Tooth extraction – Gentle and painless solution at Dobrý Dent

The decision to extract a tooth is never taken lightly. Our experienced dentists at Dobrý Dent will carefully consider all options and will only proceed with an extraction if absolutely necessary. The most common reasons include:

• Extensive tooth decay: If a tooth is so badly damaged by decay that it cannot be repaired with a filling, crown, or endodontic treatment (root canal treatment), extraction may be the only option to prevent the infection from spreading.
• Infections and Abscesses: An infection that has reached the pulp or surrounding bone and is not responding to root canal treatment may require tooth extraction to prevent more serious health problems. An untreated abscess can lead to the spread of infection to other parts of the body.
• Advanced periodontal disease (periodontitis): If periodontitis causes significant loosening of the tooth due to loss of supporting bone and tissue, extraction may be necessary. A loose tooth is not only painful, but it also poses a risk to surrounding teeth and tissues.
• Fracture of the tooth or root: A tooth that is broken below the gum line or has a broken root often cannot be saved and must be extracted. Such damage can be caused by an injury or biting on a hard object.
• Implanted (unerupted) or malpositioned teeth: Most often, these are wisdom teeth („figure eights“) that do not have enough room to erupt properly, press on neighboring teeth, cause inflammation, or cysts. Extraction in these cases is a prevention of further problems.
• Orthodontic reasons: In some cases, it is necessary to extract one or more teeth to create space for the correct alignment of the other teeth with braces. This procedure is carefully planned in cooperation with the orthodontist.
• Preparation for prosthetic treatment: Sometimes it is necessary to remove teeth that could complicate the placement or function of dental prostheses (e.g. complete removable dentures).
• Supernumerary teeth: The presence of extra teeth can prevent the correct eruption of permanent teeth or cause aesthetic and functional problems.

We assess each case individually and always discuss with you in detail the reasons for the recommended extraction and all available alternatives.

At the Dobrý Dent clinic, we place maximum emphasis on patient comfort and safety throughout the extraction process. We use the most modern procedures and technologies to ensure the smoothest possible course of the procedure and minimize any discomfort.

1. Consultation and precise diagnostics

It all starts with a thorough initial consultation. The doctor will assess the condition of the tooth and surrounding tissues, discuss your medical history and the reasons for the extraction with you. An essential part is an X-ray examination (X-ray), which will show us the position of the tooth, the shape and number of roots and their relationship to the surrounding structures (nerves, cavities, neighboring teeth). For more complex cases, especially with impacted wisdom teeth or teeth near sensitive anatomical structures, we use our state-of-the-art 3D CBCT (Cone Beam Computed Tomography) examination. This detailed three-dimensional image allows us to plan the procedure with absolute precision, minimize risks, and choose the most gentle procedure. Based on this information, the doctor will explain the procedure, possible risks, and answer all your questions in detail.

2. Anesthesia for maximum comfort – Painlessness comes first

We understand that concerns about pain are common during tooth extraction. That is why at Dobrý Dent we use the most modern methods of local anesthesia. Our standard is the STA (Single Tooth Anesthesia) system, a computer-controlled application of anesthetic. This system allows for a very slow and controlled application of anesthetic, which significantly reduces or completely eliminates the discomfort during the injection. The anesthetic is applied specifically to the tooth in question, ensuring its perfect numbness without unnecessary numbness of surrounding tissues (e.g. the lip or tongue in some types of classic anesthesia). During the entire procedure, you will not feel any pain, only pressure or pull.

3. The procedure itself – Gentleness and precision

The extraction process varies depending on whether it is a simple or surgical extraction.

• Simple extraction: It is performed on teeth that have already erupted into the oral cavity and have a relatively simple root shape. Using special instruments (elevators, forceps), the doctor carefully releases the tooth from the bone bed and then gently equips it.
• Surgical extraction: It is necessary for teeth that are not fully erupted (impacted), are broken below the gum level, have complexly curved roots or are firmly anchored in the bone. In this type of extraction, the doctor makes a small incision in the gum to gain access to the tooth and bone. Sometimes it is necessary to remove a small part of the bone covering the tooth or divide the tooth into smaller parts for easier and gentler removal. At Dobrý Dent, we also use an operating microscope for more complex extractions, which allows us to work with maximum precision, minimize trauma to surrounding tissues, and ensure better healing. After the tooth is removed, the wound can be closed with several stitches that promote healing and protect the bone bed. We use absorbable and non-absorbable stitches, depending on the specific situation.

During the entire procedure, we ensure maximum sterility and use only high-quality tools and materials. Our experienced team works quickly, efficiently, and above all, with your comfort in mind.

4. Post-extraction care – The key to rapid healing

After a successful procedure, proper care of the extraction wound is key to preventing complications (e.g. inflammation of the bed – alveolitis) and ensuring rapid and uncomplicated healing. Immediately after the extraction, we will place a sterile gauze pad in your wound, which you will bite on for about 20-30 minutes to stop the bleeding and form a blood clot, which is the basis for healing. You will receive detailed written and oral instructions from us on how to care for the wound in the following days. These instructions include recommendations regarding diet, oral hygiene, the use of painkillers and limiting physical activity.

Simple extraction

As already mentioned, simple extraction refers to teeth that are clearly visible and accessible in the oral cavity. This is the most common type of extraction. After applying local anesthesia, the doctor uses a lever (elevator) to gently disrupt the tooth’s attachment apparatus and slightly expand the bone bed. Then, using extraction forceps, he grasps the crown of the tooth and, using rocking and rotating movements, carefully releases and dislodges the tooth from the bed. The whole process is usually very quick and painless thanks to anesthesia. The patient feels only pressure.

Surgical extraction

Surgical extraction is a more complex procedure that requires more time and precision. It is indicated in cases where the tooth cannot be easily grasped with forceps or its removal requires modification of the surrounding tissues. Typical examples are:

• Retained (unerupted) teeth: Teeth that have remained completely or partially hidden under the gum or in the bone (most often wisdom teeth).
• Teeth broken at or below the gum level: When the tooth cannot be grasped by the crown.
• Teeth with severely curved or branched roots: Which could easily break during simple extraction.
• Teeth firmly fused to the bone (ankylosis).

During surgical extraction, the doctor, after anesthesia, makes an incision in the gum (the so-called mucoperiosteal flap) to expose the tooth and possibly the bone. If necessary, a small amount of bone that prevents access to the tooth is removed using a special drill. Sometimes it is more effective to divide the tooth into several parts (so-called separation) and then remove them individually. This procedure is often gentler on the surrounding bone. After the tooth is removed, the doctor carefully cleans the wound, smoothes any sharp edges of the bone, and closes the wound with stitches. The use of an operating microscope at Dobrý Dent allows us to perform these procedures with extraordinary precision, which leads to less tissue damage and faster healing.

Wisdom teeth extraction („figure eights“)

Wisdom teeth, the third molars, are the last teeth to erupt, usually between the ages of 17 and 25. However, there is often not enough space for them in the jaw, which leads to a number of problems:

• Retention (impaction): The tooth remains completely or partially trapped in the bone or under the gum.
• Incorrect position: They grow obliquely, horizontally or press on neighboring teeth (sevens), which can lead to damage to them or crowding of the front teeth.
• Pericoronitis: Gingivitis around a partially erupted wisdom tooth, caused by the accumulation of bacteria and food debris under the gum. It is manifested by pain, swelling, redness and sometimes limited mouth opening.
• Tooth decay: Wisdom teeth are difficult to clean due to their position at the back of the mouth, and are therefore more susceptible to decay. The decay can also spread to the adjacent tooth.
• Cyst formation: A cyst can form around an unerupted wisdom tooth, which can damage the surrounding bone and teeth.

Wisdom tooth extraction is often a preventive procedure that prevents these complications. Thanks to our 3D CBCT, we can accurately visualize the position of the wisdom tooth, its relationship to the nerves (especially the inferior alveolar nerve in the lower jaw) and other structures. This allows us to plan the extraction with maximum safety and minimize the risk of complications. The extraction itself is most often performed as a surgical procedure, under effective local anesthesia STA.

Why choose our clinic Dobrý Dent for tooth extraction?

• Experienced and empathetic doctors: Our team of dentists and dental surgeons has extensive experience in performing all types of extractions, from simple to the most complex. We emphasize a human approach and try to dispel all patient concerns. We have been operating in Prague 5 since 2010.
• High-tech for your safety and comfort: We invest in the most modern equipment:
  • STA painless anesthesia: For maximum comfort without pain during the procedure.
  • 3D CBCT X-ray: For perfect planning of complex extractions and minimizing risks.
  • Operating microscope: For maximum precision during surgical procedures and better healing.
  • 3D intraoral scanner: For accurate planning of subsequent prosthetic solutions (implants, bridges).
• Emphasis on painlessness: We use the most effective anesthetics and techniques to make the procedure as pleasant as possible.
• Individual approach: We devote enough time to each patient, explain the entire procedure and propose a treatment plan tailored to their needs.
• Comprehensive care under one roof: We offer a wide range of dental services. After extraction, we can offer and implement the most suitable solution for replacing a lost tooth (dental implant, bridge).
• Modern and pleasant environment: Our clinic in Anděl (Prague 5) is designed to make you feel as comfortable and relaxed as possible.
• Detailed postoperative instructions and care: We will provide you with all the information and support for a smooth healing process.

Proper post-extraction care is essential for a fast and uncomplicated healing. Please follow these instructions:

• Bleeding: Bite on a gauze pad for 20-30 minutes after the procedure. If bleeding persists, replace the pad with a new one and continue biting. Slight bleeding or pinkish discoloration of the saliva is normal in the first 24 hours. Do not rinse your mouth vigorously to avoid disrupting the blood clot.
• Pain: You may feel some pain after the anesthesia wears off. Take painkillers (analgesics) recommended by your doctor (usually ibuprofen or paracetamol). Do not take medications containing acetylsalicylic acid (Aspirin, Acylpyrin), as they increase bleeding.
• Swelling: Swelling of the face in the extraction area is a common reaction, especially after surgical procedures. It usually peaks on the 2nd-3rd day after extraction. Apply cold compresses (ice wrapped in a towel) to the outside of the face – 20 minutes of cooling, 20 minutes of rest. Sleep with your head elevated.
• Oral hygiene: On the day of extraction, do not rinse your mouth or brush your teeth around the wound. From the second day, start careful oral hygiene. Brush your teeth with a soft toothbrush, avoiding the wound. Carefully rinse your mouth with lukewarm salt water (half a teaspoon of salt in a glass of water) or a recommended mouthwash (e.g. chlorhexidine) several times a day, especially after meals.
• Diet: Eat a soft, mushy, and non-irritating diet (yogurt, soup, puree, smoothie) on the day of the procedure and the following days. Avoid hot drinks and foods, alcohol, hard, and crunchy foods that could irritate the wound or disrupt the clot. Drink plenty of fluids, but do not use a straw (sucking can loosen the blood clot).
• Smoking: Smoking significantly slows down healing and increases the risk of complications (especially dry bedsores). Avoid smoking for at least 48 hours after the extraction, ideally throughout the healing period.
• Physical activity: Avoid heavy physical exertion, lifting heavy objects, and bending forward on the day of the extraction and for the next 2-3 days. Rest.
• Sutures: If you have non-absorbable stitches, your doctor will tell you when they will be removed (usually in 7-10 days). Absorbable stitches will dissolve on their own.
• Check-ups: Keep your doctor’s scheduled check-ups. If you have severe pain that does not go away with medication, significant swelling, fever, persistent heavy bleeding, or other unusual symptoms, contact us immediately.

Losing even one tooth can have a negative impact on your ability to bite, speak, the appearance of your smile and can even lead to the displacement of surrounding teeth. That is why it is important to consider the options for replacing an extracted tooth. At Dobrý Dent, we offer you modern and aesthetic solutions:

• Dental implant: It is considered the best and most durable solution. It is a titanium screw inserted into the jawbone, which replaces the root of the tooth. A crown is then attached to the implant, which fully replaces the lost tooth both functionally and aesthetically. Thanks to our 3D intraoral scanner and CBCT we can plan the implantation precisely.
• Dental bridge: It replaces one or more missing teeth with a structure attached to neighboring (ground) teeth. It is a solid and aesthetic solution, but requires adjustment of healthy teeth.
• Removable denture: A partial or complete prosthesis that replaces more or all teeth. Modern removable dentures are aesthetic and functional, but require regular maintenance.

Your doctor at Dobrý Dent will discuss all options with you in detail and recommend the most suitable solution for you, taking into account your specific situation, needs and wishes.