Surgical Removal

Most teeth and roots can be removed in the dental office under local anaesthetic. Only severely retained roots and a few teeth require general anaesthetic for the patient.

Costing

8140 Z01.2 General anaesthetic if required R 159.20

8953 Z03.9 Surgical removal of residual roots R

8937 K03.9 Surgical removal of tooth R 423.70

Note: If the procedure is done in the rooms, then codes 8110, 8109 x 2 and 8220 will be levied.

Possible complications:

If a tooth/root is in close proximity to the nerve that runs in the lower jaw bone when it is removed there is a risk of nerve damage. This can range from altered sensation to the feeling of a “dead” lip – as if there was a permanent injection there. Treatment for this is to try to encourage nerve healing with medication and physiotherapy, but results are not predictable.
Normal swelling occurs but it can be severe in some cases but anti-inflammatories, cold and hot packs and physiotherapy ease the situation.
Post operative pain can be severe, but pain killers will be supplied or others added to the medical regimen.
The sutures can come loose and this needs to be assessed before re-insertion of them is decided upon. “Dissolvable” stitches take between 7 and 10 days to fall out.
A piece of bone and or gum can be so tightly attached to the tooth that on tooth removal it can come along with the tooth. This is treated by suturing of the wound site.
When healing is impaired a “dry” socket can develop which is painful. This is treated easily by the dentist rinsing and cleaning the site and placing medication into the socket.
While removal of the tooth/root is taking place by forceps or being sectioned surgically it can fracture. Most of the time all the pieces can be removed but sometimes it is unwise to continue looking for a small piece due to anatomical considerations like a nerve nearby. These small root remnants are then left behind. They can surface into the oral cavity spontaneously at a later time.

Any untoward reaction or symptom should be reported to the dentist as soon as possible so that the problem can be found and rectified.

Post-operative instructions:

Usually antibiotics, analgesics and a mouth wash will be prescribed and instructions will be on the label of the product. In cases where there is no script issued for the chemist then the following will apply:
Nothing to eat or drink for two hours so that the blood clot stabilises.
No smoking or alcohol to be used for 24 hours as both these substances are known to impair wound healing.
From the next morning one is to rinse with a saline rinse – take a cup of warm water, dissolve a teaspoon of salt into it and rinse after every time one eats for a week’s duration