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                                                        DR. DAN PETERSON

                                                                      1415 SAGE STREET ~ GERING, NEBRASKA 69341 
                                                             
      Call: 308-436-3491       www.dentalgentlecare.com           

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EXTRACTIONS DISCUSSED

     Extraction involves the complete removal of a tooth from the mouth

     Some extractions may require cutting into the gums and removing supporting bone and/or cutting the tooth into sections prior to removal. 

      One of the main goals of Dr. Peterson is the prevention of tooth loss. All possible measures are taken to preserve and maintain your teeth because the loss of a single tooth can have a major impact upon your dental health, speech, biting, chewing and appearance. 

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    We encourage root canal therapy over extraction.  Extractions can cause:

bulleta great deal of trauma 
bulletpulling teeth may affect memory
bulleta higher incidence of bacteremias, especially with heart patients, or if you are predisposed to bacterial endocarditis and/or joint infections. 
bullet If you loose the tooth you will loose 10% of your chewing ability
bulletMay loose other teeth due to drifting.

     Choosing to have a tooth extraction, whether than having root canal therapy, can release between 68% to 84% more bacteria into the blood stream which can affect your overall health. 

     Choosing a root canal over an extraction whenever possible is:

bulletsafer
bulletless invasive 
bulletless expensive in the long run because an extracted tooth must be replaced with an implant or bridge which is far more costly and time-consuming.  

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Nothing is as good as a natural tooth!

     Other alternatives to an extraction are fillings, crowns and/or gum treatment.

Our goal is to save teeth to help keep you in good overall health

     However, it is still sometimes necessary to remove a tooth. Here are some of the reasons a tooth may need to be extracted: 

bullet  Severe decay 
bullet Pain
bullet  Advanced periodontal disease 
bullet Infection or abscess 
bullet Orthodontic correction
bullet Malpositioned teeth
bullet Fractured teeth or roots 
bullet Tooth is unrestorable
bullet   Impacted teeth

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     The intended benefits of an extraction is to relieve your current symptoms and/or to permit you to continue with any additional treatment.

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     The risks associated with any type of surgical procedure are: 

bulletdiscomfort
bulletbleeding
bulletswelling 
bulletstiff jaws.

     The best time for women to have dental surgery is right after ovulation, when pain tolerance is highest.  

Very often, losing just one tooth can lead to the loss of support, and teeth begin to drift into the empty space, causing a change in the bite. It also forces the remaining teeth to carry an additional load, sometimes past their ability to adapt. In most cases, when even one tooth is lost, the remaining teeth suffer and are more likely to be lost as well

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     Less common complications that can occur are:

bullet loosening of dental restorations
bullet injury to adjacent teeth and soft tissues
bullet sinus exposure
bullet extraction may fracture
bullet severed nerve 
bullet infection 
bullet dry socket if you do not follow your post-op instructions.

Be true to your teeth, or they will be false to you!

There is a potentially important association between tooth loss and
 coronary heart disease.

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Extraction  Research Updates

Stockholm Study  - Severe teeth loosening increases the risk of premature death due to cancer or cardiovascular disease according to a new Swedish study, reports said Tuesday. Researchers at Karolinska Institutet in Stockholm tracked some 3,743 randomly selected people, aged between 30 and 40, when the study began in 1985.

"Actual loss of teeth suggests a disease that has been ongoing for some 15, 20 years without being detected," Professor Birgitta Soder, one of the study's authors, told the Goteborgs-Posten newspaper.  During the 16-year period, 110 deaths were registered. The average age of the deceased was 47 years. The average life span for women in Sweden is 83 years and 78 years for men.  "We found a clear link between severe tooth loosening disease, loss of one or several molars and a tripled risk of premature death," Soder said.

The researchers have not been able to explain the link but have a theory that a long-term inflammation during teeth loosening produces harmful  sub-stances such as cytokines that may impact the immune system. Another hypothesis was that the affected people suffered from a weakened immune system.  Some other studies have suggested a similar link between teeth loosening and a rise in cardiovascular disease. 9/07

Prior studies of a link between periodontal and cardiovascular disease have been limited by being predominantly observational. We used a treatment intervention model to study the relationship between periodontitis and systemic inflammatory and thrombotic cardiovascular indicators of risk. We studied 67 adults with advanced periodontitis requiring full-mouth tooth extraction. Blood samples were obtained: at initial presentation, immediately prior to treatment ofpresenting symptoms; (2) one to two weeks later, before all teeth were removed; and (3) 12 weeks after full-mouth tooth extraction. After full-mouth tooth extraction, there was a significant decrease in C-reactive protein, plasminogen activator inhibitor-1 and fibrinogen, and white cell and platelet counts. This study shows that elimination of advanced periodontitis by full-mouth tooth extraction reduces systemic inflammatory and thrombotic markers of cardiovascular risk.

Full-mouth Tooth Extraction Lowers Systemic Inflammatory and Thrombotic Markers of Cardiovascular Risk
B.A. Taylor, G.H. Tofler, H.M.R. Carey, M.-C. Morel-Kopp, S. Philcox, T.R. Carter, M.J. Elliott, A.D. Kull, C. Ward, and K. Schenck Dent Res 85(1):74-78, 2006

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The aim of this study was to determine the incidence and bacteriology  of bacteremia associated with various oral and maxillofacial surgical  procedures. A total of 237 patients who underwent oral and maxillofacial surgery  were included in this study. Blood samples were obtained for  bacteriological examination immediately after the essential steps of  the surgical procedure had been performed.

Bacteremia was detected in patients who underwent surgery for tumor,  infection and trauma, and surgical reconstruction of jaw. In  particular, decortication for osteomyelitis and tooth extraction  resulted in a higher incidence of bacteremia compared with other
surgical procedures.
The incidence of bacteremia was not affected by  oral hygiene, gingival inflammation, blood loss, and duration of  surgery. Furthermore, concerning tooth extraction, there was no  statistical difference in the incidence of bacteremia with respect to  the number of teeth extracted and the method of extraction.  Extraction of teeth with odontogenic infection (periodontitis, periapical infection, and pericoronitis) did however produce a
significantly increased incidence of bacteremia compared with  infection-free teeth
(P < .01). Viridans streptococci were the  predominant group of bacteria isolated from the bacteremias. Oral and maxillofacial surgery involving transoral incision produces  bacteremia, regardless of the extent and degree of surgical invasion.  In particular, surgical procedure at infected sites is more likely to  result in bacteremia compared with infection-free sites.


Incidence and bacteriology of bacteremia associated with various oral  and maxillofacial surgical procedures
Sumie Takai DDSa, Tomoari Kuriyama DDS, PhDb, , , Maki Yanagisawa  DDSa, Kiyomasa Nakagawa DDS, PhDc and Tadahiro Karasawa MD, PhDd aPhD Student, Department of Oral and Maxillofacial Surgery, Kanazawa  University Graduate School of Medical Science, Kanazawa, Japan Clinical Instructor, Department of Oral and Maxillofacial Surgery,  Kanazawa University Hospital, Kanazawa, Japan Associate Professor, Department of Oral and Maxillofacial Surgery,  Kanazawa University Graduate School of Medical Science, Kanazawa,  Japan Professor, Department of Laboratory Sciences, School of Health  ciences, Kanazawa University, Kanazawa, Japan Received 2 April 2004;  revised 2 June 2004;  accepted 20 October
2004. Kanazawa, Japan KANAZAWA UNIVERSITY.  Available online 16 February 2005.

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Diet Changes Because of Tooth Loss Could Lead to Heart Risk 

Changes in diet because of tooth loss could increase the risk of developing chronic ailments, including cardiovascular disease, according to a study in this month's Journal of the American Dental Association (JADA). In the study, researchers assessed the relationship between tooth loss and changes in diet over an eight-year period among 31,813 male health professionals. They focused on consumption of specific foods and nutrients associated with cardiovascular and other systemic diseases.  The results of this study support the detrimental impact of tooth loss on dietary intake. Results suggest that changes in diet owing to tooth loss could contribute to an increased risk of chronic disease that has been associated with poor dentition.  According to the study, the dietary change of men who lost five or more teeth was unhealthier than that of men who lost no teeth.  www.rdh.net 10/03

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               February 06, 2008

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PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
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