The roots of the tooth are very vulnerable. Inside them there is a sensitive bundle of nerve endings and blood vessels: Any disease affecting the roots? leads to unpleasant sensations, hypersensitivity, spread of infection, exacerbation chronic diseases, deterioration in general health. All this is a good reason why removal of a rotten tooth root should be carried out shortly after the problem is discovered.
Why do the roots rot?
Dentists will identify several diagnoses that are characterized by the formation of pus. Do not forget that diseases also do not arise just like that, so they can rather be considered a consequence than a root cause. The causes of any oral diseases are poor hygiene, poor nutrition, lack of vitamins and microelements, bad habits. It is very important to always take care of your health, then no dental diseases will bother you.
Pulpitis
This is the name for severe inflammation of the pulp - the nerve and blood endings of the tooth, which we talked about earlier. In most cases, this disease occurs after a violation of the integrity of the crown, for example, during the treatment of caries or the same pulp. If you do not carefully treat the entire surface of the soft tissue, it may become infected, which will develop even after the installation of a filling or ceramic inlay. The nerve of the tooth will become inflamed, and the root will literally rot from the inside. Purulent pulpitis is the most acute stage disease, with it removal of the rotten tooth root is inevitable.
Toxic effects
An incorrectly selected filling, or more precisely, its material, can also cause tooth decay. The most dangerous material for a filling is plastic. It has a toxic effect, which is generally safe for humans, but taking into account the fact that the filling is in close proximity to blood vessels, the harm from such material increases significantly. Of course, plastic looks very good and ranks third among all materials in terms of strength, but all these qualities are not worth the possible consequences.
Periodontitis
Often, if not treated in a timely manner, pulpitis can develop into a more serious form - periodontitis. This disease affects not only the tooth itself, but also the gums.
The disease is characterized by disruption of the ligaments between the tooth and its socket. The root begins to loosen, cavities form around it, which become an environment for the development of infections. Inflammatory and purulent processes occur.
With this disease, especially in its acute form, there is extremely little chance of preserving the crown and root. If the source of the problem is not removed in time, the infection can spread throughout the body and lead to irreparable consequences.
Cyst
When an infection gets into the gum and pulp area, it inevitably occurs. inflammatory process, which most patients may not even notice. Soon such an infection leads to the formation of a cavity with pus.
Modern developments in dentistry make it possible to cure such a disease without affecting the tooth itself, for example, using a laser, however, for the treatment to be effective, it must be carried out on time. This is not always possible, because, as a rule, patients turn to a specialist at the very last moment, when they can no longer endure the pain.
Sometimes people even come to a specialist only after their tooth falls out. The cyst grows all the time and destroys the connective ligaments near the tooth, all the while causing pain to the patient. Soon the affected tissue reaches such an area that the tooth root will no longer be secured by anything.
In fact, in this case, it is not the root itself that rots, but the space around it.
Is it possible to save a crown by removing the root?
The myth that you can remove the roots without affecting the outside stems from misunderstandings about some dental procedures. Indeed, the root and crown can be removed in different time, but only in this order - first the crown and only then the root.
There is no separate operation to remove the inner part while preserving the outer part: it will be too risky, because for the sake of the root alone, the surgeon will have to cut off the gum and drill through the bone tissue. Because of high sensitivity Gum surgery can only be performed under general anesthesia.
Preserving the crown of a tooth in this way does not justify itself, because it would be much easier to completely remove the tooth and use one of the many types of prosthetics, fortunately today it has developed so much that anyone can choose a crown or bridge that is affordable.
Moreover, there will be no crown without a root. full tooth. Without nerve endings, it will quickly dry out and darken. Any physical injury will become critical for her.
Removing the crown of a tooth without roots, on the contrary, is possible, and some dentists, especially those who specialize in prosthetics, even insist on such a measure. Preserved tooth roots will allow the installation of removable overdentures, which in all respects are superior to any other type of false teeth. This prospect may not seem very interesting to young people, but a couple of decades will pass and they will change their minds, but for now, the “emptiness” in the dentition can be closed with a bridge.
Is it painful to remove a rotten root?
Removing a single root, especially if it is rotting, is much more difficult than simply removing a tooth, because first you need to clear the path to it, then cut off a little soft tissue, separate the root from the hole and pull it out with forceps, process and sew up the hole.
During the operation, the dentist will constantly touch soft tissues and nerve endings, so patients are often even more afraid than removing an entire tooth, because everything is much simpler there.
In fact, the patient will not feel the difference between removing a root or tooth or even installing a filling, because today almost any dental intervention is performed under anesthesia. For the especially impressionable, dental treatment under anesthesia is even available. Therefore, to the question of whether it hurts, you can definitely answer “No.”
How is the removal done?
The operation can be divided into several stages:
1) The patient is given an anesthetic injection in the cheek or gum area. After this, you need to wait a few minutes for the anesthetic to take effect.
2) If the crown and the root itself are intact, the operation is similar to a standard tooth extraction.
3) If the crown of a tooth has previously been removed, most likely soft tissue has grown around the top of the root and is covering it. In this case, part of the gum is cut.
4) The apex of the root is lifted with an elevator - a special tool in the shape of a thin blade. This is done to make it easier to remove the root from the hole.
5) The root is grabbed with forceps and pulled out of the hole.
6) The wound is disinfected and sutured. In some cases, implantation can be performed immediately.
7) A few weeks after the operation, the sutures are examined and removed.
What happens if you save a rotten root?
Even though the operation itself is very simple, there are still a lot of people who will be against it. We have already explained the reasons why it is advisable to preserve the roots of teeth, but all of them are crossed out if they rot. During this irreversible process, connective tissue and pulp cells are destroyed. The root will no longer stay in the hole, even if you remove everything damaged tissue, so there is absolutely no point in preserving the rotten root.
In most cases, it can even lead to the development of a host of new diseases, most of which are extremely dangerous for general condition health.
How much does removal cost?
In terms of complexity, root removal surgery is not much different from tooth extraction, which is why the prices are the same - from 1,500 to 2,500 rubles. There are clinics where this service will cost more and even those where the roots will be removed for a more reasonable price. It all depends on the specific region. Sometimes the price includes anesthesia, consultation with an anesthesiologist and tests. Then the price of the service can increase to 5,000, or even 10,000 rubles.
If you wish, you can independently decide which services you need and pay only for those that you used: for local anesthesia 200-300, for anesthesia - 3500-4500, for a specialist consultation - from 500, for tests - 400-500, for removal of stitches - 300-400 rubles.
1. Forced measure
Unfortunately, there is almost no case when a person has preserved the entire upper or lower chewing row, in cases where there were big problems with teeth. There are forced situations when the tooth root remains, and we need to part with the hard element that helps us chew food.
Why is this happening? Because the hard outer tissue is severely damaged by caries, and gradually causes bad condition that part through which solid elements are held. In this case, the tooth root is removed.
The procedure is necessary to eliminate the process of inflammation inside the gums.
Complication in soft tissues due to infection, swelling of the gums
Let's consider when it is better to remove a tooth root
- with a significant absence of the entire part of the chewing element due to its destruction or injury;
- in case of poor or inflamed condition of the internal part.
What happens if the tooth root is not removed?
Since conditions for pronounced problems can be created, it is necessary to urgently remove the rotten tooth root. In the opposite case, local appears and general deterioration human condition.
2. The question that interests everyone is when a tooth root is removed, does it hurt?
There is no need to worry that you will feel anything during the procedure.
Before the tooth root is removed, only certain painkillers used for this are selected. In modern dentistry, there are special anesthetic compositions specifically for this manipulation.
Due to severely damaged tissues of the hard element or even missing ones, the root remains broken off inside the gum. Sometimes we, left alone with the problem, think whether it is necessary to remove the roots of the teeth in this condition. Moreover, if there are no nerves in them, they don’t bother you. But this is only a certain period of time when there is a lull. Over time, an infection will get inside and this will cause a reaction in the form of inflammation.
Broken chewing element, with the remaining internal part (root)
Don't think that if you have a piece of debris left, it will be difficult to remove. There are many such cases. Let's look at how a tooth without walls is removed, and what is used for this.
In the procedure for extracting the inner part of the chewing element, one thing is important: the ability to grasp it with a tool (forceps). If difficulties arise, instruments are used to move away the covering tissue near the hard part.
How is the root of a tooth removed if the tooth is destroyed?
- To do this, the tissues are peeled off and deepened from the outer part by no more than 1 cm.
- Before the roots of the teeth are removed, if the tooth is destroyed, they may need to be rocked.
- When the remains of a hard element are located far from the outer side of the gum (deeper than usual), a spatula is used. Under the force of rotation and pressure of the tool, the residues are removed by pushing out.
- The effect on the remains of the tooth is supplemented by sawing parts with a drill (if necessary).
3. Complications during tooth extraction, the root remains, consequences and other problems
Bleeding may occur after the procedure and must be stopped. Considering the traumatic nature of how a tooth is removed, if only the root remains, the gums may be severely damaged or a splinter may remain there. Trauma to the hole or infection leads to alveolitis (inflammation).
Considering all the options for how to remove the root of a tooth if the tooth is destroyed, the doctor will first of all choose the path in which it will be possible to reach it with a tool and injure everything there as little as possible. But it is impossible to plan some situations, even with the high professionalism of a specialist.
This could be nerve damage or damage to the jaw bone. Such consequences include damage to nearby chewing elements and penetration into the maxillary cavity.
Human teeth are an organ that is subject to frequent destruction. This happens due to a series of various reasons– from poor care to injury. But when the crown is destroyed as a result of damage to the dental tissue, a root (or several roots) remains in the gum. The question arises - whether to delete it. If the patient cares about maintaining the integrity of the dentition, and immediately after losing a tooth goes to restore it, for example, to install an implant, removal is inevitable. But in most cases, people do not rush to the dentist to extract a root from the gum, which, as they think, does not interfere and does not pose a danger.
Save or delete
During treatment, dentists try to preserve at least one root on multi-rooted teeth as much as possible. If possible, it will serve as a support for the restored crown, and the tooth will perform its functions to a sufficient extent.
But after complete destruction of the dental tissue, if the carious process has reached the roots and completely captured them, it is better to remove the pathogenic source of infection from the gums as soon as possible, before it spreads to a large area, damaging neighboring teeth.
Removing a root with a damaged dental crown is difficult surgical procedure. Patients rightfully consider it one of the most unpleasant. And although today, thanks high level development of anesthesia, the process is not as painful as before, patients remain afraid of this operation.
By the way. Fortunately, in most cases it is not necessary to remove all of the tooth roots. If the carious lesion is not captured last stage, it is enough to treat the remaining roots, and subsequently resort to prosthetics or tooth restoration.
But when the carious process has destroyed the roots to the ground, if they are rotten through and through, it is necessary to part with them as quickly as possible.
A rotten root is a breeding ground for infection. The longer it is present in oral cavity, the greater the problems it creates.
Most often, patients with neglected rotting roots left after a tooth crown falls out or chips come to the surgeon for emergency assistance with the words: “The rotten root didn’t bother me for so long, didn’t hurt, and then suddenly my whole cheek was swollen.” Of course, this does not happen suddenly. A natural fact that will happen 100% at the most inopportune time if you have a damaged root in your mouth.
Important! For a patient with gumboil, it is almost impossible to painlessly remove the root, since anesthesia should take into account the projection of the roots into the gingival tissue, but this place is filled with pus. In some cases, it is necessary to make an incision in the gum to drain the purulent masses, carry out disinfection and send the patient without removing the ill-fated root. And not all patients return on time as prescribed by the doctor in order to undergo the removal operation. Many people leave everything as is, waiting for a new flux.
Indications for removal
If none of the tooth-preserving techniques can be used, the roots of the tooth are removed. There are a number of situations when surgery is unavoidable.
Table. The need for tooth root removal
| Reasons for deletion | Description |
|---|---|
| Complex transverse fracture, lobar fracture, or fracture of a dental crown. |
| Near the root there is a focus of inflammation. This can be a cyst, phlegmon or abscess, as well as in the case of osteomyelitis and periostitis. |
| There are three degrees of root mobility, the last of which, the third, is an indication for its removal. |
| The dental crown is completely destroyed below the level of gum tissue |
| Atypical location of the tooth root to be removed. |
The crown can be destroyed both on a “living” tooth and on a “dead” one. In the first case, the root is not badly damaged and can be saved. A pulpless tooth almost always has a severe degree of damage to the roots, and it cannot be restored using prosthetic techniques by adding a crown part. Root extraction and implant restoration are shown here.
By the way. For the roots of the posterior molars, the situation almost always requires their extraction.
- These are the most complex and problematic teeth, located in the far part of the jaw closure, which are difficult to care for. Therefore, hygiene is not carried out in full, and their destruction occurs faster than others.
- During the process of eruption, posterior molars often cause displacement of the dentition, disrupting the bite.
- They often provoke chronic injury to the mucous membrane, as a result of biting the mucous membrane from the inside of the cheek. This can lead to constant inflammation and the formation of malignant tumors.
Since there is no need to restore the coronal part, which often does not even fully emerge from the gum tissue, on wisdom teeth, in case of their abnormal growth or destructive carious lesions, the rear molars are removed along with the root.
From dental practice
There are many situations in which it is necessary to make a decision to remove or preserve roots. An inexperienced dentist, for example, insisting on preserving a half-rotten root to install a bridge may be wrong if:
- the root has high mobility (the prosthesis will also be mobile along with it);
- the interroot septum is destroyed by necrotic processes;
- the focus of inflammation is localized at the root apex (narrow part);
- the root has low functional value.
The latter means that even if it is therapeutically possible to preserve the root, this is not always advisable. Even if the root is partially restored, the restored coronal portion attached to it may not be fully functional.
Better to extract:
- roots of posterior molars;
- teeth that do not have antagonists (therefore they cannot perform the chewing function);
- roots of teeth emerging from the dentition.
How roots are removed
There are many methods for removing tooth roots in dentistry. But patients always feel fear when it comes to removing roots when the crown is completely or largely destroyed.
By the way. If the root is quickly removed from the gum before it is completely destroyed, the operation will not be the most difficult. Using forceps with “cheeks”, even without tissue incisions (if the root is not completely covered by the gum), an operation to remove the root of average complexity lasts about ten minutes.
The least difficult is root removal in patients aged forty years and above. In mature and old age, the alveolus atrophies, the height of the interroot septa decreases, and in almost all cases when the crown is destroyed, an inflammatory process forms in the root. Therefore, it is, as it were, pushed out, rejected by the body.
In younger patients, the hilar tissue usually remains healthy. When it is planned to remove two or more roots, the operation is considered complex.
Dental surgeon tools
Once upon a time, the roots were literally gouged out of the jaw with a chisel and a hammer (special dental ones, not construction ones, but it was still painful).
Today, the root is removed by cutting out the gum tissue using a drill and extracting it piece by piece using an elevator.
Cases when the root has to be hollowed out from the gums are recorded in only 2% of patients.
Anesthesia is complete and effective, and painful sensations minimal, as well as when extracting a tooth with a preserved crown part.
Unbelievable but true
Even today, in the 21st century, and by no means residents of “dense” villages, but completely civilized and educated people They try to remove the root of a damaged or dilapidated tooth on their own using pliers. The fear of going to the dentist is so great that, having taken a glass of vodka as anesthesia, the patient tries to grab the base of the root with this instrument, believing that after this it will not be difficult to pull it out.
Of course, when attempting such a removal, which usually will not be successful:
- the wound becomes infected;
- pain shock occurs;
- part of the root is crushed, filling the wound with fragments, which subsequently rot;
- complications arise.
Complications after removal
It is worth noting that complications are not uncommon after surgery to extract the root by a dentist. True, this doesn’t really concern experienced doctors who do not have much experience in such operations.
Due to inattention, negligence or due to lack of professionalism, root fragments remain in the wound. The doctor reassures the patient, assuring that the non-removed parts will subsequently come out of the gums on their own. Of course, this doesn't happen.
With severe removal, the surgeon may create a situation where the root tip breaks off. This is not always noticeable, because from the wound there's blood coming out. Experienced dentists in such cases, the appointment is postponed and the patient is scheduled for repeated removal.
Important! Leaving a broken root fragment in the wound is unacceptable. Yes, for a long time this fragment can be in the gum without causing concern to the patient. But he will move towards the surface, along fistula channel. And if there was a cyst at the top, then even after several years of “calm” behavior, the remains of the root can provoke gumboil.
The second unpleasant situation can arise with a seemingly successful outcome, when the remainder of the root tissue is covered by the gum and ends up locked in a capsule of gum tissue. Such a “time bomb” will certainly provoke phlegmon or an abscess, and will also cause periostitis and osteomyelitis.
Sometimes a situation arises: the root is removed completely and purely in depth, but fragments are stuck in the gum tissue above. This is the most common surgical negligence that the patient must monitor. If you feel that life has not improved after removing the rotten root, consult another doctor. Listen to the opinion of at least three dentists in order to subsequently avoid alveolitis or other diseases.
Summary
IN modern dentistry everything is not as scary as it seems. For any pain threshold, the patient is given local anesthesia. The anesthetic will remain effective throughout the procedure and for two hours after it.
As the anesthetic begins to take effect, the jaw becomes numb. Modern lever elevators will then remove plaque, food and other foreign organisms quickly enough to allow access to the root. You need to remove it. Therefore, the best thing you can do if you have a root in your mouth is to go to the surgeon and find out whether it is worth carrying out a planned, timely removal so as not to cause serious pathological complications.
Video - Removing tooth roots
Tooth roots are a condition that results from tooth fracture due to injury or during dental procedures, such as extractions. It can also be the result of advanced caries, leading to complete or significant destruction of the crown. In some cases, the crown is restored using a filling with a pin or by prosthetics (depending on the degree of preservation of the coronal part). But often the roots must be removed. Many patients cannot imagine how to remove a tooth root. This operation in dentistry is indeed one of the most technically complex. If the root is broken during removal, then its remainder is located inside the alveoli and is visible only on x-ray. This is usually detected immediately, since doctors always examine the tooth after removal and check whether the roots are broken. If this happens, the patient is sent to take an X-ray, and the operation is completed on the same day. Many “carry” the roots of teeth destroyed by caries for years and decide to remove them only when pain occurs.
Removal Tools
The use of dental surgical instruments depends on the anatomical structure of the tooth. There are upper and lower teeth, as well as chewing teeth, incisors and canines. For each case, different forceps are provided (straight, bayonet-shaped, S-shaped, beak-shaped). To remove tooth roots, in addition to forceps, you need elevators (straight, bayonet-shaped, angled, double-bent). Sometimes dentists use a hammer and chisel, but today this method is used less and less.
How to remove tooth roots if part of the crown remains
The operation is performed different methods depending on the presence of pathologies in the tissues surrounding the tooth, its location and the degree of destruction of the crown. In some cases, you can do without a special tool. If there is no inflammatory process, then using a smoothing tool the circular ligament is separated from the neck of the tooth, and the gums are separated from the alveoli. Then forceps are applied and removed. With inflammation, the surrounding tissues are more pliable, and it is possible to apply the instrument more deeply.
Removing roots that are completely devoid of a crown
But it is not always possible to “grab” the rest of the tooth, then the surgeon resorts to using a special tool. In this case, an elevator is used, which is inserted between the wall of the hole and the root. If it is not possible to remove a tooth with connected roots in this way, then they are separated with a drill and removed one at a time using an elevator and forceps. In addition, a chisel and a hammer are used to remove roots connected by a bridge. In this case, you also need an assistant. This method removes the tooth faster than using a drill, but such an operation is too unpleasant for the patient. Often, sutures are required after root removal.
Take care of yourself ahead of time
Do not keep tooth roots in your mouth, which are a chronic source of infection. Better yet, don’t let your teeth get to this point. Prevention and timely treatment at the stage of medium caries, they significantly save money and your nerves.
Tooth extraction, and especially tooth root removal, is still considered a “terrible” procedure. Perhaps this is true if you visit the dentist once every few years and choose offices in municipal clinics. Today's dentistry has come a long way, and if you are undergoing treatment in a clinic equipped with modern equipment, there is no reason to be afraid of pain and consequences.
Myths and truth about root removal
tooth root removal will relieve pain
Most cases in which tooth extraction was previously practiced are now amenable to conservative treatment. And the use of new drugs allows treatment to be carried out quickly, painlessly and while preserving the functions of the tooth. What does this mean for the patient?
First, are you really going to have to extract the root of the tooth? First, you need to consult a dentist. Today, the main actions of the doctor are to preserve the structure and integrity of the tooth, removing only the affected tissue. Thus, if a tooth is broken at the root as a result of a mechanical impact (for example, a strong blow), there is a high probability that it will be possible to save it - to carry out extensions.
A specialist can correct the situation even if the tooth has been damaged improper treatment or the patient neglected the treatment too much. If only the root remains of the tooth due to the fact that the upper part has broken off or crumbled, extension is also possible. In fact, tooth extraction with all its roots is now performed only if it is severely degraded (softened) bone tissue around it or if the root itself has crumbled.
Having come to terms with the inevitability of going to the dentist, the patient begins to be interested in only one question: does it hurt to remove the root of a tooth? - No, today it’s no more painful than getting a vaccine. For pain relief, an injection is made with a very thin needle. The tooth and adjacent tissues are “frozen” and become completely insensitive.
Removing the nerve during root treatment also causes a lot of fear. The fact is that many still believe that arsenic is used for this. In fact, this is only practiced in the cheapest dental offices. IN modern clinic the nerve is removed under local anesthesia in one session, often together with subsequent manipulations. Thus, treatment is faster and more comfortable for the patient.
Which is correct: remove the root or remove the roots?
Molars in an adult usually have from two to four roots. Since caries and subsequent changes in tooth tissues usually begin with a single focus, not all roots are affected. Therefore, an operation called root extraction will be required for one or two roots. The remaining roots can be preserved, and the tooth does not lose functionality. It is involved in chewing food and is used as a support for prosthetics.
There are several types of root removal surgery:
Hemisection. Partial tooth extraction. Performed on molars lower jaw in order to localize pathological processes. The dentist removes the affected root with the adjacent crown (the top part of the tooth). The roots adjacent to the one being removed are sealed.
Amputation. Actually, complete removal tooth root. Performed on molars upper jaw, also for localization pathological processes. First, the roots of the teeth are exposed due to the detachment of the mucous tissue of the gums, then the affected root is cut off with a bur and removed using forceps. The vacated space is filled with osteoplastic material.
Cystectomy. The cyst on the root of the tooth is removed. To do this, the dentist opens top part root, exfoliates the cyst and fills the adjacent tissues with osteoplastic material, which promotes the restoration of bone tissue. This operation guarantees tooth preservation in 100% of cases. Manipulations are carried out only with the affected root.
All these operations, as mentioned above, are performed under local anesthesia.
When is root removal necessary?
As a rule, tooth root removal is required during treatment of complications, when inflammatory processes develop in the root of the tooth and in the tissues adjacent to it. If the inflammation is not stopped, it will spread to the upper jaw maxillary sinuses, and on the lower one it can cause osteomyelitis and fracture.
Leads to tissue death or cyst formation. Inflammation develops very often if sterility has been violated, treatment methods and materials for filling have been poorly selected. If the granuloma is advanced, there is a high probability that the tooth will have to be lost. Also, a dentist who is not completely confident in his abilities will offer you a complete tooth extraction.
However, cystectomy or is one of the most common root operations today. If it is carried out correctly, it is possible to stop the inflammatory process and preserve a functional tooth.
Another reason why intervention has to be performed is perforation of the tooth root. When perforation occurs, the inside of the tooth becomes connected to external environment, from there microorganisms penetrate into the tooth and inflammation also occurs.
Perforation, as a rule, is also a consequence of unskilled work by the dentist. However, in many cases the patient simply does not come for a long time. preventive examination. The fact is that treated teeth still degrade over time, for example, new cracks appear on them. Even careful care at home is not always a guarantee that a tooth will last you the rest of your life. Therefore, we remind you once again: a timely visit to the dentist will guarantee you minimal intervention and will allow you to save teeth that would otherwise have to be removed.
