Tooth extraction: what instruments does the dentist use?

August 18, 2017

Tooth extraction is an unpleasant, painful and even frightening procedure. But it seems so only to the patient - for a dental surgeon this is a completely ordinary, everyday and ordinary operation. UltraSmile . ru offers to see what tools the dentist uses to remove teeth. You can also find out ways to restore teeth>>>

Forceps

This is the main device that helps pull the tooth out of the socket. The doctor literally grabs the tooth with forceps and begins to swing it, which leads to the destruction of the ligaments holding the root. Next, the dentist carefully removes the tooth along with the root, again using forceps. The device looks, of course, scary, but not a single dental surgeon can do without forceps. It is noteworthy that such a seemingly simple tool is available in many variations: with inclined, thick or thin, with rounded or even flat nippers (or, in scientific terms, cheeks).

Dental forceps

How does ultrasonic removal work “in your sleep”?

Ultrasound removal is performed using special piezosurgical devices. The main feature is that the device affects only hard tissues and turns off when it touches soft ones, such as gums, nerves and blood vessels.

Sequencing:

1. A butterfly catheter is fixed on the patient’s wrist (we use the most delicate ones from a children’s set) and an infusion pump is connected for controlled administration of drugs.
2. If necessary, the assistant administers local anesthesia to be 100% sure that the treatment is painless; by this time the patient no longer feels the injection.
3. The doctor checks sensitivity to pain and the removal operation begins. While the surgeon works, the anesthesiologist monitors the patient's condition, checks breathing, pulse and measures blood pressure on cardiac monitors.
4. An ECG is performed directly during the treatment process; control of the balance of oxygen and carbon dioxide is automated by our own oxygen generation station.
5. The work ends, the anesthesiologist awakens the patient, and the assistant takes him to a control x-ray to check the correctness of the operation.
6. 30-40 minutes after removal and the anesthesiologist checking the patient’s condition, you can go home.

Ultrasound tooth extraction is an ordinary routine event for our surgeons. At the Doctor Levin center, the most complex maxillofacial and ENT operations using piezosurgery are performed daily: sinus lifting, maxillotomy, multiple tooth extractions. For an average surgeon, the remaining teeth before implantation are a hindrance and do not stand on ceremony with them. The result is broken bone structures of the jaw, wandering remnants of roots, unremoved cysts growing into the maxillary sinus, perforations, fistulas, osteomyelitis and much more. Not to mention the shocking post-operative pain that overtakes the patient after such punitive surgery. Entrust removal to an oral and maxillofacial surgeon. Only the maxillofacial surgeon has enough theoretical and practical skills to perform tooth extraction without complications.

My life's goal is to create the best oral and maxillofacial clinic in the world.

High-quality surgical care without complications and with absolute comfort - in your sleep, without stress, pain and unpleasant memories

Levin Dmitry Valerievich Chief physician and founder of the Doctor Levin center

Elevator

When an impacted or unerupted tooth (most often wisdom teeth) needs to be removed, the dentist will use an elevator. The tool consists of a handle and a working part, which is used to extract the root. The elevator operates on the principle of a lever, that is, the doctor literally picks up the tooth from below and removes it from the bone tissue. Removing teeth using elevators is very traumatic, but in some situations you simply cannot do without them.

Elevator for tooth extraction

Recommendations after wisdom tooth removal –

After a simple extraction, it is enough to follow the standard recommendations after tooth extraction. But what to do after the removal of a wisdom tooth, if the removal was difficult or was carried out against the background of purulent inflammation. To the standard recommendations in the link above, we recommend adding the following -

• 
  NSAID-based analgesics - without waiting for the anesthesia to wear off, take an NSAID-based analgesic (for example, ibuprofen). The advantage of these drugs is that in addition to pain relief, they also have an anti-inflammatory effect. Be sure to drink on day 1, then as needed. And remember that after removal you cannot take aspirin and its derivatives.

• Antihistamines - they are also called antiallergic. We recommend taking it (preferably Suprastin) once a day before bedtime in the first 3 days after a complex removal. The advantage of these products is that they help reduce the swelling of soft tissues, which will certainly develop after a complex removal.

• Antibiotics – Antibiotics after wisdom tooth removal should only be prescribed by a dental surgeon and not taken on your own. Most often, dental surgeons are accustomed to prescribing Lincomycin 0.25 capsules (2 capsules 3 times a day, for 5 days). This is an inexpensive Russian drug, quite effective, but it has a strong effect on the intestinal microflora, killing all living things.
  Another popular antibiotic in dentistry is Amoxiclav. For adults, it is necessary to use Amoxiclav tablets containing 500 mg of amoxicillin and 125 mg of clavulanic acid - 2 times a day. However, if you have had stomach upsets (diarrhea) after taking antibiotics, then it is better to opt for the antibiotic Unidox-solutab 100 mg 2 times a day for 5-6 days.

  We recommend the latter option. And try never to take Russian antibiotics in your life if possible, if you do not want to develop pseudomembranous colitis. It would be better then to give preference to inexpensive Indian antibiotics.

Auxiliary Tools

Forceps and elevators are the main tools of a surgeon. But in addition to them, scissors, scalpels, raspators (thin “spatulas” for separating gums from bone tissue), tweezers, clamps and all kinds of hooks are also used. A chisel (to separate bone tissue and expand the hole if the root is very deep) and a hammer can also be used. Patients are often horrified by the thought of having a chisel manipulated in their mouth, but there is nothing scary about such a procedure. With the right anesthesia, you will not feel anything. In addition, when removing teeth, a drill can also be used - the device will be required if the tooth has several roots and they will need to be separated before removal. This will significantly facilitate the process of extracting the tooth, because the doctor will not extract it entirely, but in parts.

Auxiliary Tools

Advantages of the method

• Complex removal without general anesthesia under local anesthesia.
• High-quality operation in hard-to-reach places.
• The non-contact method eliminates the risk of tissue overheating during exposure. The pulp will definitely not get burned, and the patient will not get inflammation of the pulp.
• The exact localization of the impact determines minimal injury. They destroy only hard tissues, but the mucous membrane and nerve endings are not affected.
• Fast healing.

The cost of extracting a dental element using a piezotome is 2 times higher than the traditional one. But treating the wound surface with ultrasound has a disinfecting effect, and the patient saves on taking antibiotics. Minimizing the risk of complications eliminates the cost of their elimination and long-term rehabilitation.

Laser

The use of laser is one of the greatest achievements of medicine in general and dentistry in particular. In addition to making the dentist’s work easier, the device provides patients with a comfortable procedure and a fairly quick, painless recovery. The laser will not terrify a person, as can happen, for example, with a drill, because it works completely silently.

Laser

In general, in dentistry, lasers are used to treat shallow caries, install implants, treat gums, remove plaque, and even whiten teeth. When applied to the process of tooth extraction, the laser allows for a careful incision of the gums (in this case, the beam stops the capillaries, which means there will be no bleeding and severe trauma to the tissue), a more careful separation of the roots, as well as antiseptic treatment of the wound and restoration of damaged tissue.

Video of wisdom tooth removal using laser

How much does it cost to remove a wisdom tooth: price in Moscow

How much does it cost to remove a wisdom tooth: the price in Moscow will depend on the complexity of the removal, as well as on the pricing policy of the dental clinic. For example, the cost of wisdom tooth removal can differ significantly in public clinics and private economy class clinics - from the price in clinics of medium and high price categories.

In addition, in some clinics there may be a gradation of wisdom tooth removal only into simple and complex, while in others - into simple, medium complexity and complex. After analyzing the prices, we divided them into economy class clinics and clinics in the middle and high price segment.

Wisdom tooth removal: price in economy class clinics in Moscow

• A simple removal of a wisdom tooth costs from 1,500 rubles, the cost already includes anesthesia, but if you need to put 1-2 stitches, you will have to pay another + 500 rubles.

• Removal of average complexity costs about 3,000 rubles, this price includes anesthesia and suturing.

• Complex wisdom tooth removal - from 5,000 rubles, this includes the removal of impacted and dystopic wisdom teeth. The price is already “all inclusive”, including anesthesia, repeat examinations and suture removal.

The price of wisdom tooth removal in clinics of the middle and upper price segment is –

• Simple removal – from 3500 rubles.
• Complex removal costs about 10,000 rubles, this price is also “all inclusive”, including repeated examinations.

Piezo device

Along with a laser, a piezoelectric device is another modern device that makes the dental treatment process more comfortable and safe. The device generates ultrasonic waves that replace a traditional drill. It works almost silently; when removing teeth, it allows you to make incisions in the gums, the teeth themselves, and bone tissue. In this case, the cuts are made using ultrasonic vibrations, and the tip of the device does not come into contact with the surface being treated. Due to this, the tissues are practically not injured, the operation is carried out with high precision even in difficult-to-reach areas.

Piezo device

Conventional removal or ultrasound?

So, is ultrasound tooth extraction technology modern and effective? Absolutely yes. Is it worth choosing it if it is not possible to save the tooth? Yes, because piezosurgery has a number of very important advantages compared to the classical extraction technique. At the same time, the cost of ultrasonic tooth extraction is quite high: for one unit you will have to pay at least 4–5 thousand rubles. The classic removal procedure will cost about half as much.

Attention!

The final success of treatment primarily depends on the qualifications and professionalism of the attending physician. That is why choosing a specialist who you can trust with your health is paramount. Startsmile will always help you find a suitable clinic and specialist.

This is interesting: the tools that our ancestors used

It's surprising, but all modern hand tools for tooth extraction have been in use for several centuries. Of course, their ancestors looked very scary, and sometimes a simple operation led to very sad consequences, even death.

One of the first devices for removing teeth were pelicans, so named because of their external resemblance to the bird of the same name. They have been in use since the 14th century. The components of the device were a rotating claw and a base - the tooth was placed between them and twisted out of the hole.

Pelican

Another “torture instrument” of dentists was a special key. A claw was placed at the tip of the shaft, which allowed the tooth to be rotated around its axis. Fortunately, this method has not been used since the end of the 19th century.

Key

A rather unusual instrument is a goat's leg, with a double tip that resembles an animal's hoof. It was used to extract remains of tooth roots.

Goat leg

This is only a small part of the instruments previously used in dentistry. Most of them bear little resemblance to medical devices, causing associations with torture devices. No wonder people were afraid to go to the doctor! Perhaps it was then that a fear of dentists was formed, passed on to modern generations at the level of instinct. However, today there is simply no point in being afraid of dentists. Advanced instruments and devices, together with high-quality anesthesia, make the process of treatment and tooth extraction absolutely painless.

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removal of a tooth

What are the main advantages of the piezosurgical device?

• The speed of the operation is 15–20% faster than the traditional method. This is convenient especially if it is necessary to remove several teeth at once;
• It is not only simple, but also not painful to remove a tooth. This method can become an alternative to dental treatment under anesthesia, limiting oneself to local anesthetic during even the most complex operations;
• Allows removal of dystopic, impacted teeth;
• There is practically no blood during the operation, which can be explained by the rapidity of the intervention;
• Avoid heating and causing burns to soft tissues. Please note: heating is especially dangerous for the pulp - it can become inflamed.
• This technology allows operations to be performed even on patients who suffer from vascular diseases;
• This is the only option for tooth extraction for a patient with poor blood clotting;
• Antiseptic effect of ultrasound, which is good when performing operations on people allergic to antiseptic drugs;
• The risk of postoperative complications is extremely low;
• Non-contact influence of the device.

If we talk about the disadvantages of this removal method, then there is probably only one – cost. The price of ultrasonic tooth extraction is several times higher than conventional methods, although it cannot be called inaccessible. And the antiseptic effect of the ultrasonic pointer eliminates the need to prescribe antibiotics. And now parents don’t have to lie that it doesn’t hurt at all to remove a tooth - with ultrasound this is true.

When is root removal required?

It happens that only the root remains in the gum, and its crown part has been completely lost due to mechanical stress or untreated caries. After an X-ray examination, CELT specialists determine the possibility of treating such roots and their further use as a support for the crown. If this is not possible and the tissue surrounding the root is changed, a decision is made to remove it. Indications for root removal of front, broken, baby and other teeth are:

It is worth noting that the crown part of the tooth can be destroyed both on a tooth with a nerve and on a pulpless tooth. If the tooth is “alive” and the destruction of its coronal part is not severe, its preservation is quite possible. As for a tooth with a removed root, the latter, as a rule, are seriously damaged and their restoration is quite difficult. In this case, the doctor may recommend removal of the tooth root and subsequent implantation.