
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:
- You will be sent home with gauze over the removal site; change it before it becomes saturated. Keep light pressure over the socket using your teeth.
- Rinse with a saline solution regularly, once 24 hours have passed following the procedure. It is made of 1/2 teaspoon salt and 8 ounces of warm water. This will help prevent infection and soothe the site.
- Eat soft foods or soup. You will gradually be able to reintroduce firmer foods, but allow two to three days before doing so.
- Avoid spitting forcefully, brushing the extraction site, or as previously mentioned, drinking with a straw. Any of these could dislodge the clot in the socket.
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.
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