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A dental extraction (also referred to as tooth extraction, exodontia, exodontics, or historically, tooth pulling) is the removal of teeth from the dental alveolus (socket) in the alveolar bone. Extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become unrestorable through tooth decay, periodontal disease or dental trauma; especially when they are associated with toothache. Sometimes wisdom teeth are impacted (stuck and unable to grow normally into the mouth) and may cause recurrent infections of the gum (pericoronitis). In orthodontics if the teeth are crowded, sound teeth may be extracted (often bicuspids) to create space so the rest of the teeth can be straightened. Tooth extraction is usually relatively straightforward, and the vast majority can be usually performed quickly while the individual is awake by using local anesthetic injections to eliminate painful sensations. Local anesthetic blocks pain, but mechanical forces are still vaguely felt. Some teeth are more difficult to remove for several reasons, especially related to the tooth's position, the shape of the tooth roots and the integrity of the tooth. Dental phobia is an issue for some individuals, and tooth extraction tends to be feared more than other dental treatments like fillings. If a tooth is buried in the bone, a surgical or trans alveolar approach may be required, which involves cutting the gum away and removal of the bone which is holding the tooth in with a surgical drill. After the tooth is removed, stitches are used to replace the gum into the normal position. Immediately after the tooth is removed, a bite pack is used to apply pressure to the tooth socket and stop the bleeding. After a tooth extraction, dentists usually give advice which revolves around not disturbing the blood clot in the socket by not touching the area with a finger or the tongue, by avoiding vigorous rinsing of the mouth and avoiding strenuous activity. Sucking, such as through a straw, is to be avoided. If the blood clot is dislodged, bleeding can restart, or alveolar osteitis ("dry socket") can develop, which can be very painful and lead to delayed healing of the socket. Smoking is avoided for at least 24 hours as it impairs wound healing and makes dry socket significantly more likely. Most advise hot salt water mouth baths which start 24 hours after the extraction. The branch of dentistry that deals primarily with extractions is oral surgery ("exodontistry"), although general dentists, and clinicians from other dental specialties may also carry out tooth extraction routinely since it is a core skill taught in dental schools. ==Reasons== The most common reason for extraction is tooth damage due to breakage or decay. There are additional reasons for tooth extraction: *Severe tooth decay or infection (acute or chronic alveolar abscess). Despite the reduction in worldwide prevalence of dental caries, it is still the most common reason for extraction of (non-third molar) teeth with up to two thirds of extractions. *Supernumerary teeth which are blocking other teeth from coming in. *Severe gum disease which may affect the supporting tissues and bone structures of teeth. *In preparation for orthodontic treatment (braces) *Teeth in the fracture line *Teeth which cannot be restored endodontically *Fractured teeth *Supernumerary, supplementary or malformed teeth *Prosthetics; teeth detrimental to the fit or appearance of dentures *Treatment of symptomatic impacted wisdom teeth, whose impaction is causing pathosis that will lead to yet more (infection, inflammation, bone resorption) *Preventive/prophylactic removal of ''asymptomatic'' impacted wisdom teeth. Although many dentists remove asymptomatic impacted third molars, both American and British Health Authorities recommend against this routine procedure, unless there are evidences for disease in the impacted tooth or the near environment. The American Public Health Association, for example, adopted a policy, ''Opposition to Prophylactic Removal of Third Molars (Wisdom Teeth)'' because of the large number of injuries resulting from unnecessary extractions.〔 〕 *Cosmetic; teeth of poor appearance, unsuitable for restoration *Receiving radiation therapy to the head and neck area may require extraction of teeth in the field of radiation. *Deliberate, medically unnecessary, extraction as a form of physical torture. *It was once a common practice to remove the front teeth of institutionalized psychiatric patients who had a history of biting. *Reduced cost compared to other treatments 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Dental extraction」の詳細全文を読む スポンサード リンク
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