When the remnants of the tooth root remain as a result of an incomplete tooth extraction, the removal of this remaining root will be done under the opinion of the dentist. Surgical steps of remaining root in the gum Removing the root of the remaining tooth with surgery is a simple process. Your dentist will provide a local anesthetic to numb the area, or if you are too anxious about the procedure, local anesthesia may be prescribed. Next, your dentist will make an incision along your gum line and create what is known as a "surgical flap." This "flap" is a device that allows the dentist to access the bone along the jaw that covers the root of the tooth. Once the flap is in place, your dentist will likely need to use a surgical handpiece to gently separate the bone to allow access to the remaining root for extraction. After observation, if the remaining root cannot be extracted completely, segmentation or cutting may be required to remove it. After sectioning, your dentist may need to "rock" the root back and forth to make it easier to remove. This is done either with a pair of forceps or a dental tool known as an "elevator", which is similar to a regular lever and somewhat like a small flat-head screwdriver. Since our jawbone is soft, this gentle rocking motion actually compresses the bone slightly so that the root can be removed without applying too much force. Final removal is usually done with forceps. Once the root of the tooth is removed and depending on your next steps, take the necessary care. Your dentist may perform a cavity graft to prevent bone loss that causes tooth loss, or simply allow the gum cavity to heal on its own, like a wisdom tooth extraction. Immediate or future dental implants may also be performed or recommended. All adult teeth have up to four roots that connect the tooth to the jawbone. Usually, when the tooth is removed by the dentist, the roots are removed with it. However, if the tooth is lost due to an accident or decay, the root or roots may remain in the jawbone and gums, causing problems such as oral infection and pain. In this case, the roots must be surgically removed. Sometimes teeth, especially wisdom teeth, do not erupt from the gums at all. This is called a dormant tooth and can also cause problems, although such teeth may lie dormant and require no attention for years. ### How are the remaining roots removed? The complexity of root removal surgery depends on the nature of the problem. Some of the remaining roots involve a simple extraction that can be done quickly under local anesthesia. Others involve a longer procedure and you may be given a sedative to help you relax. In the most severe cases, it may be necessary to remove part of the gum and possibly a small part of the jawbone to free the roots. In this case, you will usually be prescribed a general anesthetic. ### What to expect after removal of residual root? Naturally, you will experience pain, swelling, and bruising after major oral, maxillofacial, and facial surgery, such as removal of residual roots. You may also feel stiffness around the mouth and feel pain when eating or talking for a few days. Bruising and swelling will decrease in about a week to ten days. We've put together information for all oral surgery patients so you can take care of your mouth afterward and make sure you recover as quickly as possible. In most cases, the wound is sutured using dissolvable sutures, which dissolve on their own and do not require a return visit for removal. You should usually return for a checkup in about two weeks so your dentist can make sure you're healing properly. You may have an x-ray taken at this visit to make sure the entire root has been removed. You will be given antibiotics to reduce the risk of infection and advised to rinse your mouth with salt water several times a day for the first week. You should only need over-the-counter pain relievers such as acetaminophen. You will initially be aware of any holes or scars left by the procedure, although these scars will eventually disappear as the gums and jawbone reshape. Dangers and complications of residual root surgery As with all surgery, there are risks and complications, especially if you have general anesthesia. In the following articles, we will explain these to you in detail, but in summary: You may experience an infection at the wound site, although the use of antibiotics and a saline mouthwash can significantly reduce this risk. You may also experience minor bleeding from the wound site. If the bleeding does not stop, you should contact us immediately. Between 5 and 10 percent of patients may develop what's known as a "dry hole," where a blood clot breaks off at the wound site or doesn't form properly in the first place. If this happens, you may need to pack the wound with medicated gauze for a few days to help it heal.