Tooth extraction is the removal of a tooth from its socket in the bone. A tooth may need to be removed when repair from disease or trauma is not an option. In some cases, permanent teeth may need to be removed for orthodontic treatment.
Tooth extractions are a relatively standard dental procedure, performed for a variety of reasons. In the event that you do lose a tooth or need to have a tooth extracted, it is recommended to replace the missing tooth. Tooth replacement options include bridges, dentures, or implants.
When is tooth extraction necessary?
- Decay or infection has reached deep into the tooth
- Trauma or injury
- There is not enough room for all the teeth in your mouth
- Baby teeth don’t fall out in time for the permanent teeth to come in
- Orthodontic treatment might require tooth extraction to create room for the teeth as they move into place
- Wisdom teeth, also called third molars, are often extracted either before or after they come in
Preparation
Before removing a tooth, your dentist will thoroughly review your medical and dental history and take the appropriate x-rays. X-rays reveal the length, shape, and position of the tooth and surrounding bone. From this information, your dentist can determine the best way to remove the tooth. For some complicated surgical extractions, your dentist might refer you to an oral surgeon.
There are two types of extractions:
Simple extraction
A simple extraction is the removal of a tooth that is visible in your mouth. It is common for a general dentist to perform simple extractions. During this procedure, your dentist will numb the tooth and gum tissue with a local anaesthetic. He or she then will loosen the tooth with an instrument called an elevator before removing it with dental forceps.
Surgical extraction
A surgical extraction is a more complex procedure used for a tooth that may have broken off at the gumline or has not come into the mouth yet. General dentists can and do perform some surgical extractions; however more complicated cases will be referred to an oral surgeon. During a surgical extraction, the dentist will make a small incision (cut) into your gum and remove the underlying tooth.
Aftercare
Following any extraction, it’s most important to keep the area clean in order to prevent infection. Immediately following the procedure, your dentist might ask you to bite down gently on a piece of dry, sterile gauze, which you should keep in place for up to 30 to 45 minutes to limit bleeding, while clotting takes place. Your dentist will provide you with detailed aftercare instructions, but for 24 hours following your extraction, you should not smoke, rinse your mouth vigorously, or clean the teeth next to the extraction site.
You can expect a certain amount of pain and discomfort following an extraction. In some cases, your dentist will recommend a pain killer or prescribe one for you. It might help to apply an ice pack to your cheek to reduce swelling. You should also limit strenuous activity, avoid hot liquids, and do not drink through a straw. Under normal circumstances, discomfort should diminish within three days to two weeks. However, if you experience prolonged or severe pain, swelling, bleeding, or fever, call your dentist or oral surgeon immediately.
Complications from tooth extraction
Although a safe and routine procedure, there can be complications following the extraction of a tooth. Some of the potential problems associated with have a tooth pulled include:
“Dry socket” – Occurring in approximately 3-4% of teeth-pulling cases, a dry socket is what happens if a blood clot fails to form in the hole after pulling teeth, or if the blood clot breaks off too soon. Without the blood clot, the underlying bone is exposed, creating a dry socket. This condition can be painful and should be treated as soon as possible in order to facilitate complete healing.
Sore jaw – Your jaw may be sore due to anesthesia or to the strain of keeping your mouth open during the procedure. Depending on the health of your jaw, this sensation should not last long.
Numb lips and chin – Occasionally, with the removal of lower wisdom teeth, if the nerve in that area is traumatized, your lower lip or chin may be numb for several weeks or even months. This sensation should decrease over time.
Infection – Infection is always a possibility after any surgery and tooth extractions are no different, but it is unlikely in individuals who have healthy immune systems.
Achieving a good outcome
Whether you are a first-time extraction patient or have prior experience, it is best to follow your dentist’s recommendations carefully before and after the procedure, in order to have a successful and uncomplicated outcome.
Restoration
Once your healing is complete, your dentist will discuss the options open to you, if replacing the missing tooth is recommended.
