Removing retained tooth roots

Mr Cascarini is a face, mouth and jaw surgeon with considerable experience in dental techniques. One common problem that requires surgical expertise is a retained tooth root.

How do retained roots arise?

All adult teeth have up to four roots that anchor the tooth into the jawbone. Usually, when a tooth is removed by a dentist, the roots are taken out with it. However, if the tooth is lost through accident or decay, the root or roots may be retained within the jawbone and gums, causing problems such as mouth infections and pain. If this is the case, the roots need to be surgically removed.

Sometimes teeth, especially wisdom teeth, fail to erupt from the gums at all. This is called an impacted tooth and can also cause problems, although such teeth may remain dormant and not need attention for many years.

How are retained roots removed?

The complexity of retained root removal surgery depends on the nature of the problem. Some retained roots involve a simple extraction, which can be done quickly under local anaesthetic. Others involve a more lengthy procedure, and you may be given sedation to help you relax.

In the most difficult cases, part of the gum, and possibly even a small section of the jawbone, may be need to be removed to free the roots. If this is the case, you will usually be given a general anaesthetic.

What to expect after removal of a retained root

Naturally, you will feel sore, swollen and bruised after major dental surgery such as retained root removal. You may also feel stiff around the mouth and experience an ache when eating or talking for a few days. The bruising and swelling will subside in around a week to ten days. Mr Cascarini has developed information for all patients having mouth surgery so that you can take care of your mouth afterwards and make sure healing is as fast as possible.

In most cases, the wound will be sewn up using dissolvable stitches, which will melt away of their own accord and will not require a return visit for removal. You will usually have to return for a check up after around two weeks, to ensure that you are healing properly. You may have an X-ray on this visit to check that all of the root has been removed.

You will be given antibiotics to take to reduce the risk of infection, and you will be advised to rinse your mouth out with salt water several times a day for the first week. You should only need over the counter painkillers, such as paracetemol.

You will be very aware of the hole or scars left by the operation at first, although these will eventually disappear as the gums and jawbone reshape.

Risks and complications

As with all surgery, there is a risk of complications, especially if you have a general anaesthetic. Mr Cascarini will explain these in detail to you but, in brief:

• You may experience an infection at the wound site, although the use of antibiotics and the saltwater mouthwash significantly reduces this risk.

• You may also experience minor bleeding from the wound site. If this bleeding does not stop, you need to contact us immediately.

• Between 5% and 10% of patients may develop what is known as ‘dry socket’ where the blood clot at the wound site is dislodged, or fails to form properly in the first place. If this occurs, you will need to have the wound packed with medicated gauze for a few days to help with the healing.