A prognosis is a prediction. When a dentist diagnoses a tooth with a major problem, the dentist gives a prognosis or prediction of the success of dental treatment.
When an oncologist gives a cancer patient 6 months to live, he is predicting the outcome of the patient’s disease.
Similarly, a dentist gives a prognosis on a tooth to predict the outcome of its disease and any treatment it undergoes.
Hopeless Prognosis – A tooth has a hopeless prognosis when there is no dental work that will restore it to normal function. In these cases, the only solution is extraction of the tooth. When a tooth is hopeless, an extraction is necessary to prevent the spread of infection to other areas of the mouth and body. An extraction is the only treatment option.
Poor long-term prognosis – Often, teeth have a poor long-term prognosis. This means there is dental work that can restore the tooth to function, but it is likely to fail at some point in the future. Examples of this are cracked teeth, root canals with new infections or extensive tooth decay. An extraction is not the only treatment option, but it is usually the best treatment option for teeth with poor long-term prognoses.
What can I expect during a tooth extraction?
A tooth extraction is dental surgery. The area of your mouth where the tooth is located will be anesthetized (numbed) so that you feel no pain during the procedure.
You also have the option to request various types of sedation so that you are less aware of the procedure or even completely asleep.
Many patients have teeth extracted with no sedation. They are able to proceed comfortably because the local anesthetic used to numb the area removes the sensation of pain.
When a person loses a baby tooth, he waits until it is loose and then wiggles it out. Some permanent teeth become loose on their own, but many do not.
When the dentist extracts a permanent tooth, he or she must make it loose. There are many technical terms describing the forces put on a permanent tooth to extract it. Simply put: the dentist pushes on it.
While you are numb and do not feel pain, you will feel the pressure the dentist puts on the tooth to loosen it. If you do feel pain, you should let your dentist know so that they can address it with local anesthetic.
What is a surgical extraction?
There are some teeth that we are unable to remove with just pulling force. This can be due to severe breakdown of the tooth from a large cavity or crack. A tooth with an old root canal is also difficult to remove in one piece.
These teeth require different surgical techniques in order to remove the entire tooth with all of its roots.
There is no increase in pain during a surgical extraction versus a simple extraction. In fact, patients often state that they are less uncomfortable during a surgical extraction because there is less pushing.
A surgical extraction does carry an increased risk for dry socket afterwards. Post-operative instructions must be followed diligently to lower this risk.
What can I expect after a tooth extraction?
After an extraction, we give each patient strict post-operative instructions. These instructions help to minimize pain after the dental surgery.
It is normal for the surgical site to bleed for several hours after the procedure. Your instructions will include the protocol for the promotion of a healthy blood clot in the extraction site.
After the local anesthesia wears off, you will experience some post-operative pain. Most patients experience pain at the extraction site for the first 2-3 days and take over-the-counter medications to address it.
Stitches are not always necessary. We place stitches only as needed. If you do have stitches, you will receive instructions on care and removal of them.
The gum tissues will close over the extraction site after 2-3 weeks. It is important to keep the surgical site clean while it is healing.