Rotten molar tooth. How is the root removed, if only it remains in the gum, and the tooth is completely destroyed and crumbled? Aching pain in the gums

A snow-white smile always attracts attention and disposes of the interlocutor, but rotten teeth only cause disgust.

The most common ailment of the oral cavity is, which in its essence becomes the impetus for the development of the problem.

Failure to comply with oral hygiene causes the spread of pathogenic bacteria that affect several teeth at once. With an untimely appeal to the dentist, the enamel appears and begins to destroy.

Problems with teeth are present in almost all people, but only a small part of the population visits a doctor on time for a preventive examination. It is quite difficult to understand the reason why teeth rot, but it is even more difficult to stop the process.

Decayed teeth become an obstacle to normal full life, because communication with other people is reduced to a minimum.

If pus forms under the tooth, and only the root is damaged, you should know that pathology is a sign of a serious disruption in the work of the whole organism.

What causes the rotting process ... or who?

There are several reasons why a tooth can begin to fester, and often the person himself is the culprit:

Other diseases and problems can provoke the development of tooth decay:

1. Periodontal tissue damage contribute to the occurrence of a dental problem. This, and more serious diseases that negatively affect the tooth enamel.
2. Often the cause is infections, liver disease, digestive system and poor functioning thyroid gland .
3. Formation near the roots in the gum in the form affects not only adjacent tissues, but also teeth. The swelling has dense walls; without treatment, pus accumulates in the tooth.
4. Lack of minerals and provokes the occurrence of dental diseases.

Who is most at risk?

Regardless of the state of the oral cavity, most patients do not even suspect that they are at risk of getting rotten rotten teeth:

• unfavorable ecological situation, lack of fluoride and dirty air negatively affects the health of teeth and the whole body;
• hereditary predisposition often becomes a provoking factor in the appearance of pathology;
• during puberty, pregnancy and breastfeeding the hormonal system is malfunctioning, this is reflected in the general condition of the teeth.

Concomitant symptoms

The signs of the disease depend on the severity of the course of the disease:

Sometimes teeth rot from the inside, from the root - in this case, the tooth may fall out on its own or it will need to be removed by the root. With the development of pathology from the coronal region, there is no pain due to the death of the nerve, but the decay spreads further.

In advanced cases, the dentition is curved, white color changes to brownish-yellow, and the enamel becomes covered with black spots. As a result of all of the above symptoms, a person develops a complex and psychological problems are added to everything else.

How to restore health and beauty to teeth?

If the tooth is already rotting and is visible on the gum, then the first step is to get rid of the source of the infection. The site of inflammation is removed by the dentist by cleaning dental plaque and filling the root canals.

Application of conservative techniques

The essence of the procedure is to widen the canals and drill out caries. After processing with dental instruments, pus is drained from the affected area.

After that, the doctor conducts therapy using antibacterial agents and antiseptics. If you cannot completely clear the focus of pus, then a small incision is made on the gum. After removal of purulent residues and caries, the canals are filled with healing material. At the last stage of dental treatment, either a filling is placed.

What to do if teeth rot and no medications and procedures help? Then the surgeon will come to the rescue.

Surgical intervention

Surgical treatment is required after filling the canals, but only if the procedure was unsatisfactory, especially near the top of the root. In this case, tooth decay often recurs, but this can be cured by resection of the root apex.

The procedure is a scraping of pus from the gums after cutting off the affected area of \u200b\u200bthe root with a drill.

The operation can be done only after elimination of inflammation, that is, after elimination of internal pus and implementation of antibiotic therapy. It takes from 40 minutes to an hour.

To avoid the need for surgical methods, you need to contact your dentist if you suspect the development of caries.

People who have a predisposition to the formation of plaque and other diseases need to carefully carry out hygienic procedures for the oral cavity, monitor the work digestive tract and the immune system.

How to prevent tooth decay?

Taking good care of your oral cavity will help prevent pus from forming in your teeth.

After all, it is much easier to devote time to preventive measures than to become a regular patient of the dentist later:

Bacterial blow to the whole body

Tooth decay is negative, because in addition to the destruction of enamel and root canals, bacteria enter the body and cause many diseases. Only a dentist can prevent this process.

Rotten teeth in the oral cavity have an extremely negative effect on human health - the consequences for the body can be very serious:

It has been proven that if a woman has caries during the period of bearing a child, then there is a risk of its appearance in the future child.

Beautiful and snow-white teeth are evidence proper care behind the oral cavity. The rotting process repels others, because it makes an unpleasant impression. This problem is not only physical, but also psychological.

If you do not contact your dentist in a timely manner, the consequences can be serious for the whole body. Prevention and proper oral hygiene will help protect a person from pathology.

Possession of a snow-white smile has already become the norm of life and one of the requirements of society. Not surprisingly, people wonder why teeth rot and what to do about it when faced with similar problems. After all, the cause and its consequences must be eliminated quickly, otherwise psychological discomfort and other troubles will follow.

Today dentistry has such means, medicines and instruments that it is not a problem to cure any common disease. It is important that the patient himself seeks help on time and follows all the recommendations of the doctors. Otherwise, tissues, soft and hard, will collapse and provoke common diseases organism.

Why do teeth rot?

The most common causes of caries and other destructive processes in hard tissues can depend on the person himself:

• smoking and other bad habits in the form of drug addiction or frequent consumption of alcoholic beverages - in addition to leading to a general weakening of health and reducing all protective functions, including on the teeth, they also additionally contribute hypersensitivity enamels violate metabolic processes in the mouth and prevent tissue regeneration;
• malnutrition or the use of sugary foods in large doses - this leads to a reduced function of the immune system, and also worsens the condition of the teeth, sugar is especially destructive to hard tissues;
• not healthy image life in general reduces the protective functions of the body, contributing to the formation of various diseases, including dental diseases;
• low level of oral hygiene - directly leads to a deterioration in the aesthetic appearance of a smile and to the rapid spread of diseases in the oral cavity.

General problems of the body, failures in the work of internal systems also have a special effect, since they act from the inside:

• most of all, periodontal diseases are displayed - periodontitis, and others, destroying the gums, eventually move to the tooth part;
• various infections of a general nature - diseases of the digestive system, liver, kidneys, thyroid disorders;
• becomes a destructive factor for hard tissues, due to which adjacent organs are affected, and the collected pus causes their infection;
• even a lack of some vitamins or minerals can also affect the health of the oral cavity.

Another group of risk factors:

• the surrounding ecology, which today is especially bad in large cities - a lack of fluoride in the soil, polluted air, poor-quality water, various impurities and additives;
• genetic causes weaken a person and suggest a tendency to form certain problems that are transmitted from generation to generation;
• especially susceptible to such diseases are people suffering from any transitional, temporary conditions, for example, pregnant women or adolescents during hormonal changes.

Tooth decay

Depending on the stage of decay, the symptoms of pathology manifest themselves in different ways:

1. It all starts with, when there are no special sensations yet, but due to the formed plaque and the abundance of bacteria, an extraneous smell is felt during a conversation.
2. Spots appear on the enamel, the smile turns yellow or brown, which is especially noticeable on the front teeth.
3. Over time, destructive processes intensify and black dots or even entire areas are formed. True, if the root rots initially, then this will not be noticeable, since the disease passes under the gum and is invisible to the eye. For diagnosis in this case, you need to make an X-ray.
4. Further, cavities are formed in hard tissues, which looks like a hole in a tooth. Over time, their size only increases.
5. Pain appears and gets worse each time. Having reached the pulp, the inner part of the unit, such sensations become unbearable and signal a dangerous destruction of nerve endings.
6. After necrotization of the soft part of the tooth, the pain may disappear, but this threatens the loss of a whole unit and infection of the surrounding tissues.

When the visible part of the row is destroyed, a psychological and aesthetic problem also occurs, since appearance the smile deteriorates significantly and becomes unattractive. This makes a person stay away from others, withdraw into himself, complexes appear.

Much worse are other consequences of untreated caries - constantly getting inside the body with saliva, pathogenic bacteria rapidly spread throughout all organs and systems, which leads to various internal pathologies.

Rotting process in adults

The presence of problems and the corresponding reasons for the appearance of caries in adults are very many and sometimes they act in a complex manner, accelerating the decay of teeth and the spread of infection in the oral cavity. This can happen under fillings, veneers, braces, and other structures.

The destruction is also facilitated by the problematic growth of the wisdom tooth, which provokes inflammation of the surrounding tissues, and sometimes, due to an incorrect inclination, injures neighboring units. In this case, you need to remove the "eight", which can only be done by a doctor.

Without identifying and not curing caries, a person is faced with a lot of problems, both personal and business. After all, today the perfect smile is an important part of the working style. It must be remembered that it is much easier to treat teeth on time than to start a putrefactive process and then spend a long period in a specialist's chair to eliminate the consequences.

Why do children's teeth rot?

In pediatric dentistry, everything is similar. The reasons are usually the same, except bad habits and some other nuances. But there are also some peculiarities:

• The baby's love for sweets and the inability of parents to stop them leads to a rapid process of destruction and infection.
• Since children's teeth are poorly protected by thin enamel, not fully formed, then rotting occurs very rapidly, which is especially frightening for adults.
• If the milk units are sick, then the constant ones that replace them also quickly become infected and destroyed.
• Children do not follow good personal hygiene and do not brush their teeth daily high level... Parents should control this process and help.
• Hereditary factors and health problems in the mother during pregnancy could also affect the condition of the baby's enamel.

You need to understand that it is almost impossible to cope with this on your own, therefore, at the first signs of dental diseases in children, you need to show them to the dentist and adhere to all recommendations.

Destruction during pregnancy

This time is special for a woman - she is restructuring the whole body, hormonal balance, tastes are changing, there are malfunctions nervous system... In addition, the future baby takes over most nutrients from foods you eat, especially calcium and fluoride for bone growth.

With insufficient nutrition, the mother manifests various consequences of the lack of minerals and vitamins. Calcium deficiency leads to rapid tooth decay and dental disease.

But leaving the problem until the very birth is wrong, since the presence of caries in a pregnant woman will lead to possible infection internal organs, and also provoke the appearance of the same disease in a child immediately after the eruption of the first teeth.

Today, dentists can process, treat and seal a unit even in a patient in such a delicate position, since modern drugs and the tools are safe for the body. The sooner you seek help, the easier the manipulations will be, and initial stage you don't even need anesthesia.

What methods can be used to cure the disease?

Any caries found should be treated and the root cause of it removed. To do this, you need to contact your dentist and conduct a detailed examination. Usually, an integrated approach is used, which includes the treatment of the tooth cavity, filling, additional prescription of vitamin and mineral preparations, nutritional correction and recommendations to get rid of bad habits.

Obviously, if you eliminate the cause itself, then in the future the problem will no longer bother you. Unfortunately, patients are accustomed to delaying even with banal caries until serious problems appear, and treatment is carried out until pain symptoms are eliminated. The real factors that contribute to the destruction of the tooth and other organs are ignored.

It is very important for a professional to establish the main focus of infection and completely clean it out. The treatment process usually looks like this:

• the affected tooth is found and channels are opened with the help of special tools for better access and visual inspection;
• with inflammation and necrotization of nerve endings, the pulp is removed;
• all caries residues are thoroughly cleaned out and drilled out in hard-to-reach places;
• if pus is present, then it is removed, sometimes an incision is made in the gum for this;
• on the treated surfaces, therapy is carried out with the help of antibacterial and antiseptic drugs, disinfecting them and stopping the spread of infection through the oral cavity;
• then the doctor puts in the medicine and seals all the channels.

If the tooth is badly damaged, then a crown will need to be installed in order to fully restore the aesthetics and functionality of the row. In the case when simple therapy did not have an effect, they resort to surgical methods... Relapses can be eliminated only in a radical way.

In this case, a thorough scraping is carried out purulent formations in the gums, cutting off the affected parts of the root and other manipulations, depending on the location and degree of the disease. Almost always in postoperative period the patient is prescribed a standard course of antibiotics.

Video: what to do if a tooth is badly damaged?

Prevention

In order not to bring the situation to a critical one and not to suffer from the unpleasant consequences of the disease, not to look for an answer to the question of what to do, you need to adhere to simple rules that any dentist will tell you about:

1. Brush your teeth twice a day, morning and evening. And after eating, rinse your mouth with warm water.
2. You also need to pay attention to the care of the tongue, which is cleaned with the back of the brush.
3. Preventive examinations at the dentist every six months will provide an opportunity to notice the problem at the initial stage and eliminate it, avoiding any unpleasant sensations.
4. You should also do and general condition health, improve immunity due to proper nutrition and a healthy lifestyle. And by getting rid of bad habits, you will also get additional benefits.
5. By enriching the diet with solid fruits and vegetables, foods containing calcium and drinking pure water, you thereby help to strengthen the enamel.

Of course, everyone knows the fact that rotten teeth in the mouth are the main cause of bad breath, horrible smiles and become a direct threat to the health of the whole body. There are a lot of reasons for the appearance of rotten teeth. Most importantly, in order not to face such a problem, you need to regularly visit a specialist. The tooth decays gradually, but on early stage destruction can still be restored by eliminating the causes of the problem that began. If you find any manifestations of tooth decay, you can not wait until the tooth completely decays, in order to avoid the development of complications or complete its removal.

When teeth begin to rot in a person's mouth, systemic diseases of the heart and joints occur. After all, the infection that affects them spreads throughout the human body. It is better to prevent such processes at an early stage of the development of the disease.

Causes

The disease has a huge number of reasons. Many of them relate to the patient's lifestyle and habits.

Each of the signs is characteristic of a certain category of people. But it's not a fact that teeth won't start to rot even in a decent-looking person. And the reason for this will be only improper oral hygiene or its complete absence. This is primarily important for people with weak immune systems. It is imperative to increase hygiene and take vitamin complexes for diseases, pregnancy or lactation.

Effects

It should be remembered that rotten teeth entail dangerous consequences for the whole organism.

Treatment

Treatment of this kind of disease should be carried out in an integrated manner. First, the doctor must identify the cause of the disease, and then prescribe the necessary therapy. Basically, this is taking antibiotics in combination with anti-inflammatory drugs. Only after treatment can you start filling and restoring, if possible. When restoration is not possible, the tooth is pulped and all canals are treated.

The ideal option would be to quit any bad habits after treatment. And without fail to eliminate the causes that led to large-scale decay. If the treatment is carried out on time, then there is a chance that such teeth will serve for a long time and may not have to be removed.

Prevention

Decay, of course, is easier to prevent than to treat it later. People who think that rotten teeth are just a cosmetic flaw are deeply mistaken. In fact, this is a massive accumulation of pathogenic bacteria and various kinds of infections that easily penetrate the bloodstream and sometimes cause irreparable harm to the entire body as a whole. Until the teeth are treated, infection of other organs cannot be ruled out, as bacteria are still in the body. But what if the decay process has already started?

1. It is imperative to observe the necessary hygiene and take care of the oral cavity with special attention;
2. Undergo dental check-ups at least 2 times a year. Even in the absence of signs of decay;
3. If carious cavities are found, it is better to eliminate them immediately, they are the main causes of the onset of decay;
4. To give needed by the teeth load in the form of solid food. Try to minimize the consumption of sweets.

Strong the immune system and a healthy lifestyle is a guarantee not only of healthy teeth, but of the whole organism!

• In what cases it may be necessary to remove the root of the tooth, or part of it (for example, apex resection);
• Why "rotten" tooth roots should be removed as soon as possible and what can you expect if you do not do it in time;
• In what cases can the roots of the tooth still be preserved (for subsequent prosthetics) and by what methods is this preservation implemented;
• Typical clinical situations when the root of a tooth must be removed (and what is useful to know if, for example, a significant chunk of a tooth breaks off while eating);
• Methods for removing the roots of teeth, from simple to complex and traumatic (using a dental chisel and hammer);
• What to do if a root or small debris remains in the hole after tooth extraction ...

Sometimes the coronal part of the tooth is so badly damaged that only the root of the tooth eaten away by caries remains - in such cases, the question of removing these "rotten" remains usually arises. Often there are annoying injuries: for example, while eating, a piece of a tooth can break off, and a chip (or crack) sometimes goes deep under the gum - in this case, the removal of the tooth root may also be required.

A separate story, when the tooth is outwardly more or less functional, but the condition of its root (or roots) is far from normal - there are cysts, granulomas. Then the dental surgeon may suggest a root apex resection or even amputation of the entire tooth root. We will also talk about this a little later ...

Fortunately, in some cases it is not necessary to remove the root of the tooth, and you can limit yourself to its treatment followed by prosthetics or restoration of the crown part of the tooth. However, it should be understood that tooth remnants ("rotten roots") that are severely destroyed by the carious process should be parted as quickly as possible and without regrets, since their preservation is more harmful than beneficial to health.

Let's start with just this - let's see why, in fact, it is necessary to remove the decayed tooth roots as soon as possible ...

Why rotten decayed tooth roots should be removed

From the point of view of a dentist, a situation when a patient walks for years with destroyed to the ground rotten toothlooks like this: this person does not feel sorry for himself. The fact is that in such cases, the roots of the teeth need to be removed urgently (see the example in the photo below).

The reason is simple: rotten roots are a breeding ground for infection, and the more there are in the mouth, the more pronounced the problems are, and they are far from being limited to constant bad breath. These porous "rot", like a vacuum cleaner, absorb bacteria and food particles. In addition to rotting food, the remains of the tooth also have hard-to-remove plaque and almost always supra- and subgingival tartar, which causes gums to suffer.

In almost 100% of such cases, an inflammatory process is observed at the tops of rotten roots, accompanied by rarefaction bone tissue, a granuloma or cyst is formed. Simply put, at the top of the root hangs a purulent sac, which is just waiting in the wings to break through with the formation of a "flux".

The photo below shows an example of extracted teeth with cysts on the roots:

Against the background of the vital activity of microorganisms, human immunity is forced to constantly spend its resources on fighting infection in order to somehow compensate for this problem (frequent diseases may occur).

If such a tooth root is not removed, sooner or later a moment comes when the forces of the body can no longer prevent the spread of infection - an acute inflammatory process will occur, often accompanied by significant edema. Favorite phrase of such patients: "For so many years the root rotted, did not hurt, and then suddenly the cheek suddenly swelled, and, as always, at the wrong time."

On a note

And how, it may be asked, to such a patient with a "flux", to whom the slightest touch on the gums causes severe pain, should a dentist perform a tooth root extraction painlessly? After all, almost always anesthesia is done in the projection of the roots of the tooth onto the gum, and there at this moment a significant amount of pus accumulates. The surgeon here has a choice: somehow try to make an injection of anesthetic as painlessly as possible, cut the gum, releasing the pus, and send the patient home, and after a few days, when he feels better, calmly remove the destroyed tooth root.

Or you can remove it here and now, but in this case there is a very high risk that the removal of the root will be painful.

As you can see, it is not worth delaying the removal of rotten tooth roots - they must be removed, and the sooner the better.

In what cases it is possible to save the roots of the tooth, and by what methods it is implemented

Suppose that you have such a tooth (or even several) in your oral cavity, which can hardly be called a full-fledged tooth due to decay, but it also hardly falls under the category popularly called “root”.

For example, for a long time, there were large fillings on dead teeth, which for some reason fell out, and only "horns and legs" remained of the tooth: one or two walls or remnants of the walls of the tooth. Or, for example, during a meal a significant chunk broke off from a molar, and only a “stump” with sharp edges remained.

Is it necessary to remove the roots of the tooth in such cases, or is it still possible to come up with something to preserve them with subsequent prosthetics of the crown part?

So, today there are many so-called tooth-preserving techniques - the main ones are divided into conservative and conservative-surgical.

Conservative methods of preserving teeth do not include surgical interventions, and the preservation of the root (tooth stump) is carried out by preparing the canals (if necessary) and restoring the coronal part using a suitable method, for example, using a restoration with a light-curing material using a post, or an inlay and a crown.

A conservative-surgical method may be required when there is an inflammatory process at the apex of the tooth root: after filling the canals of the tooth (most often with dental cement), resection of the root apex is performed on the same day or delayed. This operation is usually performed under local anesthesia and can be performed on both single-rooted and multi-rooted teeth. The operation is generally straightforward and usually takes 15-30 minutes.

However, sometimes, with an inflammatory process at the apex of the root or even roots, it is possible to do without surgical procedures - if it is possible to carry out treatment by introducing an anti-inflammatory agent into the canal (channels), then the dentist puts drugs for a certain period (from 2-3 months to 1-2 years) with the expectation of bone recovery around the root apex. With a significant loss of bone tissue, the doctor is likely to choose the conservative surgical method, either as the only way to preserve the tooth, or in order to reduce the treatment time (not a year, for example, but 1-2 months).

On a note

Root apex resection is performed in several stages. At the first stage, there is preliminary preparation (taking anamnesis, especially for allergies, treatment of the surgical field) and anesthesia (most often with articaine drugs).

The second stage involves the beginning of the operation itself: creating access to the apex of the root through the gum incision, peeling off soft tissues, cutting out a special small "window" in the bone and detecting the problem root.

At the third stage, a part of the root with a cyst or granuloma is cut off with a drill, after which drugs are placed in the wound to stimulate the growth of bone tissue and accelerate healing. The wound is sutured. Prescribing drugs for home treatment (including painkillers) allows you to minimize possible painful sensations and allows the patient to return to normal life in a matter of days.

Hemisection and root amputation are much less popular techniques to prevent the extraction of the entire tooth.

During hemisection, the affected root is removed with a part of the rotten crown of the tooth, and healthy roots with the remaining intact crown part are left for prosthetics.

Amputation of the tooth root, in contrast to hemisection, does not imply excision of the coronal part: only the root (entire) with the cyst or granuloma on it is removed.

It is interesting

Exclusive options for preserving a severely decayed tooth are coronary-radicular separation and tooth replantation (for example, if the tooth was knocked out by mechanical action).

Coronoradicular separation is performed for large molars when there is a non-treatable focus of inflammation in the area of \u200b\u200broot bifurcation or trifurcation (where the roots branch off). The tooth is dissected into two parts, and the affected tissue between the roots is removed. Subsequently, each segment of the tooth is covered with welded crowns with the restoration of the lost function of the dentition.

Tooth replantation - in other words, it is a return to a tooth socket, which for one reason or another was previously removed from it (on purpose, or, for example, was knocked out by accident on impact). It sounds incredible, but true. Today, such operations are rarely performed, usually in cases when the tooth is brought to the dentist, which has just been knocked out.

In Soviet times, when they were not available modern methods preservation of complex destroyed roots, such methods were more or less popular for various options for unsuccessful conservative treatment. For example, a dentist-surgeon could carefully remove a tooth beforehand, while a dentist-therapist performed intracanal treatment with filling and (sometimes) resection of the root apex (amputation, hemisection). The prepared tooth (or part of it) was fixed back into the hole in its original place using splinting with exclusion from the bite for several weeks.

Due to the technical complexity and not always justification, today the method of replantation of teeth is used only in exceptional situations.

When do you still have to remove the root?

If none of the tooth-preserving techniques can be applied, then the roots of the tooth must be removed.

Below are the most common situations in the practice of a dentist, involving the removal of tooth roots:

• With complex fractures of the tooth (for example, with longitudinal - see the example in the photo below);
  
• Against the background of serious inflammatory processes near the root (large cyst, periostitis, osteomyelitis, abscess, phlegmon);
  
• The destruction of the coronal part of the tooth is significantly below the level of the gums;
• Root mobility III degree;
• Atypical position of the decayed tooth (various dentoalveolar anomalies).

And some others.

However, as noted above, not every tooth fracture has to remove the remaining roots. A splinter can break off both from a living tooth and from a dead one, that is, previously pulped, and the dead are more vulnerable in this respect, since they become fragile over time. So, if the root is not badly damaged and has a solid base, then the tooth is restored by the usual methods: the canal is treated (if the tooth was alive) and the coronal part is restored using restoration or prosthetics.

There are some nuances regarding the roots of wisdom teeth: many patients are in a hurry to get rid of such teeth as soon as possible - the reasons may be different:

• Sometimes the hygiene of wisdom teeth is difficult and they are rapidly destroyed due to caries;
• Erupted wisdom teeth can cause displacement of the remaining teeth in the dentition, which often leads to an incorrect bite;
• Sometimes eights lead to regular cheek biting, that is, to chronic mucosal injury, and this is dangerous with the risk of malignant tumors.

Etc. However, before rushing to remove the eights, it is worth taking into account the fact that there are times when even a seemingly badly damaged wisdom tooth is important for removable or non-removable prosthetics. Not all people can afford the installation of dental implants in order to "scatter" even such teeth.

Therefore, in certain situations, a dentist can preserve the roots of a wisdom tooth by carrying out their full-fledged endodontic treatment and restoration of the tooth (for example, with an insert), followed by using it as one of the supports, for example, a bridge.

From the practice of a dentist

In fact, most dentists fairly conditionally adhere to the list of indications for the extraction of a tooth or its roots. The fact is that over the years of work, a practicing doctor forms his own opinion about the possibility of preserving a tooth in a particular clinical situation (this is often the result of numerous trials and errors).

So, for example, an inexperienced orthopedic dentist may insist on preparing the roots of a certain tooth for a future bridge, to which a competent and experienced dentist-therapist, suppose, refuses, justifying this with the mobility of the root (or roots), destruction of the inter-root septum, obstruction canals due to the resorcinol-formalin treatment method carried out many years ago, or a significant inflammatory focus at the root apex. Even one of the listed reasons is quite enough to abandon such an undertaking.

In addition, there is such a concept as "the functional value of a tooth": even if a tooth root can be technically restored in an accessible way, this does not mean that without a detailed analysis of the entire clinical situation, it is worth taking it up immediately. Will the tooth be able to function normally in the future? If not, then there is little point in this preservation. For example, this applies to the roots of teeth that are outside the dentition, or wisdom teeth that do not have antagonists (that is, they are not able, therefore, to perform a chewing function).

Root extraction methods: from simple to complex

In some patients of the old Soviet school, the doctor's message about the need to remove a tooth root causes almost panic. Typically, this reaction is associated with a number of the following fears:

“My molar on the bottom left fell apart, they said that I need to pull out the roots. Believe me, it hurts terribly, I myself went through this recently. They also told me that I would hardly feel anything, they comforted me so that I would not be very afraid. It's terrible, I burst into tears right in the chair, they even gave me a sedative. They crushed and hammered my jaw for an hour, the doctor was already sweating all over. The pain is wild, despite three injections ... "

Oksana, St. Petersburg

Fear of the dental office often leads to the fact that a person can walk for years with rotten remains of a tooth in his mouth: he looks in the mirror - the root has not yet completely rotted and does not hurt, so you can still be patient. All this time, the remains of the tooth will undergo more and more carious destruction, which in the future may further complicate the process of root removal.

Meanwhile, if you do not pull to the last, then it will be quite easy for the dentist-surgeon to remove the roots of the tooth with forceps, with cheeks specially adapted for this. Even if the roots are partially covered by the gums, incisions are not made. Moreover, the missing roots have an access line, that is, the gum cannot completely close the "rot" even over the years, so the dentist-surgeon only needs to slightly open them with a trowel and remove them with forceps. This usually takes about 3-10 minutes.

The photos below show the extraction of a tooth, the crown part of which is destroyed almost to the level of the gums:

From the practice of a dentist

In patients in adulthood (from 40 years of age and above), the removal of rotten tooth roots in the overwhelming majority of cases does not present any particular difficulties, since against the background of atrophy of the alveoli, a decrease in the height of the septa and inflammatory process near the roots, the organism “rejects”, as it were, "therefore, there is often their mobility to one degree or another. Practitioners are well aware that the older the patient is, the better, since removal, together with anesthesia, almost always takes a few minutes - to the delight of the patient and the doctor.

Now a few words about chiseling with a chisel and hammer. There are difficult cases when there is a tandem of 2-3 or more roots, that is, there is a full-fledged partition between them, and the patient's age is relatively young, the bone tissue around the roots is full. In other words, there is clearly no gift for the dentist-surgeon.

In such cases, forceps rarely help in solving the problem, and a professional dentist takes on ... No, not a chisel and a hammer. Currently, a professional dentist prefers modern approaches to remove such roots: sawing out with a drill and removing the roots separately with an elevator and / or forceps. This is especially true for the sixth teeth and wisdom teeth.

Photo of a tooth, the roots of which are separated by a drill before extraction:

Then in what cases do they still resort to a hammer and a chisel?

It is extremely rare, in dense villages of central Russia (figuratively speaking), this technique is used - moreover, it is used as the main one, since the dentist-surgeon either does not know about removing the roots using a drill and even hammer teeth with an almost intact crown, or he does not have a drill available (everything happens from the poor equipment of the offices).

Concerning pain during the procedure: when removing the roots of a tooth, absolutely the same anesthesia is performed in terms of quality and technique, as when extracting teeth with a crown part. If a dentist uses an outdated anesthetic in his work and, moreover, does not have a professional technique of anesthesia, the result will be disastrous, especially for the patient.

On a note

Quite actively circulated among the people, is it possible to remove a decayed tooth on your own using pliers? Even scary (from a professional point of view) examples of removal by this tool are given. Firstly, in many cases, a diseased tooth that has even deep carious destruction should not be removed, but it can be successfully cured by a dentist-therapist. Secondly, removal requires anesthesia, and without it, the pain will be very severe. Thirdly, with such a tooth extraction at home, there is a high risk of introducing an infection into the wound with the subsequent development of complications. And this is not to mention the fact that many of the daredevils can simply crush or break off part of the tooth with pliers, leaving roots and fragments in the hole.

About situations when after the extraction of a tooth its remnants remain in the hole

Patients' fears often relate not only to the fear of removing the roots of the teeth, but also to the prospects of the possible leaving of the remains of the tooth in the hole due to the doctor's carelessness (for example, a broken root with a cyst or fragments). Indeed, in practice, not very experienced specialists sometimes encounter similar precedents. Interestingly, a number of such dentists are firmly convinced that everything will be in order, and they tell their patients: "Do not worry, over time the root will come out by itself."

What happens if the tooth root was not completely removed by the doctor?

With complex tooth root removal, the dentist often finds himself in a situation where the root tip (tip) breaks off, and the view for further actions is closed by increased bleeding from the hole (in other words, the hole is all covered with blood and it is problematic to see anything in it). A professional can either work blindly, relying on his experience, or postpone the appointment, correctly explaining to the person what to do and when to visit him again to complete the work.

But if the doctor does not have much experience in tooth extraction, or fundamentally prefers the "hands-off" tactic (sometimes so as not to waste his time), then he advises the patient to simply wait for the root to "come out by itself." Say, do not worry, the problem will resolve itself.

Dentist opinion

The practice of leaving a broken tooth root in the hope that everything will be fine is flawed. Indeed, in many cases, a root or splinter left behind can long time do not bother, and the wound simply does not heal completely over the years - something like a canal or fistulous passage remains, and the root gradually moves to the surface of the gums. It can take a very long time (up to several years), and for the owner of such an incompletely extracted tooth, there is nothing good: the infectious process at the apex of the root continues its negative effect on the body.

It turns out worst of all when the root tip remains with a granuloma or cyst. Problems arise either immediately in the form purulent inflammation on the gum ("flux"), or delayed, but they will almost certainly occur (they can happen even after 10 years). The most unpleasant situation is when the left root is tightened by the gum and a new bone is formed around it, that is, the remainder of the tooth lies in a kind of capsule that separates it from healthy tissue. How long it will take before all this makes itself felt is not important, but the later the visit to the dentist follows, the more likely it is that with the development of an exacerbation of a purulent process (periostitis, osteomyelitis, abscess, phlegmon), help will be provided already in hospital on the operating table.

Thus, if the tooth was not completely removed (after the tooth was removed, a fragment of the root remained in the hole), then it is advisable to take measures to bring the work started by the doctor to the end, and this should be done in the near future. This will allow not to leave the inflammatory focus on long years, despite the assurances of the attending physician to wait until everything goes away by itself. In such cases, it is useful to contact another dentist without leaving a time bomb in your jaw.

After the extraction of a tooth, it may turn out that its roots will be completely extracted, but at the level of the gums you will find some small fragments at home. Moreover, a dentist from the picture can state the absence of roots in the hole, but will not pay due attention to the gingival margin. Here the fact is that a tooth destroyed by caries often crumbles during removal, and single fragments connected to the gum are not removed by a dentist-surgeon for a number of reasons:

• Poor vision due to bleeding of injured tissues;
• Inattention of the doctor;
• Negligence.

If this debris remains in the hole (even small pieces carious tooth), then the risks of developing alveolitis, an infectious inflammation accompanied by pain, edema, fever, general malaise and other unpleasant symptoms, increase to a certain extent. That is why a competent dentist not only removes all the roots of the tooth, but also examines the wound for the presence of small fragments of a tooth, pieces of bone (if the removal was difficult), and filling material.

A clean wound heals, as a rule, much faster and more comfortable than a contaminated one, therefore it is so important to consult a dentist in a timely manner and clean the hole if anything foreign is noticed in it.

Is it possible to remove a tooth root yourself

Today, on the Internet, you can often see the emergence of video reviews about how people remove their teeth at home. Moreover, there are not only video reviews, where adults and, to put it mildly, drunken men pull out their dilapidated teeth on their own, but there are also examples of self-removal of milk teeth in children.

Let's see if it's worth experimenting like this?

Not only does it not look very attractive from the point of view of aesthetics (people writhe in pain, blood literally runs down their fingers), but the main concern is, above all, the lack of sterile conditions during the procedure. You don't have to talk about the professional component at all: if the removal of a more or less whole tooth is realized once more from the tenth time (provided that the coronal part does not crumble into fragments), then teeth that have been destroyed to the root practically cannot be removed on their own.

Therefore, you should not even try to "pull out" teeth at home (including loose milk ones).

Interesting video: removal of the roots of two teeth with subsequent suturing of the wound

Available description of the instruments used in tooth extraction

Rotten teeth are not only the reason unpleasant odor from mouth. The process of decay in the oral cavity can lead to the loss of the affected dental unit, infection of adjacent teeth and the development of pathologies of internal organs. To prevent this from happening, you need to recognize the symptoms of this phenomenon in time and take measures to eliminate it. Everyone who cares about the health of not only the oral cavity, but the whole body, needs to know how to prevent tooth decay and what will happen if you ignore the signs of this process.

Causes of tooth decay

There is no unequivocal opinion about why teeth can rot, since too many factors can influence this process. External causes that provoke rotting include:

• neglect of regular teeth brushing;
• bad habits in the form of tobacco smoking, alcohol and drug abuse;
• a poor diet, leading to a deficiency of trace elements necessary for the body;
• excessive consumption of sweet and savory foods.

Along with this there are internal reasons... It is customary to refer to them:

• dental diseases;
• weakening of the body's defenses;
• pathology of internal organs;
• genetic predisposition;
• pregnancy;
• living in environmentally unfavorable conditions.

Wisdom teeth are often prone to decay. This is explained by the fact that the "eights" due to being in a hard-to-reach place is extremely difficult to clean from plaque, which eventually provokes the development of caries. In the case of ignoring carious lesions, the wisdom tooth begins to decompose.

Signs and stages of tooth decay

Teeth rot gradually. Depending on the stage of this process, the signs of pathology are manifested in different ways:

1. At the first stage, there are no painful sensations. As a result of the accumulation of plaque, a putrid odor from the mouth occurs.
2. After a certain time, the enamel acquires a yellow or brown tint, dark spots appear on its surface.
3. The next stage is characterized by an increase in the destructive process and the formation of black areas of various areas in the area of \u200b\u200bthe tooth neck. However, on a rotten tooth root, they will not be noticeable, since the destruction occurs under the gum. They can only be detected using radiography.
4. In the absence of treatment, hard tissues begin to rot. Gradually, a hole forms in the tooth, which will only grow over time (we recommend reading: why holes appear in the teeth and how to prevent this?). This stage is accompanied by painful sensations.
5. Further rot affects the inner part of the tooth - the pulp. In this case, unbearable pains appear, indicating the irreversible death of nerve endings. Some patients, even in such a situation, believe that nothing terrible is happening, and try to stop the painful sensations with the help of painkillers and various rinses.
6. After the development of the necrotic process, the pain subsides in most cases, but the inflammation spreads to the root of the tooth.
7. If the unit collapsed before the dental clinic, the surgeon will have to remove it along with the almost completely rotten root.

In difficult situations, the dentition becomes crooked, while the teeth are a terrible sight - the enamel becomes stained, their base becomes black, and the affected units turn yellow-brown. In addition to physiological problems, the patient begins to experience psychological difficulties, especially if the decay process has affected the front units, which are visible during conversation or laughter. Rotting teeth have to be hidden behind closed lips.

Can a rotting tooth be cured?

If the diseased dental unit has not completely rotted, going to the doctor will help save it. To understand if it is treatable, it is prescribed x-ray examination, according to the results of which the cause of the development of the decay process will be determined. The method of treatment is determined taking into account the factor that provoked the destruction of the tooth.

Modern dentistry has a large number of tooth-preserving techniques, the main types of which are subdivided into conservative and conservative-surgical. In the first case, the preservation of the destroyed unit does not provide for the intervention of the surgeon, the restoration of the root is carried out with the help of restoration, in the process of which pin structures, inlays or coronal elements are used.

If there is inflammation at the apex of the tooth root, in this case, a conservative-surgical method of tooth preservation is used. Its resection is performed after preliminary filling of the canals. This procedure is uncomplicated, in most cases it is carried out under local anesthesia and lasts no more than half an hour.

In certain situations, with inflammation of the apex or base of the tooth root, it is possible to do without surgical intervention... An anti-inflammatory drug is injected into the tooth canal for a period of 2–3 months to 1–2 years, which allows you to restore the bone tissue surrounding the apex of the tooth root.

If the decay has covered a significant part of the bone, the doctor will most likely prefer the conservative-surgical method as the only way to preserve the affected unit or to reduce the treatment time to several months instead of 1-2 years.

The radical way is removal

Removal of a rotten tooth root is carried out in cases where none of the tooth-preserving techniques can be applied. It will not be possible to avoid the removal of a rotten tooth root if:

• complex fractures of the dental unit;
• acute inflammation of the tissues surrounding the decaying root;
• destruction of the part of the crown of the tooth located significantly below the level of the gums;
• mobility of the dental root of the third degree;
• abnormal location of the affected unit.

As for wisdom teeth, in most cases, if they are damaged, they must be removed. Almost all "eights" after eruption cause a lot of problems. Firstly, the inconvenient location significantly complicates their care, as a result of which plaque accumulates on their surface, which provokes the development of caries and subsequent decay.

Secondly, wisdom teeth can shift the dentition, leading to malocclusion. Thirdly, when they erupt, they often injure the cheek from the inside, as a result of which it hurts and bleeds. It makes sense to preserve these teeth only when it becomes necessary to use them as support units during installation. orthodontic structuresused in dental prosthetics.

If a child's teeth rot

Rotten teeth are not only found in adults, babies are also prone to this phenomenon. In the smallest children, teeth often rot before they even have time to fully form. In this case, the main causes of destruction are an excess of sweets in the child's diet and poor oral hygiene.

If the mother did not eat properly during pregnancy or used certain medicationsforbidden to pregnant women, there is a high probability that the future baby will be susceptible to the development of putrefactive processes in the oral cavity. For young patients, the rapid transition of tooth decay to a severe form is characteristic.

If a baby's milk tooth decays, many parents ignore this phenomenon, believing that, since we are talking about a temporary unit, its loss will not cause any consequences. This is a misconception. When rot appears in the tooth, the child should be shown to the pediatric dentist as early as possible.

If possible, the specialist will save the diseased unit, otherwise it must be removed, which will eliminate the likelihood of infection of adjacent teeth and damage to the gums.

How to prevent pathology?

Particular attention should be paid to oral health for those who are at risk for a predisposition to the occurrence of various dental problems. These include women during the period of bearing a child, patients with poor heredity, as well as residents of ecologically unfavorable regions.

Parents of babies whose teeth are prone to destruction, the question arises of what needs to be done to eliminate this phenomenon. Experts recommend using various vitamin and mineral complexes that contribute to the proper development of the baby's skeletal system. Before giving a baby a pacifier, some parents or grandmothers dip it in honey, jam, or condensed milk. This is absolutely impossible to do.

Along with this, the child's consumption of sweets should be significantly limited, especially those that contain a large amount of dyes and various additives of artificial origin. An important preventive measure is the timely training of the baby to regularly brush his teeth. The first time you should control this process.

At least a couple of times a month, parents should examine oral cavity children. If black dots are found on the baby's enamel, you should immediately show the doctor. Effective way protection of children's teeth from caries and its consequences are procedures such as fluoridation and remineralization. In addition, children should regularly visit the dentist in order to carry out a preventive examination. Strict observance of these rules by both adults and children will save their teeth from the development of putrefactive processes and prevent possible removal sick unit.

What happens if you leave everything as it is?

Any pathological processes occurring in the oral cavity, in the absence of treatment, provoke the development of diseases of the internal organs. Ignoring the appearance of rot can lead to:

• gradual damage to all units of the dentition;
• activation in children of a hereditary predisposition to tooth decay;
• complete loss of appetite;
• malfunctions of the cardiovascular system;
• the development of endocrine diseases;
• kidney damage;
• destruction of bone tissue and dysfunction of the musculoskeletal system;
• the entry into the body of pathogens that provoke the development of severe pathologies of internal organs;
• hair loss from the occipital or temporal region - with damage to the units of the chewing group;
• frequent attacks of headache and the development of endocarditis - with the destruction of teeth at the base of the root.

Along with this, putrid breath can lead to social isolation of the patient, which will inevitably affect his mental state... In order to avoid these consequences of ignoring the process of rotting in the oral cavity, it is necessary to carefully monitor not only the health of teeth and gums, but also the state of the body as a whole, as well as the way of life.