Removal of teeth (so-called tooth extraction) can be necessary for various reasons and is one of the most common procedures performed by oral and maxillofacial surgeons. Thanks to modern technology, today it is possible to remove teeth in a particularly gentle, safe and minimally invasive way.
Our oral and maxillofacial surgeon, doctor and dentist Dr. med. Thomas Franke carries out the tooth removal after a detailed analysis in the pleasant atmosphere of our practice in Berlin Charlottenburg. Years of experience in this field have enabled him to develop a treatment concept that takes a holistic view of our patients and ensures a rapid recovery and restoration.
When is a tooth removal necessary?
The removal of a tooth may be necessary for various reasons. Severe damage to the teeth, for example caused by a pronounced caries or damage to the root of the tooth, can often unfortunately make it unavoidable that a tooth has to be removed. However, teeth that are not fully erupted, chronic inflammation or teeth that are too loose, caused for example by bone resorption, can also result in tooth extraction. Even if there is not enough space in the jaw, the removal of one or more teeth may be advisable for orthodontic reasons.
Patients are often referred by their family dentist to oral and maxillofacial surgeons for further treatment as they are able to remove the affected tooth including the root. This usually makes it possible to preserve the bony tooth socket for later dental implantation. In this context one speaks of the so-called “socket preservation”.
What is the exact procedure for tooth removal?
As a rule, a local anaesthetic is sufficient for outpatient surgery. You will not feel any pain during the procedure with this local anaesthetic. After careful removal of the tooth, root and tooth remains, a suture seals the opening in the gum.
A comprehensive diagnosis is carried out in advance, in which possible previous illnesses, the general condition and special circumstances, such as an existing pregnancy of the patient, are clarified in a detailed conversation with Dr. med. Thomas Franke.
Of course, we also address the fears, questions and wishes of our patients and discuss the procedure, the appropriate form of anaesthesia and also necessary follow-up treatments and aftercare in detail.
In some cases, it may be useful to carry out an X-ray diagnosis before an operation, for example if it is suspected that the affected tooth is too close to a nerve and the removal of the tooth can therefore be carried out with special precautions and only with the most precise planning. Even in the case of a planned implantation after tooth removal, prior clarification is necessary.
In our practice, we use digital volume tomography (DVT) in such cases, which allows the most detailed image possible of the tooth, the tooth root and the neighbouring structures without any overlapping.
Digital volume tomography (DVT) is a modern, high-resolution X-ray procedure that enables the most accurate three-dimensional image of the head and face, including the jaws and sinuses, with only a low radiation exposure.
DVT can, for example, accurately determine the length and shape of the tooth root, but also the course of nerves. In this way, possible complications can be assessed and special circumstances can be taken into account so that a risk-minimised intervention can be carried out. For a subsequent implantation, DVT enables an exact assessment of the bone structure and also the exact planning of the implant.
The procedure itself is performed on an outpatient basis in our practice in Berlin Charlottenburg by Dr. med. Thomas Franke. It is important to us that the procedure is carried out in a pleasant atmosphere and we also take our patients’ existing fears very seriously.
The stunning
As a rule, we perform a local anaesthetic for this procedure, i.e. local pain elimination. The local anaesthetic is applied in such a way that the patient does not feel any pain during the subsequent treatment.
For anxious patients and in special cases, the procedure can also be performed in twilight sleep or under general anaesthesia. This will of course be discussed in detail in advance.
Tooth removal
As soon as the pain elimination works reliably, the gum is first detached from the tooth and the root is exposed. The tooth and its root are then extracted from the tooth socket and removed. Finally, if necessary, any remaining teeth are removed. Tooth removal is carried out as minimally invasive and as safely as possible.
Wound cleansing and wound suturing
The wound is then cleaned and any inflamed tissue removed. Finally, a fine seam seals the opening in the gum.
If a dental implantation is planned at the affected area, it can be carried out directly after the tooth extraction in most cases, which is very pleasant for many patients, as no further intervention is necessary for the implantation.
Of course, a desired implantation is taken into account accordingly in the previous diagnostics, planned in detail and discussed in detail with the patient.
As dental implants, we only use high-quality ceramic implants, which are completely free of metal and have a high quality, the best possible biocompatibility and also optimal aesthetics.
After the procedure, our patients still receive recommendations for strengthening the immune system in order to achieve the best possible healing and treatment results and also to get our patients back to full activity as quickly as possible.
To support wound healing, we also offer wound healing support with PRP on request. The Platelet Rich Plasma procedure is a special autologous blood therapy which accelerates wound healing and minimises the risk of osseous inflammation.
What happens afterwards and how does the healing process proceed after the tooth removal?
Immediately after the procedure we provide our patients with painkillers and recommend them to take it easy in the first 24 hours after the procedure. We also advise our patients to cool the cheek area after the procedure to reduce swelling and bruising.
For the first few days after an operation, patients should also eat only soft food to counteract inflammation. In addition, we recommend our patients to take an individually tailored medication regimen that supports the immune system and ensures better healing and treatment results.
After about 10 to 14 days, the stitches are removed in a control appointment. After three to five months, healing in the bone area is also completed.
Is the tooth removal painful?
While the tooth is being removed, our patients do not feel any pain, as we usually provide a local anaesthetic in advance to completely eliminate the pain.
After the treatment, slight to moderate pain can be expected for a few days, which can usually be kept at bay with painkillers. In addition, cooling of the cheek area also helps to reduce the pain here.
Gentle removal of wisdom teeth
Not every wisdom tooth has to be removed. However, it turns out that most upper and lower jaws are too small for wisdom teeth. This lack of space can cause a feeling of pressure or even pain and inflammation.
After a detailed diagnosis, our oral and maxillofacial surgeon, doctor and dentist Dr. med. Thomas Franke will carry out the ambulant removal of wisdom teeth in a pleasant atmosphere in our practice. We are specialised in the holistic treatment of our patients and pay particular attention to minimally invasive and gentle removal. State-of-the-art diagnostic procedures also allow for a safe removal of wisdom teeth and our holistic treatment concept ensures the best possible wound healing and a quick recovery of our patients.
When is the removal of wisdom teeth necessary?
Wisdom teeth remain in the jaws of some people for life, in others they grow out in their teens and in some people they are not there at all. However, once a wisdom tooth breaks through, it can be extremely painful. It is not always necessary to remove the wisdom teeth, as long as they break through in the correct position and with enough space. In any case, the necessity of wisdom tooth removal must be assessed individually.
As the wisdom teeth are the last to break through in the dentition, in many cases there is no space left in the row of teeth at this point. It has also been shown that most upper and lower jaws are too small for the wisdom teeth. This lack of space can cause the wisdom teeth to break through in the wrong place or even grow horizontally instead of vertically, thus damaging the neighbouring molars. The pressure that arises can also displace other teeth. And it is also possible that the mucous membrane between one wisdom tooth and the neighbouring cheek tooth is squeezed, which in turn can lead to painful inflammation.
Most patients then describe symptoms such as pain and inflammation behind the last molars. Frequently, an expected crowding is already noticeable during orthodontic treatment.
In order to avoid damage or to remedy complaints, in these cases the wisdom teeth are removed as gently and minimally invasively as possible after a careful diagnosis.
What is the exact procedure for wisdom tooth removal?
The removal (extraction) of the wisdom teeth takes place in an outpatient procedure in our practice in Berlin Charlottenburg.
Before the procedure
Before the procedure, a careful examination of the area in question and the dentition is carried out. In some cases, it may be advisable to carry out an exact clarification using digital volume tomography (DVT), which allows an extremely detailed image of the condition and position of the wisdom tooth and neighbouring structures without any overlapping.
DVT is an ultra-modern X-ray procedure that enables high-resolution, three-dimensional imaging of the head and face, including the jaws and sinuses, with low radiation exposure.
DVT can be used to precisely determine the length and shape of the wisdom tooth including the roots as well as the course of nerves and other neighbouring structures. Thus, a necessary removal of the wisdom tooth can be planned exactly. This procedure also allows possible complications to be taken into account so that a risk-minimised intervention can be carried out.
Finally, in a personal conversation with Dr. med. Thomas Franke, pre-existing conditions, the general condition and special circumstances as well as possible fears and wishes are discussed in detail. In this conversation, Dr. med. Thomas Franke also clarifies the exact procedure, the type of anaesthesia and the aftercare with the patient.
The intervention
The removal of wisdom teeth is carried out by Dr. med. Thomas Franke in a pleasant atmosphere as an outpatient in our practice. Of course, we also take into account existing fears of our patients and offer – if necessary and desired – assistance and alternatives.
First of all, the area in question is anaesthetised using gentle methods so that pain is completely eliminated during the procedure. After a sufficient waiting period, the affected area is completely anaesthetised, and the patient then no longer feels any pain during the procedure.
As a rule, the pain is eliminated by local anaesthesia. For anxious patients and in special cases, the procedure can also be performed in twilight sleep or under general anaesthesia. This is discussed in detail with the patient in advance.
If the anaesthesia works reliably, the operation can be started. In the first step, the gum is detached from the tooth at the affected area so that the root is exposed. The tooth and its root can then be removed from the tooth socket. If the wisdom teeth are trapped in the bone or even hidden, the surgical procedure becomes more complex. As an oral and maxillofacial surgeon and thanks to his many years of experience, Dr. med. Thomas Franke is able to carry out even complicated procedures as safely and minimally invasively as possible thanks to the detailed preliminary examination.
Afterwards, the wound formed by the removed tooth is cleaned and usually closed by a fine mucous membrane suture.
If desired, treatment with the PRP method can also be carried out in the wound area. This is an autologous blood therapy that accelerates wound healing and minimises osseous inflammation.
After the operation
After the removal of the wisdom tooth and careful wound care, we prepare an individually tailored medication schedule for our patients, which should be followed without fail in the days following an operation. In this way the development of pain can be largely contained. We also stabilise our patients’ immune systems and help to achieve optimal healing results and rapid regeneration after the operation.
What happens after the removal of the wisdom tooth?
In addition to the individually tailored medication regimen against the pain and for the optimal care of the immune system, we also give our patients further recommendations for the days following the procedure.
For example, the cheek should be sufficiently cooled in the operated area. In addition, sufficient protection should be provided, especially 24 hours after an operation. We also recommend that our patients only eat soft foods such as soups and porridge. However, food containing grains or especially crusty food should be avoided, as they can become embedded in the surgical wounds and cause inflammation.
Sports activities should also be avoided in the first few weeks to prevent secondary bleeding. Avoiding coffee, caffeine, alcohol and tobacco also promises a better healing process.
The stitches are removed after about a week at a check-up appointment.
Is the removal of the wisdom tooth painful?
During the removal of the wisdom tooth, our patients do not feel any pain, as the affected area is sufficiently and reliably anaesthetised. After the procedure, slight to moderate pain can be expected, which only lasts a few days and can be reduced with painkillers. We also recommend that the affected cheek area be cooled sufficiently.