Medicină Dentară II – seminar 7

TOOTH EXTRACTION

When it comes to dental procedures, tooth extraction — or having teeth "pulled" — is

among the patients' most dreaded prospects. Also referred to as exodontia, tooth extraction involves
removing a tooth from its socket in the jaw bone. Before the dentist considers extraction, every
effort will be made to try to repair and restore the tooth. However, sometimes a tooth extraction is
necessary. There are several reasons for extracting a tooth. These include:
Severe Tooth Damage/Trauma: Some teeth have such extensive decay and damage
(broken or cracked) that repair is not possible. For example, teeth affected by advanced gum
(periodontal) disease may need to be pulled. As gum disease worsens, the tooth — supported by
less surrounding bone — often loosens to such an extent that tooth extraction is the only solution.

extraction – extracţie
extractor – extractor
to extract (a tooth) (syn.) to pull out (a tooth) – a extrage, a scoate (un dinte)
tooth extraction – extracţie dentară
trauma (pl. traumata) – trauma
crack - crăpătură, despicătură
to crack - a crăpa, a sfărâma, a sparge
cracked - crăpat, spart, rupt
to worsen (syn.) to aggravate - a (se) înrăutăţi, a (se) agrava, a (se) îngreuna
worsening (syn.) aggravation - înrăutăţire, agravare, îngreunare
to loosen (syn.) to detach (syn.) to unfasten – a se slăbi, a se desface, a se desprinde

Malpositioned/Nonfunctioning Teeth:
To avoid possible complications that may result in an eventual, negative impact on oral
health, the dentist may recommend removing teeth that are malaligned and/or essentially useless
(teeth that have no opposing teeth to bite against).
Orthodontic Treatment: Orthodontic treatment, such as braces, may require tooth
extraction to make needed space for improved teeth alignment.
Extra Teeth: Also referred to as supernumerary teeth, extra teeth may block other teeth
from erupting.

malposition (syn.) dystopia - malpoziţie, distopie

malalignment (syn.) misalignment – malalinere, aliniere defectuoasă a dinţilor
braces – aparat dentar
extra teeth (syn.) supernumerary teeth (syn.) supplemental teeth – dinți supranumerari
supernumerary (syn.) epactal – supranumerar, epactal
to erupt – a erupe
tooth eruption – erupție dentară
eruptive – eruptiv

Radiation: Head and neck radiation therapy may require the extraction of teeth in the
field of radiation in order to help avoid possible complications, such as infection.
Chemotherapy: Chemotherapy weakens the immune system, increasing the risk of tooth
infections, heightening the risk of extraction.
Organ Transplant: Immunosuppressive medications prescribed after organ
transplantation can increase the likelihood of tooth infection. As such, some teeth require removal
prior to an organ transplant.
 radiation (syn.) radiatio (pl. radiationes) - radiaţie, radiere
chemotherapy - chimioterapie
chemotherapeutic - chimioterapic, chimioterapeutic
weak - debil, slab, fără forţă
to weaken - a slăbi, a micşora
transplant - transplant
transplantation – transplantare
removable - amovibil; care poate fi îndepărtat
removal - mutare, transportare; îndepărtare, extirpare

Commonly Extracted Teeth

Wisdom teeth removal is one of the more common categories of tooth extraction. Many
dental professionals will recommend removing wisdom teeth (third molars) before they are fully
developed — usually in the adolescent years — to help eliminate potential problems. One problem
that could occur is development of an impacted tooth that has surfaced and has no room in the
mouth to grow. Other problems associated with impacted teeth include infection, decay of adjacent
teeth, bite interference and gum disease.
Extractions of some permanent teeth that have not erupted — such as the canines, which
are also known as fangs or eye teeth — may be required in order to make space for orthodontic
treatment.

impacted tooth (syn.) retained tooth (syn.) unerupted tooth - dinte impactat, dinte
inclus, dinte neerupt
adjacent teeth (syn.) adjoining teeth - dinţi adiacenţi, dinţi învecinaţi
interference - interferenţă, obstacol, piedică
bite interference – interferență ocluzală

Types of Tooth Extractions

There are two types of tooth extractions:
Simple Extractions: These are performed on teeth that are visible in the mouth. General
dentists commonly do simple extractions, and most are usually done under a local anesthetic, with
or without anti-anxiety medications or sedation.
Surgical Extractions: These involve teeth that cannot easily be seen or reached in the
mouth, either because they have broken off at the gum line or they have not fully erupted.
Performed by dentists or oral surgeons, surgical extractions require some type of surgical
procedure, such as bone removal, removing and/or lifting and folding back all or part of the gum
tissue to expose the tooth, or breaking the tooth into pieces (called tooth sectioning). Surgical
extractions can be done with local anesthesia and/or conscious sedation. Patients with special
medical conditions and young children may receive general anesthesia.

anesthetic – anestezic
anesthesia - anestezie; absenţă a sensibilităţii
dental anesthesia - anestezie dentară
to anesthetize - a anestezia
to sedate - a seda, a administra sedative
sedation - sedare; calmare
intravenous sedation - sedativ administrat intravenos
sedative (syn.) depressant - sedativ, calmant
bone removal – îndepărtarea osului
bone addition – adiție osoasă
tooth sectioning – secționarea dintelui
 Preparing for Tooth Extraction
Prior to a tooth extraction, the dentist or oral surgeon will discuss the patient’s medical
and dental histories and take X-rays. Some dental professionals will prescribe antibiotics to be taken
before and after surgery. Antibiotics are more likely to be given to patients with infection or
weakened immune systems at the time of surgery, those undergoing longer surgeries, or young or
elderly people.
To avoid possible complications, one should inform his dentist about all the medications
— prescriptions, over-the-counter (OTC) and herbal — he is taking. For example, aspirin slows the
blood-clotting process; gingko biloba and ginseng also affect clotting.
Many people like to be sedated for a tooth extraction. Possible sedation dentistry options
include nitrous oxide ("laughing gas"), an oral sedative (such as a Valium pill) or an intravenous
sedative that is administered into the veins by injection.

history – istoric, antecedente

case history (syn.) anamnesis - anamneză
dental history – antecedente stomatologice
X-ray (syn.) radiograph – radiografie
to undergo surgery – a suferi o intervenție chirurgicală
clot (syn.) coagulum (pl. coagula) - cheag, coagul
to clot (syn.) to coagulate - a (se) închega, a (se) coagula (sângele)
nitrous oxide (syn.) laughing gas – oxid nitric, gaz ilariant

What to Expect During a Tooth Extraction

At the extraction appointment, the dentist will numb, or anesthetize, the tooth to be
extracted, as well as the jawbone and gums surrounding it. Typically, a local anesthetic such as
novocaine or lidocaine is injected to eliminate discomfort.
Simple Extraction: The dentist will grasp the tooth with specialized pliers called
extracting forceps and move them back and forth to loosen the tooth before removing it.
Sometimes, a surgical cutting instrument called a luxator — which fits between the tooth and the
gum — is used to help loosen the tooth. Dentists also use "elevators", which are levers that look
similar to small screwdrivers. Usually a dentist will first use an elevator to wedge between the tooth
and the surrounding bone. The elevator places pressure on the tooth, which helps to expand the
tooth's socket and separate its ligament.

to numb - a paraliza, a înţepeni, a amorţi

numbness – amorţeală
pliers - cleşte, pensă
extracting forceps (syn.) dental forceps – cleşte de extracție
luxator (syn.) dental elevator - elevator dentar
exolever - elevator pentru rădăcini
to wedge - a fixa o pană, a insera, a înfige
wedge - pană, clavetă

Surgical Extractions: These procedures generally are more complicated, so the dentist
may sedate the patient before numbing his tooth, then use a dental drill, apply pressure to his tooth
with an elevator or extracting forceps, and remove the tooth. Greater surgical effort may be needed
in other cases. For instance, gum and/or bone tissue may cover or surround a tooth in a way that
makes it difficult for the dentist to view and/or access it. If so, the dentist will need to cut and lift
back or remove this tissue. Sometimes a tooth is so firmly anchored in its socket that the dentist
must cut the tooth into pieces in order to remove each portion individually.

to drill - a freza, a găuri, a sfredeli

 dental drill – freză dentară
anchor - ancoră
anchorage - ancorare, fixare, întărire, consolidare

The dentist may need to place stitches and/or add bone (natural or synthetic) in the
extraction site after the procedure. Some stitches are absorbable and will disintegrate on their own;
others require removal by the dentist, usually about a week after the extraction.

Modern Tooth Extraction

While surgical cutting instruments like scalpels and dental drills are still commonly used
in surgical extractions, the use of dental lasers and electrosurgery in such procedures is growing.
Lasers use high-energy light beams to cut, while electrosurgery uses controlled heat to cut.
Benefits of laser surgery and electrosurgery as an aid in tooth extraction compared to traditional
scalpels and dental drills include greater precision, less chance of damage to adjacent structures,
less bleeding and discomfort, and quicker healing time. However, the disadvantages of their use
include higher costs, the smell of burning flesh during the procedure, and the inability to use them
to directly extract teeth.

stitch - împunsătură, cusătură; fir; junghi

scalpel (syn.) bistoury - bisturiu
to stitch - a coase, a sutura
electrosurgery - electrochirurgie
electrosurgical – electrochirurgical
to heal - a (se) vindeca, a (se) cicatriza
healing - vindecare, însănătoşire; vindecare (a unei răni), cicatrizare

Tooth Extraction Aftercare

Since bleeding is normal after an extraction, the dentist will have the patient bite on a
piece of gauze for about 45 minutes to put pressure on the area and allow the blood to clot. Some
swelling and discomfort are normal after a tooth extraction.
Cold compresses or ice packs can help decrease the swelling. If the jaw is sore and stiff
after the swelling dissipates, one should apply warm compresses. Sleeping with the head face
upward to relieve pressure on the jaw, and keeping the head elevated with extra pillows also may
help. In addition, the dentist may recommend taking an OTC pain reliever such as ibuprofen for
several days. With surgical extractions - which generally cause more pain afterwards - the dentist
may prescribe a prescription pain medication.

gauze – tifon
gauze compress - compresă de tifon
cold compress - compresă rece
compress – compresă
to compress (syn.) to compact - a comprima, a compacta
sore - rană, inflamaţie, iritaţie, loc sensibil
sore - dureros, inflamat, suferind, usturător
ice pack - compresă cu gheaţă
stiff - rigid, ţeapăn, tare; ferm, hotărât
to stiffen - a întări, a înţepeni, a amorţi
stiffness - curbatură, redoare; rigiditate; asprime, duritate

Other aftercare tips include:

Do not rinse your mouth for the first 24 hours immediately following a tooth extraction.
Stick to a soft or liquid diet (milk, ice cream, mashed potatoes, pudding) the day of and the
day after a tooth extraction, gradually progressing to eating other easy-to-chew foods. Chew with
teeth that are far from the extraction site.
Brush and floss the other teeth as usual, but avoid the teeth and gum next to the extraction
socket.
After the first 24 hours, for at least five days after extraction, gently rinse the socket with
warm salt water (1/2 teaspoon of salt in a cup of water) after meals and before bed.

to rinse - a clăti, a spăla

rinse - clătire, lavaj, spălare
rinsing - clătire, spălare

Things to Avoid After Tooth Extraction

In addition to the aforementioned aftercare considerations, tooth extraction aftercare also
involves avoiding certain foods and activities.
Avoid anything that might dislodge the blood clot and delay or prevent normal healing.
Do not smoke, vigorously rinse or spit, engage in strenuous activities, or drink through a
straw for at least two days after an extraction.
Stay away from hot liquids, foods that are crunchy or contain seeds or small grains,
alcohol, and carbonated soft drinks for two to three days after tooth extractions.
Do not brush your gums or use an OTC mouth rinse (you can use homemade water-and-
salt washes).

aftercare - ţinere sub observaţie după boală, urmărire a pacientului, îngrijire după boală
sau spitalizare
to dislodge – a deplasa, a îndepărta, a disloca
dislodgement - basculare, îndepărtarea unei proteze; deplasare (a unui cateter, a unei
sonde endotraheale)
strenuous - obositor, epuizant, istovitor
crunchy – crocant

Possible Tooth Extraction Complications

There are several potential complications that may occur as a result of a tooth extraction.
These complications may include:
Accidental damage to adjacent teeth.
Incomplete extraction, in which a tooth root remains in the jaw. The dentist usually
removes the root to prevent infection, but sometimes it is less risky to leave in a small root tip.
Alignment problems associated with chewing ability or jaw joint function. Misaligned
teeth may cause pain, teeth grinding (bruxism) and cracking or splintering of teeth withstanding the
force of the jaw. Additionally, misaligned teeth can trap food and be harder to clean, thereby
increasing the risk for tooth decay and gum disease.
Fractured jaw (most often occurring in older people with osteoporosis of the jaw) caused
by the pressure put on the jaw during extraction.
If an upper tooth was extracted, a hole may have been made into one of the sinus areas.
Normally, it will heal quickly on its own; but if it doesn't, one may need to return to his dentist.

bruxism (syn.) grinding of teeth - bruxism, scrâşnirea dinţilor

complication - complicaţie, complicare; agravare
tip - vârf, extremitate; capăt
splinter - aşchie, schijă, fragment
to splinter - a despica, a spinteca, a fractura, a crăpa, a sparge
splintered - despicat, spintecat, fragmentatt
fracture - a fractura, a rupe
 fractured - fracturat, rupt, fisurat

Infection, while rare, does occasionally occur. The dentist may prescribe antibiotics before
and after the extraction if determined you may be at risk of infection.
Nerve injury — while primarily an issue with extractions of lower wisdom teeth — can
occur with the removal of any tooth if the nerve is near the extraction site. Typically caused by
damage from a surgical drill, nerve injuries are rare and usually temporary.
Bisphosphonates — drugs used to prevent/treat osteoporosis, multiple myeloma, bone
cancer and bone metastasis from other cancers - may put patients who undergo tooth extractions at
risk for developing osteonecrosis of the jaw (a rotting of the jaw bones). It is thought that
bisphosphonates attack the teeth and bone, and may prevent cells that break down bone from
working. If you are taking an osteoporosis medication, try to avoid extraction whenever possible,
rather than opt for removal of the tooth/teeth.

myeloma – mielom
multiple myeloma (syn.) myeloma multiplex - mielom multiplu
metastasis (pl. metastases) – metastază
to metastasize - a metastaza
metastatic - metastatic
cancer (CA) - cancer; carcinom; sarcom
cancerous (syn.) cancered - canceros
rot - putrezire, putrefacţie
to rot - a putrezi, a se descompune, a intra în putrefacţie

Dry Socket
Dry socket, a common complication after a tooth extraction, occurs when a blood clot has
failed to form in the socket, or the blood clot that did form has been dislodged. This leaves the
underlying bone and nerves exposed to air and food. Often quite painful, dry socket typically
appears 2 to 5 days after extraction and can cause a bad odor or taste.
Dry socket is most frequently associated with difficult or traumatic tooth extractions, such
as the extraction of lower wisdom teeth. It occurs more often with people over the age of 30,
smokers, those with poor oral hygiene habits and women (particularly those taking oral
contraceptives). Unless there is an emergency, experts recommend that women using oral
contraceptives schedule their extractions during the last week of their menstrual cycle, when
estrogen levels are lower.

emergency - urgenţă, necesitate extremă

emergency case - urgenţă medicală; caz de urgenţă
emergency operation - intervenţie chirurgicală de urgenţă, operaţie de urgenţă

In most cases, if you develop dry socket, your dentist will place a medicated dressing into
the socket to soothe the pain and encourage healing. The dressing is replaced every 24 hours until
the symptoms of dry socket lessen (about five to seven days).
Healing Time for Tooth Extractions
Healing from a tooth extraction takes about five to seven days. The gum area should be
fully healed in three to four weeks. If the jaw is damaged during tooth extraction, full healing may
take up to six months.

to soothe - a calma, a alina, a linişti, a potoli, a uşura

soothing - calmant, liniştitor, paliativ, care atenuează durerea
dressing - pansament, bandaj; pansare, bandajare
to dress a wound - a aplica un bandaj pe rană, a bandaja o rană