Full mouth extraction (FME) is a common way to remove all the teeth that have been affected by extensive dental caries, widespread periodontal disease, or simply for better prosthetic treatments.
There are other reasons for full mouth dental extractions such as:
1. Financial barriers
2. No dental insurance
3. Age of the patients
4. Medical comorbidities
5. Inadequate social assistance
6. Poor access to dental care
7. Advanced diseases
Most cases of widespread infection or periodontal disease are caused by neglect, poor oral hygiene, or genetic factors that make your teeth and gums more likely to disease.
According to a survey conducted by the National Center for Chronic Disease Prevention and Health Promotion, 2% of adults aged 20-64 and 17% of adults over the age of 65 in the United States are without teeth.
What Are The Treatment Options to Replace My Teeth?
Treatment planning before starting the extraction procedure is mandatory. It may involve a complete or a removable partial denture or placement of a single or multiple implants or both. The surgeon and the restorative dentist decide the need for a temporary partial or complete immediate denture. There is a consideration for the need for any soft tissue surgery such as tuberosity reduction or the removal of undercuts or exostoses in critical areas. If dental implants are planned to be placed, it may restrict the choice of bone trimming and socket compression. In some cases, dental implants can be placed at the same time as the teeth are extracted. This would require the preparation of a surgical guide stent to assist in aligning the implants.
Which Teeth Should be Extracted First?
Usually, the upper teeth are removed first before the lower ones for several reasons:
1. The anesthetic solution starts working and also disappears more rapidly. This means that the surgeon can begin the surgical procedure soon after the injections have been given.
2. During the extraction process, debris such as parts of amalgams, fractured crowns, and bone chips may fall into the empty sockets of the lower teeth.
3. Upper teeth are removed with the main component of an outward force. Little or no downward traction force is used in the removal of the upper teeth.
Tooth removal usually begins with the extraction of the back teeth first. Canines are the most difficult to remove and usually are extracted last.
What Happens During Multiple Extractions?
When executing multiple extractions, the dentist will expose bone by soft tissue reflection to form a small envelope flap, around all the teeth in a quadrant. The dentist will luxate teeth in the quadrant with the straight elevator and then extract with forceps.
If the removal of any of the teeth requires the use of excessive force, the surgeon removes a small portion of the front bone to prevent fracture and excessive bone loss. It is beneficial to do as much luxation of all teeth in an area to be removed before extracting any of them.
After the extractions are achieved, the dentist will the bone into its pre-existing position unless implants are planned. The soft tissue is repositioned, and the surgeon palpates the ridge to determine areas of sharp bony spicules and undercuts.
If a removable partial or complete denture is scheduled, the dentist will smooth any pointed spicules. Soft tissue is evaluated for the presence of extra granulation tissue. If granulation tissue is present, it should be removed for it may prolong postoperative hemorrhage.
How Long Does It Take To Complete a Full Mouth Extraction?
A full mouth extraction will, as expected, take longer than extracting just one or two teeth. However, you might be surprised to learn that the extra time isn’t all that much longer. The majority of the time spent during surgery is spent administering medication, which includes any anesthetic (local or general) and possibly sedation. To extract a single tooth, the entire procedure should take between 20 and 40 minutes. Additional teeth extractions may take 3-15 minutes, depending on their location and condition.
Keep in mind that depending on whether your tooth is visible or impacted, some extractions will be simple or surgical. This can have an impact on how long the procedure takes.
Care After the Removal of Multiple Teeth
The area operated on will swell for about two days. There may be swelling and discoloration around the eye. Applying an ice pack to the jaw for the first 24 -48 hours will help limit swelling if applied soon after your surgery. The process is to apply the ice pack to the face for 20 minutes and keep it away for 20 minutes after.
If immediate dentures have been inserted, it is advisable to keep them in place until the next appointment or as instructed.
Sore spots may develop. It is recommended to make an appointment within 24-48 hours after surgery and make the important adjustments to relieve the sore spots. Failure to keep the appointment may result in severe denture sores, which will prolong the healing process.
The patient is advised against rinsing their mouth on the day of surgery. The day after, your dentist may recommend a full glass (8oz) of warm water with 1/2 teaspoon of salt and a 1/2 teaspoon of baking soda that can be used for gentle rinsing. This can be 3 – 6 times a day for the first week following surgery.
Drinking liquids or eating soft foods such as soup, eggs, ice cream, yogurt, or mashed potatoes is advised to prevent pain at the surgical site. Gradual transition to eating solid food is recommended.
Foods and Drinks to Avoid After Full Mouth Extraction
1. It is advisable to avoid drinking alcoholic or carbonated beverages.
2. Prevent the use of straws for drinking and sipping. The sucking action may cause the blood clot in the socket to dislodge.
3. The patient is advised to avoid spitting. The sucking action may cause the blood clot in the socket to dislodge. It is a painful delay in healing resulting in early loss of the blood clot from a healing tooth socket. It generally occurs in lower molar areas.
Symptoms of dry socket include an increase in pain about the third or fourth day after surgery and the inability to get relief from prescribed pain medications. The dentist will apply irrigation to clean the socket and place a healing dressing to enable uneventful wound healing.
4. The patient is advised to avoid smoking during the first 3 – 7 days after full mouth extraction surgery to aid in healing and prevent dry sockets.
5. The patient is instructed against the consumption of foods like nuts, sunflower seeds, or popcorn which may get lodged in the socket area.
Nausea is a common side effect of opioid pain relievers. If you experience severe nausea or vomiting, you may need to discontinue your pain medication or take anti-nausea medication.
Birth Control Pills
Some antibiotics may decrease the effectiveness of birth control pills. Therefore a consultation with a physician is recommended before commencing the procedure.
Limited physical activity is advised during the first 24 – 48 hours after surgery. Over-exertion may lead to postoperative bleeding.
How Long Does It Take To Recover From a Full Mouth Extraction?
If you have had all of your teeth extracted, your recovery time will be determined by how closely you follow the aftercare instructions. If you follow dentist instructions exactly and there are no complications, the pain should go away after a few days. Your gums should be healed in 7 to 10 days. The gap will have been filled with new bone and gum tissue. You can then begin reintroducing foods that you had previously avoided, such as crispier foods.
When Should I be Able to Return to Work or School After Teeth Extraction?
If there are no complications, the swelling has subsided, and you are feeling well, you should be able to return to school or work soon after the procedure. We advise patients to strike a balance between not overworking themselves after surgery and remaining relatively active. The more we move, the more blood flows through our bodies, and we recover faster. Balance is essential for optimal healing, which requires each of us to listen to our bodies’ individual needs with discernment.
What is The Cost of a Full Mouth Extraction?
The cost of a full mouth extraction is determined by the number of teeth that must be extracted. A full mouth extraction can typically cost up to $3,000. Without insurance, the average cost of a simple extraction in California ranges from $150 to $300. However, the location and level of complexity both play a significant role in how much it will cost.
Another factor to consider is the type of sedation used during the full mouth extraction, as this has a significant impact on the overall cost of the procedure. Call your dentist to discuss your options for a more detailed estimate.
Healthcare providers must adhere to the principles of ethics and consider the request of the patient while suggesting full mouth extractions as a treatment. The treatment plan following a full mouth extraction must have the patient’s consent, cooperation, and a multidisciplinary approach to ensure the wellbeing of the patient.