When all the teeth remaining in the mouth are extracted due to one or the other reason, it is called full mouth extraction. It usually precedes a definitive treatment to provide the patient complete oral rehabilitation. In the course of dental practice at some point, dental practitioners encounter patients with teeth which are affected by caries or periodontal diseases to the extent that no other treatment is possible except for full mouth extraction. The conditions in which the teeth are judged to be hopeless usually include a multifactorial set of conditions, such as genetic dental malformations, hereditary diseases of teeth, poor oral hygiene care, psychosocial systems, financial problems, improper maintenance of routine oral hygiene, lack of insufficient fluoride exposure and unhealthy dietary habits. Once condition of teeth is diagnosed as hopeless a treatment plan has to be developed by the dentist so that the infections can be treated and patient is relieved of acute or chronic pain. Some times a full mouth extraction is the only option left.
Now the question arises when the full mouth extraction is needed. It is not easy for the patient and the dentist to take the decision for full mouth extraction. It has psychological impact on the patient. Patient looses the confidence if he has to g for the full mouth extraction but some times the teeth are so badly effected that if dentist does not go for full mouth extraction it can effect the general health of the patient. So keeping in view all the things the things there are certain conditions where full mouth extraction is indicated and these are
1.Periodontal problem: Full mouth extraction is sometimes carried out in the cases of periodontal problems. Periodontitis is a disease affecting supporting structures of teeth and causing their destruction leading to loosening of teeth. Though it can be treated by various measures but if it progresses to an advanced stage it may lead to loss of teeth. At this stage excessively loose teeth remaining in the mouth have to be extracted so as to prevent further progression of disease in the bone. Excessive loss of bone can cause difficulty in denture construction. So, it has to be controlled. Full mouth extraction at this stage can help in controlling excessive bone loss.
2.Extensive Caries: If a patient is having many grossly carious teeth in his mouth which cannot be restored, then also the patient may have to go for full mouth extraction of all the teeth and complete denture should be constructed for the patient. Now-a-days rate of extensive caries among people is increasing due to certain reasons:
Food Habits: Evidences indicate that because of the changing dietary pattern the incidence of dental caries is increasing in young adult patients. Increased consumption of cariogenic diet such as excessive intake of sweets and beverages leads to extensive caries and loss of teeth.
3.Xerostomia or Dry Mouth: Xerostomia: It is a condition in which amount of saliva in the mouth decreases. Saliva protects the teeth from attack of caries due to its flushing as well as buffering action. Saliva also helps in remineralization of teeth which have been demineralized due to attack of acid. A large number of patients suffering from Xerostomia are due to various medications such as antidepressants, antibiotics etc.
Oral condition of a patient with extensive caries requiring full mouth extraction
Balancing cases: In old age, if many teeth have been lost due to various reasons, and very few teeth are remaining sometimes they have to be extracted to fabricate a suitable prosthesis.
1. Complete Dentures: Complete dentures can be constructed for the patient 6 weeks after the full mouth extractions to allow for healing of bone.
2. Immediate Dentures: These dentures are inserted immediately after full mouth extraction of teeth. Posterior (back) teeth are extracted first and denture is constructed. Denture is inserted on the day when anterior (front) teeth are extracted. But immediate dentures have to be relined after 6 months. These dentures are highly recommended for socially active patients who cannot compromiseonesthetics.
3. Implant Supported Denture: For better stability and retention, complete dentures can be fixed with the help of implants inserted in the bone. Placement of implants also reduces amount of alveolar bone loss.
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