Surgical Removal of Teeth Or Roots PI 833

Your dentist has advised you that you will need your tooth (or roots) surgically removed. This is known as a “minor oral surgical procedure” or “M.O.S”. This leaflet has been designed to improve your understanding of this treatment and contains answers to many of the commonly asked questions. If you have any other questions, or would like further explanation, please ask a member of the clinical staff.

The problem

The tooth or roots cannot be taken out simply with forceps, there can be many reasons for this:-

• If teeth or roots are not completely visible in the mouth they cannot be removed using ordinary dental forceps.
• The roots may be angled in different directions so the tooth may need to be divided.
• The gum may have “grown over” the root.
• The crown of the tooth may be completely decayed, so it “breaks off” the root during extraction.

Why do I need treatment?

Retained roots and broken down teeth can cause pain and may also become infected causing abscesses.

What does surgical removal involve?

• This involves making a small cut in the gum, so this can be lifted off the bone – this is called a “flap”.
• It may be necessary to remove a small amount of bone from around the tooth, (roots), which may need to be divided before removal.
• The gum is then put back into place with stitches.
• In the majority of cases the stitches are dissolvable and take around two weeks to disappear.

Are there any alternative treatments available?

The only alternative is to leave the teeth (roots) as they are and the problems will continue.

What will happen if I don’t have any treatment?

• The tooth / roots will continue to cause problems, which may become more severe.
• Infection is likely to recur and result in swelling and pain.
• Serious complications, such as infection of the jaw bone (osteomyelitis) or abscess formation in the neck rarely occur but can be life threatening.

What type of anaesthetic is used?

A number of options are available depending on how difficult the root or tooth is to remove. Commonly, a local anaesthetic is used.

Local anaesthetic - this is an injection into the gum surrounding the tooth or roots, rather similar to that you may have had for a dental filling. The injection takes a few minutes to numb the area and means that you will feel no pain while the surgery is carried out.

Like all medicines, local anaesthetics may sometimes cause side effects, as well as the effects that are needed. You may experience dizziness, blurred vision, drowsiness and occasionally loss of consciousness.

Serious side effects are rare and include fits, low blood pressure, slowed breathing and changes in heartbeat, which may be life-threatening. If you have concerns about any of these effects you should discuss them with your dentist.

• • Local anaesthetic and intravenous sedation – in addition to a local anaesthetic injection you can be given an injection into your arm. This makes you feel relaxed and less aware of the procedure. Further information is available in PIF leaflet number 641.
  • General anaesthetic – rarely it may be necessary to carry out minor oral surgery under a “day case” general anaesthetic, ie although you are put to sleep completely you will be able to go home on the same day as surgery. For more information, please ask for a copy of the Royal College of Anaesthetists Patient Information “You and Your Anaesthetic”.

What can I expect after the operation?

When the local anaesthetic wears off a few hours after surgery you will have some discomfort. Your surgeon will give you advice about painkillers. Occasionally, it is necessary to take a course of antibiotics. The discomfort is usually worse for the first few days although it may take a couple of weeks to completely disappear. You may need a few days off work, during which time you should avoid strenuous exercise.

Some swelling can occur both inside and outside the mouth after surgery. This is usually most noticeable for about two days. There may also be bruising under the skin in the area.