Indications.
1. Periodontal disease: teeth with advanced periodontal disease that cannot be treated due to the condition.
2.Dental defect: teeth with serious caries and cannot be restored. However, if the root and periapical condition is good, it can be treated to make pile crown or cover denture without extraction.
3.Periapical disease: The teeth with periapical disease that cannot be preserved by root canal treatment and other methods.
4, dental trauma: traumatic tooth fractured to subgingival due to trauma, or at the same time there is root fracture, which cannot be preserved by other treatment methods. Teeth on the fracture line should be decided on a case-by-case basis, and should generally be preserved as much as possible.
5, misaligned teeth: displaced or misaligned teeth should be extracted if they affect function and aesthetics, cause disease or trauma, etc.
6.Obstructed teeth: Obstructed teeth that cause caries of adjacent teeth or repeatedly cause pericoronitis.
7.Extra teeth: Multiple teeth that are misplaced or obstruct the beauty and function should also be extracted.
8.Treatment needs: teeth that need to be reduced due to orthodontics; teeth that should be extracted due to the need of denture repair; teeth that need to be extracted to prevent serious complications before radiotherapy; teeth affected by benign tumors or cysts that should be extracted because they cannot be retained or due to treatment needs.
9. Retained milk teeth: those that affect the eruption of permanent teeth should be extracted. However, if there is no permanent tooth below the baby tooth in the adult dentition or if the permanent tooth is blocked, the baby tooth does not need to be extracted if it is not loose and has function.
10. Focal teeth: Focal teeth suspected to cause certain diseases should also be extracted. Focal teeth that cause certain local diseases such as osteomyelitis of the jaws and maxillary sinusitis should be extracted after the acute inflammation is controlled.
Contraindications.
1. Severe hypertension with blood pressure higher than 180/100mmHg
2. Heart disease with other organ damage, such as: recent onset of unstable angina, angina pectoris, arrhythmia, rheumatic heart valves.
3. Hematological diseases: Patients with hematological diseases with bleeding tendency should not have their teeth extracted. For example: anemia, hemoglobin below 80g/L, leukemia, primary thrombocytopenic purpura, hemophilia, etc.
4. Fasting, excessive fatigue, high mental tension, female menstrual period.
5, liver disease, severe hepatitis.
6, kidney disease, acute nephritis, chronic renal insufficiency, patients with severe nephropathy and renal failure.
7, diabetes mellitus, blood sugar higher than 8.9/L.
8, hyperthyroidism.
9.Menstrual period, which may cause compensatory bleeding.
10.Malignant tumor. Patients with malignant tumor, if the tooth is located in the malignant tumor or has been involved by the tumor, simple extraction of the tooth may provoke the tumor to cause proliferation and should be considered as contraindicated. Generally, it should be removed together with the tumor. Before radiotherapy, the affected tooth located in the irradiated site should be extracted or completed at least 7-10 days before radiotherapy. Tooth extraction should be prohibited during radiotherapy and 3-5 years after radiotherapy to avoid the formation of radioactive osteomyelitis.
11.Patients in the open stage of pulmonary tuberculosis.
12, Patients in the acute inflammatory stage and with uncontrolled inflammation.
13. Pregnant women should not have tooth extraction in the first and last trimester of pregnancy. Avoid causing premature birth and miscarriage.
14. Patients with noradrenal cortical insufficiency.
15.Neuropsychiatric disorders. Mainly for cooperation problems. Such as Parkinson’s disease, often with involuntary activities; cerebral palsy, with spasticity; all these patients cannot cooperate. Unless general anesthesia is used, tooth extraction should be performed.
For some of the above diseases, after proper symptomatic treatment, such as hypertension and acute inflammation, the symptoms can be controlled and the teeth can still be extracted.