indications strong destruction of tooth, impossibility of treatment of tooth, emergence of a cyst on a fang or fistula on a gingiva is defined by caries. If the second tooth is swept already up, and milk still is not even unsteady, it also should be deleted. It is also necessary to extract a milk tooth with periodontitis or a pulpitis that the illness did not affect a rudiment of a second tooth.
Relative indications are a swaying of tooth which is discomfortable for the child, chronic periodontitis or a pulpitis, tooth fractures.
Removal of milk teeth is carried out under anesthesia only if there is a serious inflammatory process. If tooth is already unsteady, then the doctor deletes it easily without anesthesia.
But if process of change of teeth goes normally, then it is possible not to see doctors. The child can just allow to gnaw something firm. If tooth dropped out, then the wound which remained needs to be disinfected.
Actions after an odontectomy
After an odontectomy the doctor tells the patient as it is necessary to behave to avoid problem points. The first days after removal — the most important. Right after tooth was extracted, bleeding can proceed. For its stop in a hole put cotton wool which needs to be pressed densely. It is important that on site odontectomies the clot which protects from an infection was surely formed. Therefore, despite pain after an odontectomy, it is not necessary to rinse a mouth for days. Also it is impossible to take hot food and drinks. Gingiva after an odontectomy can swell. It is easy to remove it, putting cold to a cheek. By the way, the hole after an odontectomy begins to live worse at those who smoke. It is also undesirable to drink alcoholic beverages right after an odontectomy as alcohol can dissolve a clot.
If removal of a fang was very difficult, then after operation pain can be very intensive. At rather weak pain it is possible to apply analgetics which are on sale without recipes (for example, an ibuprofen, analginum). At severe pain the doctor appoints stronger means which should be accepted strictly according to his instruction. During reception of such drugs it is better not to be engaged in the affairs requiring special attention (for example, driving of the car). Also in the first days it is impossible to allow strong physical tension.
In the first days it is necessary to brush teeth so that not to affect a hole by a brush. Further this process also has to be sparing. It is necessary to sleep with the raised head. For this purpose under the head it is possible to put an additional pillow. Hot bathtubs are prohibited in the first days.
In a day after an odontectomy the hole can be rinsed saline solution. This procedure is carried out before going to bed and after meal.
If at the person the so-called "dry hole" is formed, then in several days of the patient dull ache can disturb, and from a hole the unpleasant smell appears. In that case it is necessary to see a doctor and to follow his recommendations. As a rule, the doctor applies a bandage with medicine a hole. Drug kills pain. Such bandage needs to be updated once a day. Sometimes, that to a surface of a hole there are parts of a numb bone. The person can remove them independently.
Healing can continue several weeks, and sometimes and months. It is necessary to consider that the odontectomy was quicker and more simply made, rather the hole will begin to live, and the probability of complications is smaller. Sometimes after a difficult odontectomy reception of antiinflammatory drugs is recommended to avoid complication.
At young people of a hole heal quicker, than at elderly. Approximately in three months after an odontectomy the hole is filled by a bone tissue.