What to Expect During a Tooth Extraction

Being told that you need a tooth extracted is never pleasant to hear. While it’s natural to dread this news, today’s extraction techniques provide a much more comfortable experience than what was typical in years past. Knowing what to expect during a modern-day tooth extraction can ease your anxiety and prompt you to seek the timely treatment that will result in a good outcome.

Conditions That Can Make a Tooth Extraction Necessary

Advances in modern dentistry have resulted in a high success rate when it comes to saving natural teeth. But even with today’s leading-edge treatments, it isn't always possible. There are numerous reasons why extraction can be necessary, including the following:

Advanced decay — Although dental decay has many treatment options, your dentist may opt for extraction if the damage is too extensive.

Advanced periodontal (gum) disease — Again, although treatment is typically successful when caught in the early stage, it may not be an option in an advanced case.

Overcrowding - This situation is common in preparation for braces, when more space is needed in the mouth for teeth to properly align. Even without braces, there are situations in which there is not enough room in your mouth for the number of teeth you have.

Impacted teeth — These are teeth that do not fully erupt from the gums and remain trapped in the jawbone or gum tissue. Impacted teeth can be partial or full, with partial impaction occurring when the tooth's crown breaks through the gum but the tooth doesn't fully erupt. This situation is most common with third molars - commonly known as wisdom teeth.

Trauma or severe damage — Teeth can become loosened or damaged due to a blow to the mouth from a contact sports injury or accident. A severely cracked tooth down to or past the gumline may also need to be extracted.

A retained primary tooth — This is a “baby” tooth that has not fallen out to allow the permanent tooth to erupt. The condition has several causes, such as hypodontia (no tooth growing behind to push it out), fusion to the jawbone (ankylosed tooth) or an infection or impact that has damaged the tooth.

Infection — As mentioned earlier, tooth decay left untreated, or caught too late, may result in extraction. In most cases, a root canal is the preferred treatment method. However, if an infected tooth risks the integrity of surrounding teeth, a dentist may choose to extract it. This is often the case if an infection has reached the pulp of a tooth. Your chance of requiring an extraction due to infection can also significantly increase due to other conditions. Chemotherapy in particular, can decrease the effectiveness of a person’s immune system, rendering them less able to fight oral infection and disease.

How a Tooth Extraction is Performed

There are two types of tooth extraction procedures: a simple extraction and a surgical extraction. The first type is typical for a fully erupted tooth above the gumline; the second is used for a tooth broken off at the gumline, or an impacted tooth.

Because the circumstances that necessitate a surgical extraction vary widely, your dentist or oral surgeon should be able to walk you through the procedure prior to your appointment. This is the time to ask any questions you may have about how the procedure will be performed, possible complications, etc.

Prior to either type of procedure, your dentist or oral surgeon will take your medical history. This includes such information as prescription medications you are on, medications you are allergic to and any underlying medical conditions you may have. In the case of infection, your dentist may prescribe antibiotics to begin before the extraction.

When the procedure starts, you’ll be given a local anesthetic. A simple extraction consists of an injection directly into the gum near the tooth that will be removed. Your dentist may apply a topical numbing agent to your gum just prior to injection to make this part of the procedure more comfortable. Your dentist will make sure the site is completely numb before beginning.

After confirming that you’re numb, the dentist uses an instrument called an elevator to loosen the tooth, and forceps to remove it. Immediately following the procedure, your dentist will place a gauze piece to keep on the extraction site for up to 45 minutes to limit bleeding while clotting takes place.

For a surgical extraction, you will likely receive both local anesthesia and intravenous (IV) anesthesia, the latter of which makes you calm and relaxed. You will be in “twilight sleep,” during which you will be unaware of the procedure but can respond to instructions from the dentist or oral surgeon. You also will be told to have someone drive you to and from the appointment, as you won’t be completely alert for several hours post-surgery.

Depending on the reason for extraction, the tooth will need to be accessed in various ways. If it is impacted, the gums and tissue will be cut away so that it can be pulled with forceps. In rare instances, the tooth may need to be cut out in segments. You may feel pressure at times, but not pain. Once the tooth is removed, blood will immediately begin to clot. The dentist or oral surgeon will assist this process by applying gauze and light pressure. If necessary, self-dissolving stitches may be used to pull the gums over the edges of the extraction site. You will be given a detailed list of post-procedure instructions to take home with you.

Self-Care After a Tooth Extraction

After the anesthesia wears off, you can expect some discomfort. Your dentist will recommend over-the-counter pain medicine or prescribe one. Applying an ice pack can help reduce swelling. Also, don’t engage in strenuous activity (including exercise) for at least three days, avoid hot liquids and drinking through a straw. This is to keep the protective blood clot that will form over the extraction site intact. Dislodging the blood clot exposes the empty socket to air and debris, causing a painful condition known as dry socket. Contact your dentist immediately if this happens!

Other self-care practices include the following:

Typically, the discomfort of the extraction should start to lessen within three days. To be sure you’re giving yourself the best possible chance to successfully heal, refer to the post-procedure instructions your dentist provided.

The Take-Home Message

With today’s advanced techniques and anesthesia, the dread that a tooth extraction evokes is far worse than the procedure itself. Removing a tooth is sometimes necessary to restore and maintain your oral health - as well as your overall health. Keep this in mind and follow your dentist’s post-procedure instructions to heal comfortably and successfully. Should you need a dental restoration - such as a bridge, implant or partial denture - your dentist will discuss the best options for your individual situation.

At NK Family Dental, it is our mission to provide the highest quality and most compassionate oral care to our Chicago patients, including both dental and periodontal services. Our practice is trusted for advanced oral surgery procedures and comfortable root canal treatment.

Our dental specialists include our general dentist, Dr. Nilofer Khan, our endodontist, Dr. Sabek, and our periodontist, Dr. Amir Danesh. Dr. Danesh is a board-certified periodontist and Diplomat of the American Board of Periodontology. He has contributed to the publication of two books, as well as published over 20 papers in prestigious dental research journals.

We understand that the main concern you may have is cost, which is why we accept all major PPO plans for dental insurance and also offer our in-house dental plan. Please see our financing page for more information.

We serve the neighborhoods of Logan Square, Bucktown, Humboldt Park, and Wicker Park with the dedication that’s earned us the reputation as the Best Dentist in Chicago!

Schedule your visit through ZocDoc, or contact us directly. We look forward to treating you soon!

Tooth Extraction: Procedure and Prevention

Our teeth are incredibly strong. In fact, tooth enamel is the hardest substance in the human body! Unfortunately, they aren’t immune to decay and damage or the effects of advanced periodontal disease. When a tooth can’t be saved through such treatments as a root canal or has undergone severe trauma, it becomes necessary to remove it. Other reasons extraction may be necessary include wisdom teeth that crowd other teeth as they emerge – or remain impacted beneath the gum line – and when there are too many teeth to allow orthodontic treatment (braces or Invisalign®) to be successful.

We at NK Family Dental understand that tooth extraction is the procedure that people dread the most. However, choosing to neglect the issue that led to the need for extraction will soon cause worse pain and a further decline in your dental health, as well as your overall health. For example, having an undetected tooth infection increases your risk of heart disease by 2.7 times.

If you have painful memories of tooth extraction in years past, today’s techniques provide a much more comfortable experience. Knowing what to expect during a modern-day tooth extraction can ease your anxiety and prompt you to seek the timely treatment that will result in a good outcome.

Of course, prevention is always preferable to losing a tooth. We’ll look at oral hygiene best practices to help you keep your teeth healthy for life, as well as safety measures to protect teeth from loss due to trauma. But despite your best efforts, extracting a tooth may become necessary at some time.

Reasons for Dental Extractions

As mentioned earlier, there are many reasons a tooth may need to be extracted. Our blog post – “Why Would You Need a Tooth Extraction?” – covers the leading causes for removal, which include the following:

How a Tooth is Extracted

There are two types of tooth extraction procedures: a simple extraction and a surgical extraction. The first type is typical for a fully erupted tooth above the gum line; the second is used for a tooth broken off at the gum line, or an impacted tooth.

But before either type of procedure is performed, your dentist or oral surgeon will take your medical history. This includes such important information as prescription medications you are on, medications you are allergic to, and any underlying medical conditions you may have. If you take a prescription blood thinner, your dentist may tell you to stop taking it a few days before, as the medication could cause excessive bleeding during the procedure. In the case of infection, your dentist may prescribe antibiotics to begin before the procedure.

Before the extraction, you’ll be given a local anesthetic. A simple extraction consists of an injection directly into the gum near the tooth that will be removed. Your dentist may apply a topical numbing agent to your gum just prior to injection to make this part of the procedure more comfortable. Your dentist will make sure the site is completely numb before beginning. Our entire team at NK Family Dental places the comfort of our patients at the highest priority and strives to ensure that you are well-informed and confident at every step of the dental services we provide.

For a surgical extraction, you will likely receive both local anesthesia and intravenous (IV) anesthesia, the latter of which makes you calm and relaxed. You will be in “twilight sleep,” during which you will be unaware of the procedure but can respond to instructions from the dentist or oral surgeon. You also will be told to have someone drive you to and from the appointment, as you won’t be fully alert for several hours post-surgery.

For all of this build-up, the simple extraction procedure itself is very straightforward. After confirming that you’re numb, the dentist uses an instrument called an elevator to loosen the tooth, and forceps to remove it. Immediately following the procedure, your dentist will place a gauze piece to keep on the extraction site for up to 45 minutes to limit bleeding while clotting takes place.

After the anesthesia wears off, you can expect some discomfort. Your dentist will recommend over-the-counter pain medicine or prescribe one. Applying an ice pack can help reduce swelling. You should also limit strenuous activity, avoid hot liquids, and drinking through a straw. This is to keep the protective blood clot that will form over the extraction site intact. Dislodging the blood clot exposes the empty socket to air and debris, causing a painful condition known as dry socket. Contact your dentist immediately if this happens! Typically, the discomfort of the extraction should start to lessen within three days. Your dentist will give you a detailed list of aftercare instructions to take home.

Because the circumstances that necessitate a surgical extraction vary widely, your dentist or oral surgeon should be able to walk you through the procedure prior to your appointment. This is the time to ask any questions you may have about how the procedure will be performed, possible complications, etc.

Depending on the reason for extraction, the tooth will need to be accessed in various ways. If it is impacted, the gums and tissue will be cut away so that it can be pulled with forceps. In rare instances, the tooth may need to be cut out in segments. You may feel pressure at times, but not pain. Once the tooth is removed, blood will immediately begin to clot. The dentist or surgeon will assist this process by applying gauze and light pressure. If necessary, self-dissolving stitches may be used to pull the gums over the edges of the extraction site. You will be given a detailed list of aftercare instructions to take home with you.

Your Tooth is Gone – Now What?

Before your extraction, your dentist will discuss restoration options with you (unless the extraction is to remove extra teeth, of course). Replacing the missing tooth could involve a bridge – crowns on either side of the missing tooth that has a false tooth in the center to bridge the gap. This gives the appearance of a natural tooth and is undetectable. Your dentist may also recommend a dental implant, which our blog post – “What Happens During Dental Implant Surgery?” – covers in detail. The option your dentist recommends will be based upon your individual situation.

Preventing Tooth Loss

Making good oral hygiene practices a part of your daily life can prevent many of the conditions that lead to tooth loss. Medical News Today provides an excellent list of best practices that include the following:

Tooth loss due to injury is all too common among student-athletes who play contact sports, as well as anyone who participates in physical recreational activities. Always wear a mouthguard while playing or practicing. And as general advice, don’t use your teeth as a bottle opener!

We hope we’ve given you the knowledge that will make you feel more assured should a tooth extraction become necessary. If you need oral surgery for wisdom teeth removal or teeth extractions, look no further than NK Family Dental for your Bucktown Chicago dentist and oral surgeon. You can rest assured knowing your oral health is in Dr. Nilofer Khan’s highly skilled and experienced care.

Read more about Dr. Khan’s qualifications – as well as those of our root canal specialist Dr. Sabek and our periodontist and dental implant specialist Dr. Danesh – then contact us to schedule your tooth extraction consultation. Appointments can be made through ZocDoc or by contacting us directly.