Hesperian Health Guides
Problems That Can Occur
Contents
Broken roots
If you can see the root, try to remove it. If you leave a broken root inside the bone, it can start an infection.
Removing a broken UPPER root. Use your straight elevator. Slide the blade along the wall of the socket until it meets the broken root.
| 1. Force the blade between the root and the socket. | 2. Move the root away from the socket wall. |
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| 3. Move the root further until it is loose. | 4. Grab the loose root and pull it out. |
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Removing a broken LOWER root. Use a straight elevator (or a curved elevator if you have one). If the broken root is from a molar tooth, slide the blade into the socket beside the broken root.
| 1. Break away the bone between the root and the blade. | 2. Force the blade between the root and the socket. |
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| 3. Move the root away from the socket wall. | 4. Grab the loose root and pull it out. |
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WARNING! It is better to leave a small broken root inside the socket. In a week or so, it will loosen itself and be easier to remove.
Root pushed into the sinus
An upper root that seems to disappear may have gone into the sinus. Do not try to find it. Instead, cover the socket with cotton gauze and send the person to the hospital. A special operation is needed to open the sinus, find the root, and take it out.
Ask the person not to blow his nose. That forces air through the opening and prevents it from healing.
Bone chips and tags of flesh
Small pieces of bone that lie loose inside the socket can cause bleeding and delay healing.
| Gently reach into the socket with the end of an elevator or spoon instrument. Feel for the piece of bone and carefully lift it out. Give local anesthetic if needed. |
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When you are finished, ask the person to bite on cotton gauze until the bleeding stops.
Small tags of flesh are not serious, but they bother the person. Hold the tag steady with cotton tweezers and use sterile scissors carefully to cut the bit of flesh free.
Rinsing with warm water makes gums tough and helps them heal. But do not rinse for the first 24 hours.
Bleeding
If the first cotton gauze does not stop the bleeding in the socket, place more cotton gauze. Wait 5 minutes to see if the bleeding stops. If this does not work, follow the steps for placing a suture.
Swelling
Hold a cloth wet with cold water against the face. This helps to prevent swelling. This is a good thing to do if the tooth was hard to take out, or if it took a long time.
If there already is swelling, heat against the face will help to reduce swelling. Hold a cloth wet with hot water against the swollen area, 30 minutes on and 30 minutes off. Be careful not to burn the skin!
A large swelling usually means there is an infection. The person needs additional treatment.
Painful socket
The socket area often hurts for a day or so after the tooth has been removed. Aspirin, paracetamol (acetaminophen), or ibuprofen is usually enough to relieve the pain.
A strong, steady pain that lasts for several days is a sign that the person is having a problem called dry socket. See information about the treatment of dry socket.
Dislocated jaw
When you press against a person’s jaw while taking out a tooth you can sometimes dislocate it. The jaw has been pushed out of position and it is not able to go back again.
See a description of the care for a dislocated jaw.
MOST IMPORTANT: Be sure to tell each person you treat, "If your problem gets worse, you can come back to see me immediately!"