The goal of modern dentistry is to preserve a tooth for as long as possible. But there are times when a tooth has to be extracted. Although this is a well-known, routine procedure, it can sometimes have complications. For example, when a splinter of tooth left in the gum after extraction. How do you realize this has happened and what steps should be taken?
Why splinters remain
When the tooth has only 1-2 roots, they are straight, the tooth is located in the frontal part, it is not difficult to remove it. But if it is a chewing unit or wisdom tooth with 3 intertwined roots, that extraction becomes difficult. Such teeth are extracted piecemeal. Sometimes some of the fragments remain in the gum.
Other situations:
- The root has split as a result of trauma
- The tooth fell apart during extraction
- When using excessive force, a part of a neighboring tooth broke off and the splinter penetrated the wound.
- Surgeon failed to check that all fragments were extracted
Factors complicating extraction
- Third molarsAccess to the “eights” is limited. It is difficult for the surgeon to apply forceps and there is not enough room for free manipulation. In addition, wisdom teeth often have crooked, tangled roots.
- Retained teethIf the tooth has erupted incompletely, or even covered with a dense layer of mucous, it becomes more difficult to remove it.
- Dystopian toothA misaligned tooth makes extraction difficult and increases the risk of damage to neighboring teeth.
- Teeth with a completely destroyed crownIf less than half of the crown (visible) part of the tooth is left, it indicates an advanced inflammatory process or trauma. In both cases, the likelihood of root damage is high. Extraction will be difficult.
The tooth has been extracted, but it seems that not all of it has been extracted
On the first day after extraction, a blood clot forms, which is important to preserve. This is a bacterial barrier to the wound. Therefore, it is important not to rinse your mouth. The liquid can wash the clot out of the hole.
Within three days after surgery, the clot thickens and becomes covered with a whitish plaque (fibrin). The appearance of the cavity after tooth extraction is not very attractive, but you should not be frightened. Unpleasant odor is also considered a variant of the norm, if it is not putrefactive and quite nasty. This is the decomposition of blood proteins in the clot. By the third day, granulation tissue begins to form. By the end of this period in 90% of patients pain and discomfort subsides.
By the 8th day, traces of edema finally disappear, the pink color of the gum returns, and areas of new tissue are visible in the hole. All unpleasant sensations disappear.
A cause for concern is the situation when the patient complies with all the rules, but a week after surgery he still has the following symptoms:
- Swelling
- Redness
- Pain when biting down
- Bad breath
- Pus discharge
- A feeling that there is something left in the gum
Often patients do not pay attention to these signs, hoping that “everything will go away by itself”.
What are the dangers of splinters
Whether the splinters will come out without the intervention of a doctor – it is unknown. But what can happen if they are not removed in time, dentists know very well…
- The tooth has collapsed as a result of trauma The remains of the tooth cause microtrauma, opening the way to the bloodstream for pathogenic bacteria. The wound can take a long time to heal, becoming inflamed. Infection can spread to the bone and periosteum and lead to severe pathologies: phlegmon, osteomyelitis. Therefore, all parts must be removed and treat the wound with antiseptic.
- Part of the root remains in the gum This is a chronic inflammatory focus, which can lead to devastating consequences: periodontitis, cysts or abscesses and destroy neighboring teeth.
Removal of a tooth root fragment
After the surgeon has extracted the root, he or she cleans out the hole with a curette spoon, removing granulation tissue and splinters. After the disinfection is done, the dentist makes sure to examine the tooth to make sure that the top of the root has not broken off. If this is not done, there remains the possibility of re-treatment due to the splinter left behind.
If there is a suspicion that the root has not been extracted completely, it is necessary to go to the clinic immediately. X-rays will show what caused the discomfort – there is a splinter left in the gum or another complication after tooth extraction. Either of these conditions requires medical intervention.
You should not remove the splinter yourself – it can lead to infection
Removal of the splinter follows standard surgical techniques:
- Diagnosis
- Anesthesia
- Removal of the splinter
- Antiseptic treatment
- Suturing
If the fragment is above the alveolar margin, it is not necessary to peel off the mucosa. In cases where the root fragment is deep, the mucosa is peeled off to make it easier to grasp.
Sometimes it is not possible to remove a tooth fragment with an elevator or forceps. Then the surgeon peels off the flap. Part of the root is sawed out with a fine bur or the bone plate is opened and the fragment is taken out. It sounds scary, but in fact the operation is painless and not very complicated.
What to remember
- A timely visit to the dentist prevents the development of serious complications.
- It is not worth stalling for a splinter to come out. Waiting is fraught with inflammatory processes.
- In no case should you remove the fragments yourself. First, it may not be a fragment, but the edge of the hole, for example. Secondly, you can damage the clot or get an infection with an instrument. In dentistry, this is unlikely.
If it’s not a splinter, what is it?
Symptoms of several complications after removal are similar, so differential diagnosis is necessary.
It could be:
- Damage to the gum and soft tissues
- Sharp edges of the hole
- Gingival exostosis
Exostosis is very often mistaken for splinters left behind. In fact, it is a bone spur that appears on the gum below the cavity of an extracted tooth. In appearance, exostosis is a small, hard bump. Complaints at its appearance, in general, the feeling of a foreign body, pain when pressing, a change in the color of the mucosa. But most often exostosis has no symptoms, except for the bulge on the gum. The bump is removed surgically, the stages are the same as in the removal of splinters: diagnosis, anesthesia, peeling off the mucosa, removing the growth, grinding the bone, suturing.
Prevention
Keeping teeth healthy helps:
- Thorough hygieneToothbrush, floss, irrigator clean the enamel from plaque. This reduces the risk of tooth decay and inflammatory periodontal disease. Healthy teeth do not need to be extracted.
- Professional teeth cleaningIt is impossible to completely destroy plaque at home. In dentistry, ultrasound, AirFlow method or laser beam are used for this purpose. They are able to clean the enamel from hard plaque and tartar. These procedures prevent infections and inflammation in the oral cavity.
- DietEating solid fruits and vegetables also helps in strengthening teeth and clearing plaque from them.
- Regular dental consultationsDuring preventive examinations, it is possible to detect pathological processes and carry out treatment before complications arise.
If the tooth has to be extracted, it is important to choose a clinic with qualified surgeons and modern equipment. An experienced surgeon will minimize the risk of debris, and quality instruments and devices will allow the operation to be performed quickly and effectively, so that the removal of the tooth root fragment will not be necessary.