Tooth extraction is a necessary operation that is carried out when the tooth in question can no longer be maintained at the level of the dental arches.
This unfortunate situation can have several causes such as trauma, caries or periodontal disease.
Each of these pathologies acts through different mechanisms but the result is the same, namely tooth loss.
Tooth extraction is not always an easy operation and the degree of difficulty depends on several factors such as:
Tooth location– teeth located in posterior areas are more difficult to extract due to difficult access and proximity to soft tissue, which reduces visibility.
Degree of destruction– teeth where only root remnants remain are difficult to extract because the pliers can no longer anchor. There are many cases where the gum covers the debris, making it harder to see and access.
Previous treatments – especially endodontic treatments, carried out in the past, can lead to ankylosing of the tooth and disappearance of the ligament space.This translates into locking of the tooth, anchoring it firmly into the bone. Extraction will therefore be difficult and sometimes requires the sacrifice of portions of bone.
Alveolitis is a fairly common complication of tooth extractions. It manifests itself by inflammation of the bone to which the bone has been anchored. When the post-extraction alveolus heals, a clot forms which protects the underlying bone from the penetration of saliva or other food debris which can increase local bacteremia or cause trauma.
If this clot is destroyed or disintegrates, the underlying bone is exposed to a contaminated external environment.
Causes
Alveolitis is a painful inflammation that causes the patient to present to the dentist and can have the following causes:
Pre-existing infections – if the patient has dental outbreaks that maintain an increased level of microorganisms in the oral cavity, the risk of them reaching the postextractional alveolus is increased, a situation that leads to the onset of alveolitis and delayed healing.
Laborious extractions – if the extractions also require significant sacrifices of bone hard tissue or teeth that are difficult to extract due to ankylosis, the risk of postextraction alveolitis is significantly increased. In these situations, post-extraction pain and inflammation of the surrounding tissues are also present to some degree.
Materials applied to the alveolus – the best dressing for tissue healing following an extraction is the clot. If some drugs or substances are applied, they often just cause the alveolitis to appear instead of promoting healing.
Failure of the patient to follow instructions – post-extraction alveolitis can also occur as a result of not following the instructions given by the dentist.
For example, it is advisable to use mouthwash after the procedure, but do not rinse vigorously as the clot may mobilize, leaving the alveola exposed.
Also, tooth brushing should be resumed the day after surgery. Sometimes patients avoid cleaning the area because they feel pain or are afraid to touch the area.
If alveolitis occurs, the patient should see the dentist for specialist treatment.
