As the days get warmer, the number of patients who come to the dentist or doctor because of dental swelling increases. Although the presence of swelling is not considered a contraindication, there is a fear of many patients (and doctors) that such teeth should not be extracted until the swelling subsides. Precisely because of such a wrong picture, I decided to write a text in which I would explain the principles of why and when these teeth can and should be extracted.
Tooth swelling, which has a dental origin (there are swellings that are not caused by processes in the tooth), is nothing more than a collection of pus that is most often found around the top of the tooth root. This pus was created as a result of the penetration of bacteria from the surface of the tooth (cavitation) through the pulp of the tooth.
This stage is called pulpitis and if left untreated, it leads to the death of the tooth pulp and the spread of bacteria outside the tooth. That's when the formation and accumulation of pus occurs around the root of the tooth. The collection of pus is at the level of the bone (when it is not visible to the naked eye) until the moment when the surface of the bone is broken (this stage is very painful) and the swelling becomes visible. The location of swelling can be different, both inside the oral cavity and outside it.
Treatment of such conditions with antibiotics is a poorly effective method. This is explained by the fact that bone is a tissue with little blood supply. As the orally taken antibiotic spreads through the body through the blood, the therapeutic concentration of the antibiotic cannot be reached in the bone. Therefore, taking antibiotics leads to a reduction in swelling, but this type of therapy has a high risk of creating strains of bacteria resistant to antibiotics.
One of the basic principles in medicine and surgery is expressed in the Latin saying "Ubi pus, ibi evacua", which in translation means: "Where there is pus, it should be removed". This principle is also applied in dentistry, so if there is swelling, the pus should be evacuated.
This can be achieved in two ways: through an incision and through tooth extraction. Incision is the procedure of making a small cut in the skin or mucous membrane in order to access the purulent collection. Since this procedure cannot always be done, and it does not remove the initial cause of the pus formation, it is considered that tooth extraction is the best way to solve tooth swelling. By extracting the tooth, the cause is removed and a free passage for pus is achieved. Moreover, tooth extraction is not recommended only in those situations where anesthesia cannot be applied due to swelling.
Therefore, do everything to prevent swelling, and if it does happen, be sure that tooth extraction is the best way to remove it.
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