Tooth extractions are routine procedures to alleviate various dental problems. But occasionally issues like broken roots or bone fragments may mean a tooth was not fully removed. When teeth are not extracted completely, potentially serious complications can develop.
Incomplete tooth extractions, where a portion of the tooth remains in the socket, can cause persistent pain, swelling, or discomfort in the affected area. If left unaddressed, these symptoms can escalate, leading to infections, abscesses, or difficulty in chewing and speaking.
Timely recognition and intervention are vital to avoid further dental complications and ensure a successful tooth extraction procedure.
Signs of Improper Tooth Extraction
1. Local Pain and Sensitivity
The main symptom suggesting an incomplete extraction is localized pain, swelling, and sensitivity in the extraction area that flares back up shortly after the procedure. This indicates likely tooth roots or bone spicules irritating surrounding tissues. Wisdom teeth are especially prone to incompletely healing if tissue remains. Swelling and tenderness localized to one area warrants evaluation.
2. Persistent Socket or Gum Infection
Typically after extractions, sockets fill with clotting blood and gradually heal over 4-6 weeks as the site shrinks. But unremoved root tips or bone can prolong the natural course of healing. Signs of infection like sensitivity, throbbing pain, bad taste, and gum inflammation may linger or reemerge rather than resolving normally. This implies debris interfering with closure.
3. Bony Protrusion Felt or Visible
If you can see or feel a hard projection of tooth or bone at the extraction site following recovery, this likely represents a remnant requiring removal. Use mirrors to inspect sites visually, especially lower wisdom teeth. Bony areas felt with the tongue suggest bone spurs irritating tissues.
4. Ill-Fitting Dentures at Extraction Site
Another telltale sign is when a denture or partial intended to fit following extractions does not sit properly or feels uncomfortable at a specific extraction region. The prosthetic should rest smoothly and evenly if all teeth completely removed. But pockets, gaps, and uneven areas imply tooth material remains under the gumline interfering with the fit.
5. Bad Breath, Taste, and Food Trapping
Incompletely healed sockets allow debris and bacteria to fester, releasing noticeable odor or metallic taste. Patients also complain of ongoing pain or irritation when eating as food gets trapped in unhealed areas. Foul tastes, breath, and lodged particles indicate unfilled voids from errant fragments.
6. Failure of Site to Completely Fill In
As gums mend post-extraction, the underlying bone fills in the space. But remnant tooth or bone obstructs complete closure. Signs that the void has not filled as expected include ongoing indentations, divots, or concavity observed in the smooth healed gum contour.
How can Incomplete Extractions be fixed?
There are a few options for fixing incomplete tooth extractions:
Second Extraction Attempt
If an extraction is proving difficult, sometimes the dentist will stop and allow healing before attempting the extraction again. This allows scar tissue to form that can make the tooth loosen up. Local anesthesia is re-administered before the second attempt.
For teeth that are difficult to grasp or bone is blocking removal, an oral surgeon may perform a surgical extraction. This involves incisions into the gum, removal of some bone, and sometimes sectioning the tooth for easier removal.
A scaffold-type material may be placed in the empty socket along with grafting material to encourage healing and reduce bone loss after incomplete extraction. This also helps site be amenable to implants.
In some cases, a small portion of root is left in the jaw. An orthodontist may attach braces to the fragment and slowly extrude it until it can be grasped and removed fully.
If the tooth fragment left behind is small and not bothersome, a dentist may recommend just monitoring it and leaving it in place to avoid further surgical intervention. However, infection risks have to be considered. As such, your dentist may recommend:
- Thorough Follow-up Care: After the extraction is completed, it’s crucial to follow the dentist’s post-operative care instructions. This often includes antibiotics to prevent infection and pain management techniques.
- Regular Check-ups: Involves follow-up appointments with your dentist to monitor the healing process. X-rays and visual examinations help ensure that the area heals properly and there are no signs of infection.
Following successful extraction, your dentist may recommend various prosthetic options like dental implants, bridges, or dentures to replace the missing tooth, restoring both function and aesthetics.
Since identifying the problem soon after extractions is ideal, be sure to schedule prompt follow up visits around 2 weeks later, especially for impacted or surgical tooth removal. Report any symptoms immediately to avoid extraction complications.
Catching small remnants early prevents big problems down the road. If found, the best solution depends on the location and extent of the remaining tooth, the patient’s symptoms, bone condition, and overall health. With advanced procedures, incomplete extractions can usually be corrected.