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If teeth rot, the body becomes poisoned. What to do if there is active tissue destruction and rotten teeth appear: photos of the disease and recommendations for treating the pathology

In what cases may it be necessary to remove the root of a tooth, or part of it (for example, resection of the apex);
Why “rotten” tooth roots should be removed as soon as possible and what can await you if this is not done on time;
In what cases can tooth roots be preserved (for subsequent prosthetics) and by what methods is such preservation implemented?
Typical clinical situations when a tooth root needs to be removed (and what is useful to know if, for example, a significant piece breaks off from a tooth while eating);
Methods for removing tooth roots, ranging from simple to complex and traumatic (using a dental chisel and hammer);
What to do if, after tooth extraction, a root or small fragments remain in the socket...

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

It’s a different 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 and granulomas. Then the dental surgeon may suggest resection of the root apex or even amputation of the entire tooth root. We will also talk about this a little further below...

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

Let’s start with this – let’s see why, in fact, it is necessary to remove damaged tooth roots as soon as possible...

Why should rotten, destroyed remains of tooth roots be removed?

From the point of view of a dentist, the situation when a patient walks for years with a rotten tooth destroyed to the ground looks 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 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 severe the problems are, and they are far from being limited to constant bad breath. These porous “rotten things”, like a vacuum cleaner, absorb bacteria and food particles. In addition to rotting food, the remains of the tooth also contain plaque that is difficult to remove and almost always supra- and subgingival tartar, which is why the gums begin to suffer.

In almost 100% of such cases, an inflammatory process is observed at the tops of rotten roots, accompanied by thinning of bone tissue, and a granuloma or cyst is formed. Simply put, there is a purulent sac hanging at the top of the root, which is just waiting in the wings to break through to form 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, the human immune system is forced to constantly expend its resources to fight the infection in order to somehow compensate for this problem (frequent illnesses may occur).

If such a tooth root is not removed, sooner or later a moment comes when the body’s forces can no longer prevent the spread of infection - an acute inflammatory process will occur, often accompanied by significant swelling. The favorite phrase of such patients: “The root was rotting for so many years, it didn’t hurt, and then suddenly the cheek suddenly swollen, and as always, at the wrong time.”

Note

And how, one might ask, should a dentist painlessly remove a tooth root for such a patient with gumboil, for whom the slightest touch to the gum causes severe pain? After all, anesthesia is almost always done in the projection of the tooth roots onto the gum, and at that moment a significant amount of pus accumulates there. The surgeon has a choice here: somehow try to inject the 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 removing the root will be painful.

As you can see, there is no point in delaying the removal of rotten tooth roots - they must be removed, and the sooner the better.

In what cases can tooth roots be preserved, and by what methods is this implemented?

Suppose that in your oral cavity you have a tooth (or even several), which can hardly be called a full-fledged tooth due to destruction, 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 all that remained of the tooth were “horns and legs”: one or two walls or remnants of the walls of the tooth. Or, for example, while eating, a significant piece broke off from a molar, leaving only a “stump” with sharp edges.

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 tooth preservation do not involve surgical interventions, and the preservation of the root (tooth stump) is carried out by preparing canals (if necessary) and restoring the coronal part using a suitable method, for example, using restoration with a light-curing material using a pin, 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 tooth canals (most often with dental cement), resection of the root apex is performed on the same day or in a delayed manner. This operation is usually performed under local anesthesia and can be performed on both single-rooted and multi-rooted teeth. The operation is generally simple and usually takes 15-30 minutes.

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

Note

Resection of the apex of the tooth root is carried out in several stages. At the first stage, preliminary preparation takes place (history collection, 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 an incision in the gum, peeling off the soft tissue, sawing out a special small “window” in the bone and identifying 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 put into the wound to stimulate the growth of bone tissue and accelerate healing. The wound is sutured. Prescribing medications for home treatment (including painkillers) allows you to minimize possible painful sensations and allows the patient to return to their normal life in a matter of days.

Much less popular techniques to prevent the removal of the entire tooth are hemisection and root amputation.

During hemisection, the affected root is removed with 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, unlike hemisection, does not involve excision of the coronal part: only the root (the entire one) with the cyst or granuloma present on it is removed.

This is interesting

Exclusive options for preserving a severely damaged tooth are coronoradicular separation and tooth replantation (for example, if the tooth was knocked out due to mechanical impact).

Coronoradicular separation is carried out in relation to large molars, when in the area of bifurcation or trifurcation of the roots (where the roots branch) there is a focus of inflammation that cannot be treated. The tooth is cut into two parts, and the affected tissue between the roots is removed. Subsequently, each tooth segment is covered with soldered crowns to restore the lost function of the dentition.

Tooth replantation - simply put, is the return to the socket of a tooth that, for one reason or another, was previously removed from it (on purpose, or, for example, was accidentally knocked out by an impact). It sounds incredible, but it's true. Today, such operations are rarely performed, usually in cases where the tooth is brought to the dentist having just been knocked out.

In Soviet times, when modern methods for preserving complex destroyed roots were not available, such methods were more or less popular for various options for unsuccessful conservative treatment. For example, a dental surgeon could first carefully remove a tooth, and a dental therapist would carry out 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 socket in its original place using splinting, excluding it from the bite for several weeks.

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

In what cases will the root have to be removed?

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 dentist practice that involve the removal of tooth roots:

For complex tooth fractures (for example, longitudinal fractures - see example in the photo below);
Against the background of serious inflammatory processes near the root (large cyst, periostitis, osteomyelitis, abscess, phlegmon);
Destruction of the crown part of the tooth is significantly below the gum level;
Root mobility grade III;
Atypical position of a destroyed tooth (various dental anomalies).

And some others.

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

There are 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 malocclusion;
Sometimes figure eights lead to regular cheek biting, that is, to chronic injury to the mucous membrane, and this is dangerous with the risk of malignant formations.

And so on. However, before you rush to remove figure eights, it is worth taking into account the fact that there are cases when even a seemingly severely damaged wisdom tooth is important for removable or fixed prosthetics. Not all people can afford dental implants to “throw away” even such teeth.

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

From the practice of a dentist

In fact, most dentists rather tentatively adhere to the list of indications for removing a tooth or its roots. The fact is that over the years of work, a practicing doctor has formed his own opinion about the possibility of saving a tooth in a given clinical situation (often this is 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 by the mobility of the root (or roots), destruction of the interradicular septum, or 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 reasons listed is quite enough to abandon such an undertaking.

In addition, there is such a thing as the “functional value of a tooth”: even if the root of a tooth can technically be restored in an accessible way, this does not mean that without a detailed analysis of the entire clinical situation it is worth taking on it immediately. Will the tooth be able to function normally in the future? If not, then there is little point in saving it. 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 therefore unable to perform a chewing function).

Methods for removing tooth roots: from simple to complex

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

“My lower left molar has fallen apart, they said I need to pull out the roots. Believe me, this is terribly painful, I recently went through this myself. And they also told me that I wouldn’t feel almost anything, they consoled me so that I wouldn’t be too afraid. This is terrible, I burst into tears right in the chair, they even gave me a sedative. They cut and gouged my jaw for an hour, the doctor was already sweating. 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 around 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, which means he can still be patient. All this time, the remains of the tooth will be subject to increasing carious destruction, which in the future may further complicate the process of root removal.

Meanwhile, if you don’t wait until the last minute, it will be quite easy for a dental surgeon to remove the roots of a tooth using forceps with cheeks specially adapted for this. Even if the roots are partially covered by the gum, no incisions are made. Moreover, the roots that have disappeared from sight have an access line, that is, the gums cannot completely close the “rotten spots” even over the years, so the dental surgeon can only open them a little with a trowel and remove them with forceps. This usually takes about 3-10 minutes.

The photographs below show the removal of a tooth, the crown part of which has been destroyed almost to the level of the gum:

From the practice of a dentist

In patients of mature age (from 40 years and above), the removal of rotten tooth roots in the vast majority of cases does not present any particular difficulties, since against the background of alveolar atrophy, decreased height of the septa and the inflammatory process near the roots, the body “rejects” these roots, as it were, therefore, there is often their mobility to one degree or another. Practicing doctors know well that the older the patient, the better, since removal along with anesthesia almost always takes a matter of minutes - to the delight of the patient and the doctor.

Now a few words about chiseling tooth roots using 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 dental 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 removing such roots: sawing with a drill and removing the roots individually with an elevator and (or) forceps. This is especially true for sixth teeth and wisdom teeth.

Photo of a tooth whose roots are separated by a drill before removal:

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

It is extremely rare, in the dense villages of central Russia (figuratively speaking), this technique is used - moreover, it is used as the main one, since the dental surgeon either does not know about removing roots using a drill and chisels even teeth with an almost complete crown, or he doesn’t have a drill (it all happens because of the poor equipment in the offices).

As for pain during the procedure: when removing the roots of a tooth, the anesthesia is absolutely the same in 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 command of anesthesia techniques, the result will be disastrous, especially for the patient.

Note

A fairly actively discussed topic among people is whether it is possible to remove a decayed tooth yourself using pliers? There are even terrifying (from a professional point of view) examples of removal with this tool. Firstly, in many cases, a diseased tooth, even if it has deep carious destruction, should not be removed, but can be successfully treated by a dentist. Secondly, removal requires anesthesia, and without it the pain will be very severe. Thirdly, with such tooth extraction at home, there is a high risk of infection in the wound with subsequent development of complications. And this is not to mention the fact that many daredevils can simply crush or break off part of a tooth with pliers, leaving roots and fragments in the hole.

About situations when, after a tooth is removed, its remains remain in the socket

Patients’ fears often concern not only the fear of removing tooth roots, but also the prospect of possible tooth remains left in the socket due to the doctor’s carelessness (for example, a broken off root with a cyst or splinters). Indeed, in practice, not very experienced specialists sometimes encounter similar precedents. Interestingly, a number of these dentists are firmly convinced that everything will be fine, and tell their patients: “Don’t worry, over time the root will come out on its own.”

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

During a complex tooth root removal, the dentist often finds himself in a situation where the apex of the root (tip) breaks off, and increased bleeding from the socket obscures the view for further action (in other words, the socket is completely filled with blood and it is difficult to see anything in it). The professional can either work blindly, relying on his experience, or postpone the appointment, competently 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 tactics of “non-intervention” (sometimes in order not to waste his time), then he advises the patient to simply wait until the root “comes out on its own.” They say, don’t worry, the problem will resolve itself.

Dentist's opinion

The practice of leaving a broken tooth root in the hope that everything will be fine is vicious. Indeed, in many cases, an abandoned root or fragment may not bother you for a long time, and the wound simply does not heal completely over the years - something like a canal or fistulous tract remains, and the root gradually moves to the surface of the gum. This can take a very long time (up to several years), and there is nothing good for the owner of such an incompletely removed tooth: the infectious process at the root apex continues its negative impact on the body.

The worst thing happens in cases where the root apex remains with a granuloma or cyst. Problems arise either immediately in the form of purulent inflammation on the gums (“flux”), or delayed, but they will almost certainly arise (they can happen even after 10 years). The most unpleasant situation is when the left root is pulled in by the gum and 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 the 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 socket), then it is advisable to take measures to complete the work begun by the doctor, and this should be done in the near future. This will allow you not to leave the inflammatory focus for many years, despite the assurances of the attending physician to wait until everything goes away on its own. In such cases, it can be useful to contact another dentist without leaving a time bomb in your jaw.

After tooth extraction, it may turn out that its roots will be completely removed, but at the gum level you will find some small fragments at home. Moreover, the dentist can state from the image that there are no roots in the socket, but will not pay due attention to the gingival margin. The point here is that a tooth destroyed by caries often crumbles during removal, and single fragments connected to the gum are not removed by a dental surgeon for a number of reasons:

Poor vision due to bleeding of injured tissues;
Doctor's carelessness;
Negligence.

If this debris remains in the hole (even small pieces of carious teeth), then the risk of developing alveolitis, an infectious inflammation accompanied by pain, swelling, fever, general malaise and other unpleasant symptoms, increases 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 tooth fragments, pieces of bone (if the removal was difficult), and filling material.

A clean wound, as a rule, heals much faster and more comfortably than a contaminated one, which is why it is so important to promptly consult a dentist 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 video reviews about how people remove their own teeth at home. Moreover, there are not only video reviews where adults and, to put it mildly, tipsy men independently pull out their dilapidated teeth, but there are also examples of self-removal of baby teeth in children.

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

Not only does it not look very attractive from an aesthetic point of view (people are writhing in pain, blood literally runs down their fingers), but the main concern is, first of all, the lack of sterile conditions during the procedure. There is no need to talk about the professional component at all: if the removal of a more or less whole tooth is still possible after the tenth time (provided that the crown part does not crumble into fragments), then teeth destroyed to the root are practically impossible to remove independently.

Therefore, “pulling out” teeth at home (including loose milk teeth) is not worth even trying.

Interesting video: removal of the roots of two teeth followed by suturing the wound

An accessible description of the instruments used in tooth extraction

Visiting the dentist's office is an ordeal for many people. Patients believe that root removal is accompanied by pain, as well as mandatory cutting and suturing of the gums. However, modern methods, instruments and materials allow the operation to be performed with virtually no discomfort or complications.

Is it necessary to remove the root of a decayed tooth?

When there is no dental crown, but there are roots in the gums, you need to determine what condition they are in. The coronal part can be destroyed both on a tooth with a nerve and on a pulpless one. If the roots of a tooth are severely damaged, it cannot be restored. The dentition is restored by installing an implant or bridge after removing fragments of the unit.

Should teeth be removed if they don't hurt? Patients often turn to dentists with the following symptoms: a tooth has crumbled to the base and rotted, but the person is not bothered by pain. The strength of the immune system allows you to contain the spread of infection for a certain time, but there comes a time when acute inflammation occurs, accompanied by swelling. Then you can lose both the destroyed unit and its neighbors.

Absolute indications for removal

Amputation of the rotten root is mandatory, since it is a breeding ground for infection. The problem is not only bad breath - bacteria multiply in the remains of the unit, supragingival or subgingival calculus is present on them, which causes gum inflammation. Almost always, the tops of the roots are infected, which can cause a granuloma to form, which subsequently leads to gumboil (we recommend reading: is it possible to remove flux from the gums at home and how?). You can see what a decayed tooth looks like in the photo.

Removal is indicated in cases:

periodontal diseases;
if the tooth is loose;
the presence of a cyst, abscess;
caries damage;
complex tooth fracture;
the presence of fragments deeply stuck in the hole;
atypical position of the unit.

Removal of wisdom tooth roots is almost always required. These are far located molars, for which there is no way to properly care, so the “eights” are quickly destroyed. Wisdom teeth often cause displacement of other units and constant inflammation due to cheek biting. Units are saved if they have grown correctly and are not too damaged. A crown is placed on the wisdom tooth or used for further restoration of the row using a bridge.

When can you leave the root if the tooth is crumbled?

If possible, dentists strive to save at least one root of a damaged multi-rooted tooth. It can become a support for the crown, thanks to which the unit will continue to perform its functions.

If a wall or only a root is present due to the loss of the filling of a pulpless tooth or the chipping of a piece of it, the remaining parts can be preserved. This is done in cases where the root or surrounding tissues are not susceptible to pathological processes.

The dentist uses conservative and conservative-surgical treatment methods. In the first case, the root is filled, and after therapy the unit is restored using a pin or stump inlay. A crown is placed on a metal base, which will allow the tooth to fully perform its function.

A conservative surgical technique is required if there is inflammation at the apex of the root canal. The operation is carried out within half an hour - the doctor cuts off the top of the root.

Sometimes, in case of inflammation, it is possible to avoid surgical intervention - the doctor injects an anti-inflammatory drug into the canal. The product can remain in it from 2-3 months to 1-2 years, during which time the bone near the apex of the root is restored. However, when there is significant loss of bone tissue, specialists often resort to surgical methods to preserve tooth remains.

How is the root removed?

Many patients are interested in the question of how roots are removed, because you need to prepare for the procedure not only physically, but also mentally. If a tooth has rotted, several methods can be used to extract it:

Preparing for surgery

If a tooth has decayed and the patient decides to undergo surgery, it is necessary to prepare for it. The person undergoes a complete examination of the oral cavity. Soft deposits and stone are removed from the teeth adjacent to the diseased unit.

Immediately before the procedure, the dentist examines the mucous membrane for inflammation or suppuration. He performs hygienic treatment of soft tissues to prevent the penetration of microbes into the wound that remains after the intervention. The patient rinses his mouth with Eludril or Chlorhexidine - this kills 90% of pathogens.

Additional treatment will be required before complex tooth root removal. The doctor wipes the patient's face with alcohol or Chlorhexidine. A cape is placed on the chest to protect clothing from possible contact with saliva, blood, etc. The manipulation will not hurt - the method of anesthesia is selected at the preparation stage, based on the patient’s age, allergies and various diseases. If the root is deep, a soft tissue incision will be required.

Required Tools

To remove a decayed tooth, doctors use several types of instruments:
(we recommend reading: how to remove a tooth yourself at home?)

Forceps. There are different types of forceps, including separate instruments for the lower and upper jaws, devices for root extraction when mouth opening is limited, etc.
Elevators. Each type of instrument (straight, angular, etc.) is intended for a separate group of teeth.
Drill. The device is necessary for sawing the tooth and removing the roots or parts thereof.

Amputation process

The operation begins by peeling away the tissue around the unit. Tooth root amputation is performed using certain working methods:

The choice of root removal method is influenced by the degree of tooth damage and the presence of transformations in the bone tissue. If the root is rotten and the bone is slightly deformed due to inflammation, then a specialist will only need forceps for extraction. They are applied at the final stage after separation of the alveoli and gums. When this instrument fails to cope with the task, the doctor uses an elevator.

What to do if the tooth has rotted down to the gum (for more details, see the article: what to do if the tooth has rotted down to the gum?)? In this case, a drill is used. The device allows you to cut the unit into pieces, then each piece is removed separately. The fragments are removed with another tool. When extracting a wisdom tooth, additional devices are used (we recommend reading: tooth extraction: what it is and the technique).

If the root is pulled out before it is completely destroyed, the operation will not be difficult. The procedure usually takes about 10 minutes. Extraction in people over 40 years of age is quite easy, since the alveolus atrophies and a focus of inflammation is formed - the body independently rejects a piece of the remaining tooth. When several roots are planned to be removed, the procedure is considered complex.

It is quite rare to resort to amputation of the subgingival part of the unit while preserving the crown. It is carried out when a cyst or granuloma forms, when there is a chance to save most of the unit.

Possible consequences

Complications after extraction of a tooth or root are a phenomenon that occurs due to the doctor’s lack of experience or his negligence. If a unit falls out due to injury, it is worth taking an x-ray so that the doctor can make sure that there are no fragments left in the hole. During the procedure, the following may occur:

Breaking off the top of the root. There is blood coming from the wound, so the fragments are not always visible. The specialist should prescribe a repeat removal.
Fragment stuck deep in the hole. Part of the tooth cannot be seen without an x-ray; it is covered with epithelial tissue and does not bother you at first. Subsequently, the capsule of fibrous tissue and fragment provokes the formation of an abscess or phlegmon.
Pieces of bone become lodged in soft tissue. This is a local complication; fragments can often be removed on your own or in a doctor's office under anesthesia (without cutting tissue).

Do I need to remove the remaining tooth fragments? Leaving them in the wound is unacceptable, as this can lead to unpleasant consequences:

What to do if there is a piece left after removal?

If there is a fragment left in the gum, you should not delay visiting a doctor. The specialist will remove residual fragments and treat the wound with an antiseptic. The operation is performed in two ways:

when the fragment is on the surface, extraction is carried out in a few minutes with a special tool;
if the piece is located deep, an incision is made in the gum to extract it.

Sometimes doctors are faced with a situation where the splinter is overgrown with gums - it is completely covered with mucous membrane. In this case, treatment is carried out in several stages:

Is it possible to pull out a rotten tooth root at home?

There are many videos on the Internet showing how people try to pull out teeth at home. Is it worth experimenting on yourself so cruelly? Attempts at self-removal can lead to unpredictable consequences for a number of reasons:

choosing an anesthetic and correctly injecting it in the right dose into the gums is very problematic without medical education;
It is difficult to maintain sterility at home, so the risk of infection in the wound is high;
improper tissue incision can cause serious bleeding;
Without the use of anesthesia, painful shock is possible.

While it is still possible to remove a strong, whole tooth, a rotten root cannot be extracted. The crown of the tooth or its subgingival part may crumble, fragments will get stuck in the socket, decomposing and infecting the surrounding tissues. Dentists categorically do not recommend trying to remove not only permanent, but even baby teeth on your own.

Orthopedic dentist Martynov D.V. Personal website.
Current information about dental prosthetics and modern dentistry.

Restoration of damaged teeth

In this article we will talk about severely damaged “teeth”, of which only part of the crown or only the root remains. As a rule, these are pulpless teeth with old fillings that have fallen out, broken walls or worn-out chewing surfaces. In most cases, there is no pulp in such teeth: it is either necrotic, or the root canals have already been filled.

Causes of tooth decay

Most often, teeth are destroyed as a result of caries and its complications, or injuries.

Caries never goes away on its own. If you do not consult a dentist, the tooth will continue to decay.
Old fillings, especially cement ones, wear out over time, and there is a need to replace them. Otherwise, the tooth will be destroyed.
Depulped teeth darken and become brittle over time. It is important to cover them with crowns in a timely manner to extend their lifespan. Without this, there is a high risk of chipping part of the tooth crown.

A frivolous attitude towards these problems over time leads to significant tooth decay.

Tactics for severely damaged teeth

1. Survey and long-term assessment

First you need to decide whether to save such a tooth? This is described in detail below.

2. Restoration of the “tooth stump” of a damaged tooth using a pin or inlay.

The method of tooth restoration depends on the degree of its destruction, the age of the patient and the condition of the oral cavity as a whole. There are 2 main methods: using pins (titanium or fiberglass) or pin-stump inlays. At this stage, the doctor strengthens and restores the inside of the tooth, which will later be used as a support for an artificial crown. It may be necessary to perform root canal treatment on this tooth first.

3. Making an artificial crown for the restored tooth.

The restored tooth must be protected from further destruction. This is achieved by making a crown to cover it.

What happens if a damaged tooth is not restored?

Significantly damaged teeth are almost not involved in chewing food, since they lack a chewing surface. They simply take up space in the mouth. The chewing pressure on them is always much less than the load that is placed on healthy teeth. Under such conditions, such teeth can exist in the oral cavity for years. This is possible provided that the root canals are properly sealed. If there are pathological changes around their roots, then such a tooth is a constant source of chronic inflammation in the body. Such a focus of bacterial infection can “shoot” at the most inopportune moment. Consequently, the issue of preserving severely damaged teeth must be addressed immediately when they appear in the oral cavity.

There are only two solutions: either the tooth is preserved or removed. If it persists, then it needs to be restored. If it is removed, then it is necessary to restore the integrity of the dentition after removing a severely damaged tooth.

Should I save damaged teeth?

Today the question is not “how to restore a tooth.” Modern dentistry can restore any tooth, even one from which only the root remains. The whole question is the feasibility of such a restoration. The key factors that are important to consider when making this decision are:

1. Long-term perspective assessment.

This is the main thing to consider. As mentioned above, damaged teeth are almost not involved in chewing. In this state they can remain in the mouth for years. If the crown of such a tooth is restored, the chewing load on it will increase significantly! In a loaded state, the lifespan of this tooth will be much shorter! If the tooth canals are sealed poorly, then the increased load will lead to an exacerbation of chronic inflammation and the restored tooth will have to be removed.

2. The condition of the tissues surrounding the tooth root.

Based on X-ray data, assesses the quality of root canal filling in a damaged tooth. Quite often it is necessary to perform repeated endodontic treatment if you choose to save the tooth. This is due to incomplete filling of the root canals, or to foci of chronic inflammation around the roots of the tooth. The doctor also evaluates tooth mobility. If it is present, then it is not always advisable to save the tooth.

3. The volume of preserved hard dental tissues.

If only the root remains of the tooth, destroyed below the gum level, then the tooth is removed.
If the crown of the tooth is completely destroyed, but the remaining root is motionless and protrudes at least 2-3 mm above the gum, then it must be preserved and included in the prosthetic plan.

It is important to note that these must be healthy hard tissues. Even if part of the crown remains of a tooth, but its entire root is affected by caries, then such a tooth is removed.

It is always the patient's decision to save the controversial tooth or remove it. The doctor’s task is to assess the actual time frame for the “functioning” of such a tooth if it is restored and explain this clearly to the patient. Each case is individual and only a dentist who has carried out a complete diagnosis can draw up an adequate treatment plan. Trying to resolve this issue over the Internet is useless. The patient’s main task is to understand the potential risk of retaining such “teeth” and make a choice based on the dentist’s recommendations and their capabilities.

Restoring teeth using pins

Previously, dentists actively used titanium anchor pins. Nowadays, preferences have shifted towards fiberglass pins. In terms of their physical and mechanical properties, they are more consistent with tooth tissue than titanium. The pin is cemented into the previously expanded root canal of the tooth. After this, it is covered with a special composite material. The advantage of the method is time saving. The doctor performs the entire procedure in one visit.

Restoration of teeth using intra-root inlays

Instead of factory pins, individually made pin-stump inlays are used. They are cast in a dental laboratory from noble (gold-platinum alloy) or base (cobalt-chrome) metal alloys.

Caring for restored teeth

A restored tooth is always less reliable than a healthy one. He requires a careful attitude towards himself. Make it a habit to always use a knife and fork. This does not mean that you need to follow some kind of diet. Just try to avoid hard and rough foods: nuts, crackers, seeds. If you have had your front tooth (incisors) restored, then you should not bite off hard fruits (pears, apples) or tough meat (kebabs).

The second important rule is maintaining excellent oral hygiene. This prevents the occurrence of secondary caries, which can destroy a previously restored tooth. In this case, it will no longer be possible to save it.

What to do when you decide to remove a controversial tooth? - Prosthetics on implants

If the tooth is severely damaged and the doctor warns you about the dubious long-term prospect of its preservation, then you should think about implantation. To do this, the decayed tooth is removed and a dental implant is installed in its place. A few months after the operation, the dentist makes an artificial crown supported by this implant.

The advantage of this solution is that there is no need to prepare adjacent teeth. This would have to be done if a bridge was chosen as a permanent structure. By removing a severely damaged tooth, you have saved yourself from the potential risks of its restoration: secondary caries and exacerbation of chronic inflammation in the periodontium.

Is it possible to restore severely damaged teeth?

Teeth, like any organs of a living organism, are given to a person once and therefore require especially careful treatment, because they play a very important role at the beginning of the digestive process and are responsible for how efficiently food is crushed before it enters the gastrointestinal tract. But what to do if, due to certain circumstances (metabolic disorders, injuries, genetic predisposition, or simply poor care), teeth begin to decay? Is it possible to restore severely damaged teeth??

Restoring decaying teeth is a painstaking process, but possible. First of all, the degree of damage to the tooth tissues (root and crown) and the condition of the tissues surrounding the tooth (periodontal, mucous, jaw bone) are assessed. Dentists first check how stable the tooth is and whether there are pathological processes in the areas adjacent to the tooth (inflammation, suppuration, cysts, bone loss). If the tooth root is healthy and stable, and the adjacent tissues are in order (previously treated by a periodontist), then the process of restoring the destroyed crown part of the tooth can begin. There are two ways to do this: cosmetic restoration of the crown part of the tooth and prosthetics of the crown part of the tooth.

Cosmetic restoration of the crown part of a tooth can be done using an anchor or fiberglass pin, one part of which is fixed in the root, and the other holds the filling material of the formed crown part. This form of dental restoration is suitable for teeth whose crown part is not destroyed to the base, and there are walls that will limit the mobility of the filling. Composite masses are used as filling materials, which can be applied in layers and gradually form the desired shape of the coronal part.

The disadvantage of this type restoration of damaged teeth considers their low endurance, for this reason teeth restored with composites require careful treatment, soft food and the abandonment of bad habits (crunching bones, seeds, sweets, etc.). With composite teeth you cannot bite off a piece of hard sausage, dry fish, hard biscuits, crust of bread, hard fruits and vegetables.

If the coronal part of the tooth is significantly damaged, it is recommended to cover the tooth with an artificial crown (plastic, metal-plastic, stamped steel, cast from base and precious metals, metal-ceramic, ceramic), which covers all damaged surfaces of the coronal part and restores chewing efficiency by almost 100%. Plastic structures require careful handling, as they tend to wear out and crack from excessive load on the tooth; ceramic masses do not tolerate temperature changes (sudden changes in hot and too cold foods and drinks).

Completely destroyed crown parts of a tooth with a well-preserved root are restored using pin teeth or root stump inlays. Both types of structures are made by casting. The difference between a pin tooth and a stump inlay is that in a pin tooth the crown part of the tooth is cast simultaneously, while a cast stump inlay requires subsequent placement of the selected type of artificial crown on it.

Any of the methods for restoring damaged teeth requires additional measures to regulate metabolic processes, therapy with minerals and vitamins, and also requires careful oral care so that the remaining parts of the teeth, like supports, are preserved for as long a service life as possible.

How is the root removed if it remains in the gum, but the tooth is completely destroyed and crumbled?

Is it necessary to remove the root of a decayed tooth?

Absolute indications for removal

Amputation of the rotten root is mandatory, since it is a breeding ground for infection. The problem is not only bad breath - bacteria multiply in the remains of the unit, supragingival or subgingival calculus is present on them, which causes gum inflammation. Almost always, the tops of the roots are infected, which can cause a granuloma to form, which subsequently leads to gumboil. You can see what a decayed tooth looks like in the photo.

Removal is indicated in cases:

periodontal diseases;
if the tooth is loose;
the presence of a cyst, abscess;
caries damage;
complex tooth fracture;
the presence of fragments deeply stuck in the hole;
atypical position of the unit.

When can you leave the root if the tooth is crumbled?

If possible, dentists strive to save at least one root of a damaged multi-rooted tooth. It can become a support for the crown, thanks to which the unit will continue to perform its functions.

A conservative surgical technique is required if there is inflammation at the apex of the root canal. The operation is carried out within half an hour - the doctor cuts off the top of the root.

How is the root removed?

Preparing for surgery

Required Tools

To remove a decayed tooth, doctors use several types of instruments:

Forceps. There are different types of forceps, including separate instruments for the lower and upper jaws, devices for root extraction when mouth opening is limited, etc.
Elevators. Each type of instrument (straight, angular, etc.) is intended for a separate group of teeth.
Drill. The device is necessary for sawing the tooth and removing the roots or parts thereof.

Amputation process

The operation begins by peeling away the tissue around the unit. Tooth root amputation is performed using certain working methods:

What to do if the tooth has rotted down to the gum? In this case, a drill is used. The device allows you to cut the unit into pieces, then each piece is removed separately. The fragments are removed with another tool. When extracting wisdom teeth, additional devices are used.

Possible consequences

Breaking off the top of the root. There is blood coming from the wound, so the fragments are not always visible. The specialist should prescribe a repeat removal.
Fragment stuck deep in the hole. Part of the tooth cannot be seen without an x-ray; it is covered with epithelial tissue and does not bother you at first. Subsequently, the capsule of fibrous tissue and fragment provokes the formation of an abscess or phlegmon.
Pieces of bone become lodged in soft tissue. This is a local complication; fragments can often be removed on your own or in a doctor's office under anesthesia (without cutting tissue).

Do I need to remove the remaining tooth fragments? Leaving them in the wound is unacceptable, as this can lead to unpleasant consequences:

What to do if there is a piece left after removal?

when the fragment is on the surface, extraction is carried out in a few minutes with a special tool;
if the piece is located deep, an incision is made in the gum to extract it.

Sometimes doctors are faced with a situation where the splinter is overgrown with gums - it is completely covered with mucous membrane. In this case, treatment is carried out in several stages:

Is it possible to pull out a rotten tooth root at home?

choosing an anesthetic and correctly injecting it in the right dose into the gums is very problematic without medical education;
It is difficult to maintain sterility at home, so the risk of infection in the wound is high;
improper tissue incision can cause serious bleeding;
Without the use of anesthesia, painful shock is possible.

Restoring severely damaged teeth is real: expert opinion

It's no secret that many people put off visiting the dentist until the last minute, when there may be little left of the tooth. Is it possible to restore a badly damaged tooth and how does this happen, says David Vyacheslavovich Babayan, chief physician of the American Dental Center “Dantist”.

32top: Which tooth is considered severely damaged?

Babayan D.: A severely damaged tooth is considered to be one in which more than 50% of the area has been restored with a filling or not restored at all. The reasons why teeth become severely damaged vary. Caries, injury, doctor's error, patient's untimely visit to the dentist, bad habits (seeds, nuts, etc.), also the cause may be increased tooth wear.

32top: Is it really possible to qualitatively restore a badly damaged tooth? In what case is a tooth no longer recoverable?

Babayan D.: Almost any tooth can be restored, with the exception of severe inflammation at the root, which is not amenable to therapeutic treatment.

Tooth restoration is also impossible when the tooth is destroyed deep under the gum, or when the tooth is mobile.

In all other cases, there is a modern way to restore severely damaged teeth. And then the restored tooth serves the patient for a long time. The main thing is to contact a qualified specialist in time to solve the problem.

32top: What methods exist for restoring a severely damaged tooth crown?

Babayan D.: In such situations, many dental therapists install large light fillings, reinforcing them with titanium pins. But the specialists of our clinic and I personally are not supporters of this method of tooth restoration, due to certain disadvantages. Such a patient should be seen by an orthopedic dentist. Depending on the extent of tooth destruction, the orthopedic dentist must choose a design for restoration. The following options are possible: a stump inlay (inlay, onlay, overlay) or a pin-stump inlay, followed by covering it with a crown.

32top: What are the pros and cons of light-curing pin fillings?

Babayan D.: Such pins are screwed into the root canal of a tooth along a thread, just like a self-tapping screw is screwed into wood. You can imagine the pressure exerted on the root canal of a tooth during the process of screwing in the pin and during chewing acts when using such a tooth. There is a huge risk of cracks and fractures of the tooth root, which can lead to the removal of the tooth. Another disadvantage is the composite material itself, which shrinks over time and so-called “secondary caries” forms under it. When this happens, you need to remove this entire structure from the oral cavity, excise fresh carious tissue and restore the tooth again. And this process will be repeated every 3-5 years.

32top: How reliable is this method of restoring teeth?

Babayan D.: Modern dentistry has long moved away from restoring teeth with pins. No one can say how long a tooth with a pin will last. During chewing, the load on the pin may increase, and then the pin may break the root or a crack may form in the root, after which the tooth must be removed. The wall of the tooth may also break off, because... a large filling will put pressure on it.

32top: What alternatives are there to light-curing pin fillings?

Babayan D.: The following options are possible:

Stump tab (inlay, onlay, overlay)
A more common method is a post-core inlay, which is subsequently covered with an artificial crown
Removal of a tooth and installation of a dental implant in its place, followed by installation of a crown on it

32top: Can a core inlay effectively solve the problem of restoring a severely damaged tooth and how does this happen?

Babayan D.: Of course. The doctor prepares the tooth, creates a place for fixing the future inlay and determines the color of the future structure. Next, the doctor takes accurate impressions of all teeth along with a specific tooth. Based on the impressions, plaster models are cast in a dental laboratory, from which the dental technician makes a core inlay. After which the doctor fixes it in the oral cavity with cement, and the patient uses this tooth as a natural one.

32top: What are the advantages and disadvantages of core inlays?

Babayan D.: This inlay is solid, thereby evenly distributing the load on the entire tooth. Also, the stump inlays do not shrink or deform, as a result of which “secondary caries” does not form. Stump inlays have very high strength and aesthetic characteristics and are in no way different from natural teeth. There are simply no downsides to stump inlays.

32top: What are the features of restoring severely damaged teeth with pin-stump inlays?

Babayan D.: The doctor prepares a previously filled root canal, unfills it to 2/3 of its length, expands it, takes impressions for casting plaster models in a dental laboratory. The technician models the future inlay with wax, after which the wax is replaced with the material of which the future inlay will be made (metal or zirconium dioxide). Next, the doctor fixes this tab into the previously prepared cavity in the tooth and does not screw anything in. The biggest difference from a titanium pin is that the entire area of the pin-stump insert is fixed onto the prepared tooth and evenly distributes the chewing load. The risk of fracture and root cracks disappears. After fixing the tab, we receive a miniature tooth, and an artificial tooth crown is subsequently made on it. This design lasts 3 times longer than the design on a titanium pin and looks much more aesthetically pleasing than a filling.

32top: Are complications possible when restoring a severely damaged tooth and how to avoid them?

Babayan D.: If the doctor and technician did everything correctly, then there can be no complications. The patient should not feel any inlays and crowns in the oral cavity; they should not interfere with the patient. You can avoid complications by choosing a competent specialist and a clinic with a good reputation. If these points are met, all that remains is to listen to the doctor’s recommendations, and then the patient’s teeth will not be in danger.

Removing the root of a damaged or rotten tooth: does it hurt, the removal process

In the last century, when asked whether it is painful to remove the root of a tooth if the crown is completely destroyed, many dentists would have given an affirmative answer. Pain during and after the procedure, complications from anesthesia and discomfort plagued many patients. But today the situation has changed - a diseased tooth and its root can be pulled out absolutely painlessly.

Who will have to part with a tooth?

Complications following tooth extraction in the doctor's office are extremely rare. Much more often, sad consequences occur when it spontaneously falls out due to destruction or injury. In such cases, there are two options: restoration of dentin and enamel or removal of the tooth root.

The tooth root will have to be removed if the following symptoms occur:

constant discomfort in the gums;
sharp pain when chewing;
swollen soft tissue;
bleeding;
the appearance of pus.

A sure sign of an inflammatory process in the gums is an increase in body temperature in the absence of symptoms of another disease.

Important! You cannot postpone a visit to the dentist, even if only one of these symptoms appears. Any suspicion that the tooth root remains in the gum and has begun to rot should prompt an urgent visit to a doctor.

What are the roots of teeth, look at the photo:

Temporary contraindications

Surgical removal of the root of a decayed tooth is contraindicated during:

relapse of complex mental disorder;
acute phase of ARVI;
exacerbation of neurological disease;
rehabilitation after a heart attack.

Doctors at dental clinics are aware of all contraindications to extraction. But not all conditions have clear clinical signs, so in order to avoid unpleasant consequences, it is necessary to warn the doctor about the ailment.

Generalized scheme for tooth extraction

The process of removing any tooth includes the following steps:

Examination and collection of anamnesis (allergic status, information about the state of health and the dental apparatus).
Preparation of the surgical field: treatment of the injection site, rinsing the mouth with an antiseptic.
Anesthesia.
Detachment of gum from tooth using a trowel.
Loosening a tooth with forceps.
Extracting a tooth from its socket.
Treating the hole with an antiseptic.
Stop bleeding with tamponade.

According to this scheme, simple removal is carried out. In some situations, for example, when a wisdom tooth or a badly damaged molar is pulled out, a complex extraction is required. Its main difference is that in addition to forceps, the dentist uses a drill to cut out bone tissue or saw the root into pieces, a chisel, a hammer and other dental instruments.

Wisdom tooth removal diagram

How is a decayed tooth removed?

The process of tooth extraction is a simple dental operation. The difficulty increases when you need to remove the root of a tooth that is completely destroyed. Factors requiring the intervention of an experienced specialist:

small size of the remaining crown;
condition of surrounding tissues;
the location of the remaining hard tooth tissues under the upper edge of the gums;
defects of gums, roots.

It affects the complexity of the operation and whether the position of the upper or lower jaw belongs. On the upper jaw, the walls of the sockets are longer and thicker; accordingly, teeth are removed from them with great difficulty - a highly qualified dentist is required to perform the manipulation.

Wisdom teeth, from which only the root remains, are removed in the same way as ordinary molars, but in some patients, healing after such an intervention is very painful.

How a tooth root is removed is shown in the video:

Examination and preparation

The procedure begins with a thorough examination and preparation of the patient. When you first visit the clinic, the doctor will take an x-ray and examine the oral cavity.

determine the condition of the tooth, assess the extent of destruction;
clarify the presence of allergies, contraindications, inflammation;
choose a method of pain relief;
draw up an operation plan;
prepare tools.

The tools used to remove rotten tooth roots are a drill, forceps, and a set of elevators (photo).

A prerequisite is hygienic treatment of adjacent tissues. Extraction is possible only after removing stones and plaque from the molars, incisors or canines surrounding the surgical field. Immediately before extraction, the oral cavity is treated with a Chlorhexidine solution.

Anesthesia

There are cases when dentin is destroyed gradually, without inflammation, without the appearance of rot. In such situations, painless root removal is possible without the use of painkillers, however, anesthesia is more often necessary.

The choice of drug is carried out taking into account:

age;
allergic status;
presence of somatic diseases;
individual intolerance to drugs;
presence of chronic diseases: epilepsy, diabetes;
complexity of the upcoming operation.

The patient must notify the dentist about any deviations before the procedure begins. In most cases, the tooth root is removed under local anesthesia - one or two injections for incisors, 2 to 4 injections into the gums for molars. But if two teeth are destroyed, or the jaw is to be opened, the patient receives general anesthesia - he will sleep until the doctor finishes pulling out the tooth.

Features of pain relief for a tooth with a rotten root

An anesthetic injection is given at the site of the projection of the tooth roots. But if the medicine is injected into the rotten area, it may not work and the person will be hurt during the extraction process.

Treatment of patients with rotten roots is carried out in two stages. On the first visit, the dentist numbs the gum, prepares it and cleans it of pus. During the second visit, anesthesia is repeated, and the doctor removes the root that has rotted inside the gum.

The doctor decides how to remove a tooth if only the root remains. Usually they start with the use of forceps. Even if the destroyed roots remain under the gum, the holes do not completely heal - the dentist can carefully pick up the remnants of hard tissue and easily pull them out.

If the tooth has crumbled to the very base, it is pulled out with an elevator. Having inserted the instrument between the gum and dentin, the doctor presses on the handle and makes rotational movements of small amplitude. As a result, the periodontal fibers shift and the root is squeezed out of the socket.

A drill is used when it is necessary to crush the hard tissues of a molar before removal. With proper anesthesia, this procedure is painless; discomfort is possible only when the gums are already healing.

Relieving inflammation

When removing a rotten root, an inflammatory process is often detected. To ensure that the wound heals safely and does not fester, it is customary to treat it with an antiseptic. But one treatment will not provide adequate prevention, so an anti-inflammatory drug is placed in a fresh hole. With it, the hole will heal faster, and the patient will have less chance of developing alveolitis.

Stitching

To extract the root system, the doctor separates and lifts flaps of soft tissue; they can only be attached back by suturing. It is customary to tighten the edges of the holes with threads during double or triple removal, when a significant part of the gum has been subjected to preparation. This is done so that the affected area heals faster and does not cause discomfort to the patient.

If there are root fragments left in the hole

If the wound edges were tightened with catgut, the patient’s treatment can be considered complete. If a non-absorbable material was used, the patient will have to return to the dentist to have the sutures removed after a week. During this time, it is necessary to monitor the condition of the gums, your own sensations and notify the doctor if:

This means that small fragments of tooth tissue, which may have gone unnoticed during extraction, rot in the hole. The doctor must prescribe a repeat X-ray for the patient, check the quality of the operation and find out the cause of the ailment. Inaction is fraught with the development of alveolitis (inflammation of the socket), osteomyelitis, phlegmon and other serious diseases.

How to remove a rotten tooth root while preserving the crown

A tooth in which only the root remains is not always pulled out entirely. For example, if an inflammatory process develops at the root apex, but the tooth itself can still be saved, resection of the root apex is performed - partial removal.

The procedure is carried out after filling the canals, under local anesthesia. The operation is simple and lasts no more than half an hour. Its main stages:

Anamnesis collection.
Preparation of the surgical field.
Anesthesia.
Cutting the gum to access the root.
Delamination of soft tissues.
Sawing out a “window” in the bone.
Cutting off the inflamed area of the root with a granuloma or cyst.
Placing drugs into the cavity that stimulate bone growth.
Stitching.

What to do after deletion

After any surgical intervention, you should follow all the dentist’s recommendations, as well as:

do not eat for 2 hours after the procedure;
cool the soft tissues of the face in the projection of the removed root;
stop smoking for two days;
take prescribed pain medication;
make antiseptic applications;
watch to see if other teeth are crumbling.

Sometimes after complex extractions, dentists prescribe antibiotics to patients. This appointment cannot be ignored - after a tooth is pulled out of the socket, a focus of infection forms in it, which can only be extinguished with the help of medications.

The following video schematically shows different methods for removing incisors, canines, molars and premolars of the lower and upper jaw.

Who will have to part with a tooth?

The tooth root will have to be removed if the following symptoms occur:

constant discomfort in the gums;
sharp pain when chewing;
swollen soft tissue;
bleeding;
the appearance of pus.

A sure sign of an inflammatory process in the gums is an increase in body temperature in the absence of symptoms of another disease.

Important! You cannot postpone a visit to the dentist, even if only one of these symptoms appears. Any suspicion that the tooth root remains in the gum and has begun to rot should prompt an urgent visit to a doctor.

What are the roots of teeth, look at the photo:

Temporary contraindications

Surgical removal of the root of a decayed tooth is contraindicated during:

relapse of complex mental disorder;
acute phase of ARVI;
exacerbation of neurological disease;
rehabilitation after a heart attack.

Doctors at dental clinics are aware of all contraindications to extraction. But not all conditions have clear clinical signs, so in order to avoid unpleasant consequences, it is necessary to warn the doctor about the ailment.

Generalized scheme for tooth extraction

The process of removing any tooth includes the following steps:

Examination and collection of anamnesis (allergic status, information about the state of health and the dental apparatus).
Preparation of the surgical field: treatment of the injection site, rinsing the mouth with an antiseptic.
Anesthesia.
Detachment of gum from tooth using a trowel.
Loosening a tooth with forceps.
Extracting a tooth from its socket.
Treating the hole with an antiseptic.
Stop bleeding with tamponade.

Getting rid of a wisdom tooth can be especially difficult. Due to its location in the posterior quadrant of the jaw, access to it is difficult. With anatomically incorrect or curved roots, which are often found in third molars, the dentist may be forced to make incisions in the gums, pull out the root piece by piece, and then apply sutures.

How is a decayed tooth removed?

small size of the remaining crown;
condition of surrounding tissues;
the location of the remaining hard tooth tissues under the upper edge of the gums;
defects of gums, roots.

Wisdom teeth, from which only the root remains, are removed in the same way as ordinary molars, but in some patients, healing after such an intervention is very painful.

Examination and preparation

The procedure begins with a thorough examination and preparation of the patient. When you first visit the clinic, the doctor will take an x-ray and examine the oral cavity.

Doctor's tasks:

determine the condition of the tooth, assess the extent of destruction;
clarify the presence of allergies, contraindications, inflammation;
choose a method of pain relief;
draw up an operation plan;
prepare tools.

The tools used to remove rotten tooth roots are a drill, forceps, and a set of elevators (photo).

Anesthesia

The choice of drug is carried out taking into account:

age;
allergic status;
presence of somatic diseases;
individual intolerance to drugs;
presence of chronic diseases: epilepsy, diabetes;
complexity of the upcoming operation.

Features of pain relief for a tooth with a rotten root

Treatment of patients with rotten roots is carried out in two stages. On the first visit, the dentist numbs the gum, prepares it and cleans it of pus. During the second visit, anesthesia is repeated, and the doctor removes the root that has rotted inside the gum.

Removal

Relieving inflammation

Stitching

If there are root fragments left in the hole

How to remove a rotten tooth root while preserving the crown

The procedure is carried out after filling the canals, under local anesthesia. The operation is simple and lasts no more than half an hour. Its main stages:

Anamnesis collection.
Preparation of the surgical field.
Anesthesia.
Cutting the gum to access the root.
Delamination of soft tissues.
Sawing out a “window” in the bone.
Cutting off the inflamed area of the root with a granuloma or cyst.
Placing drugs into the cavity that stimulate bone growth.
Stitching.

What to do after deletion

After any surgical intervention, you should follow all the dentist’s recommendations, as well as:

do not eat for 2 hours after the procedure;
cool the soft tissues of the face in the projection of the removed root;
stop smoking for two days;
take prescribed pain medication;
make antiseptic applications;
watch to see if other teeth are crumbling.

The following video schematically shows different methods for removing incisors, canines, molars and premolars of the lower and upper jaw.

Having a snow-white smile has become the norm of life and one of the requirements of society. It is not surprising that people are interested in why teeth rot and what to do about it when faced with such problems. After all, the cause and its consequences must be eliminated quickly, otherwise psychological discomfort and other troubles will follow.

Today, dentistry has such tools, medicines and instruments that curing any common disease is not a problem. It is important that the patient himself seeks help in time and follows all the doctors’ recommendations. Otherwise, tissues, soft and hard, will be destroyed and provoke general diseases of the body.

Why do teeth rot?

The most common causes of caries and other destructive processes in hard tissues may 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 general poor health and reducing all protective functions, including those on the teeth, they also additionally contribute to increased sensitivity of the enamel, disrupt metabolic processes in the mouth and interfere with tissue restoration;
Poor nutrition or consumption of sweet foods in large doses - this leads to reduced function of the immune system and also worsens the condition of teeth; sugar has a particularly destructive effect on hard tissues;
an unhealthy lifestyle in general reduces the body’s protective functions, contributing to the formation of various diseases, including dental ones;
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, malfunctions in the functioning of internal systems also have a special impact, since they act from the inside:

Periodontal diseases are the most common - periodontitis, and others, destroying the gums and eventually spreading to the dental part;
various general infections - diseases of the digestive system, liver, kidneys, disorders of the thyroid gland;
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 - lack of fluoride in the soil, polluted air, poor-quality water, various impurities and additives;
genetic causes weaken a person and imply a tendency to develop certain problems that are passed on from generation to generation;
People suffering from any transitional, temporary conditions are especially susceptible to such diseases, for example, pregnant women or teenagers during periods of hormonal changes.

Degrees of tooth decay

Depending on the stage of decay, the symptoms of the pathology manifest themselves differently:

It all starts with, when there are no special sensations yet, but due to the plaque that has formed and the abundance of bacteria, a foreign odor is felt when talking.
Spots appear on the enamel, the smile turns yellow or brown, which is especially noticeable on the front teeth.
Over time, the destructive processes intensify and black spots or even entire areas form. True, if the root initially rots, it will not be noticeable, since the disease passes under the gum and is invisible to the eye. To diagnose in this case, you need to take an x-ray.
Next, cavities form in the hard tissues, which looks like a hole in a tooth. Over time, their sizes only increase.
Pain appears and intensifies every time. Having reached the pulp, the inner part of the unit, such sensations become unbearable and signal a dangerous destruction of the nerve endings.
After necrotization of the soft part of the tooth, the pain may disappear, but this threatens the loss of the entire unit and infection of the surrounding tissues.

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

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

The process of decay in adults

There are many problems and corresponding causes of caries in adults and sometimes they act in a complex manner, accelerating tooth decay and the spread of infection in the oral cavity. This can happen under a filling, under veneers, braces and other structures.

Destruction is also facilitated by the problematic growth of wisdom teeth, which provokes inflammation of the surrounding tissues, and sometimes, due to improper inclination, injures neighboring units. In this case, you need to remove the “eight”, which can only be done by a doctor.

Without identifying and treating caries, a person faces a lot of problems, both personal and business. After all, today a perfect smile is an important part of work style. It must be remembered that it is much easier to treat teeth on time than to start the 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 happens similarly. The reasons are usually the same, except for bad habits and some other nuances. But there are also some peculiarities:

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

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

Destructions during pregnancy

This is a special time for a woman - her whole body undergoes a restructuring, hormonal balance and tastes change, and disruptions in the functioning of the nervous system are observed. In addition, the unborn baby takes in most of the nutrients from the foods it eats, especially calcium and fluoride for bone growth.

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

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

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

What methods can be used to cure the disease?

Any detected caries should be treated and the underlying cause eliminated. To do this, you need to contact your dentist and conduct a detailed examination. Typically, an integrated approach is used, which includes treatment of the dental cavity, filling, additional administration of vitamin and mineral preparations, nutritional correction and recommendations to get rid of bad habits.

Obviously, if you eliminate the cause itself, then the problem will no longer bother you in the future. Unfortunately, patients are accustomed to delaying even 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 teeth and other organs are ignored.

It is very important for a professional to identify the main source of infection and completely clean it out. The treatment process most often looks like this:

the affected tooth is detected and with the help of special instruments the canals are opened for better access and visual inspection;
in case of inflammation and necrosis of nerve endings, remove the pulp;
all remnants of caries are thoroughly cleaned and drilled in hard-to-reach places;
if pus is present, it is removed, sometimes an incision is made in the gum;
treated surfaces are treated with antibacterial and antiseptic drugs, disinfecting them and stopping the spread of infection throughout the oral cavity;
Then the doctor puts in the medicine and seals all the canals.

If the tooth is severely damaged, a crown will need to be installed to completely restore the aesthetics and functionality of the row. In cases where simple therapy does not have an effect, surgical methods are resorted to. Relapses can only be eliminated in a radical way.

In this case, careful scraping of purulent formations in the gums, cutting off the affected parts of the root and other manipulations are carried out, depending on the location and degree of the disease. Almost always, in the 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 point 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:

Brush your teeth twice a day, morning and evening. And after eating, rinse your mouth with warm water.
You also need to pay attention to caring for your tongue, which is cleaned with the back of the brush.
Preventive examinations with a dentist every six months will provide an opportunity to notice the problem at an early stage and eliminate it, avoiding any unpleasant sensations.
You should also take care of your general health, boost your immunity through proper nutrition and a healthy lifestyle. And by getting rid of bad habits, you will also receive additional advantages.
By enriching your diet with hard fruits and vegetables, foods containing calcium and drinking clean water, you will help strengthen your enamel.