The Fono

Health & Social Services

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Extractions and fillings

Extraction / tooth removal

A dental extraction is the removal of teeth from the dental socket in the alveolar bone. Extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become un-restorable through tooth decay, periodontal disease or dental trauma; especially when they are associated with toothache.

Sometimes wisdom teeth are stuck and unable to grow normally into the mouth, and may cause repeated gum infections (pericoronitis). Your Fono dentist may recommend removing wisdom teeth before they are fully developed (normally in the adolescent years) to help eliminate potential problems.

You may also develop 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.

Reasons for tooth extraction:

  • Severe tooth damage: when teeth have such extensive decay and damage (broken or cracked) that repair is not possible, for example, teeth affected by advanced gum disease
  • Malpositioned / non-functioning teeth: your dentist may recommend removing teeth that are misaligned and/or essentially useless (teeth that have no opposing teeth to bite against), to avoid possible complications
  • Extra teeth: these may block other teeth from erupting
  • Radiation: head and neck radiation therapy may require the extraction of teeth to help avoid possible complications, such as infection
  • Chemotherapy: chemo 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, so some teeth may require removal prior to an organ transplant

Types of extractions

Extracting teeth is normally relatively straightforward and can usually be performed quickly while you are awake.

Simple extractions are performed on teeth that are visible in the mouth and most are usually done under a local anaesthetic.

Surgical extractions 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. 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 anaesthetic and/or conscious sedation. Patients with special medical conditions and young children may require general anaesthesia, and will be referred to a specialist for a general anaesthetic procedure.


Fillings are used to treat a cavity, or to repair cracked or broken teeth and teeth that have been worn down from misuse (such as from nail-biting or tooth grinding).

When performing a filling, your Fono dentist will normally use a local anesthetic to numb the area around the tooth to be filled.

They will then use a drill to remove the decayed area.

The space for the filling is then prepared by cleaning the cavity of bacteria and debris. If the decay is near the root, your dentist may first put in a liner to protect the nerve. Generally, after the filling is in, your dentist will finish and polish it.

Filling materials available include gold; porcelain; silver amalgam (mercury mixed with silver, tin, zinc, and copper); or tooth-coloured plastic, and glass materials called composite resin fillings. The location and extent of the decay, cost of filling material and your dentist's recommendation assist in determining the type of filling best for you.

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