Tooth Extraction

Having a tooth extracted can happen for a variety of reasons. In some cases, even healthy teeth need to be removed. A dental extraction is a common dental practice that involves the removal of a tooth from its socket. The tooth in its entirety, including root and crown, are removed. There are a few variations of the types of extractions you can expect to find at your dentist’s office. Teeth that have fully erupted are called a simple extraction which is quite easy – you’ll dentist will simply use a specialized tool to pull the tooth from its socket. However teeth that have not yet erupted and will require surgery to be removed. This can either be performed by a dentist or a qualified oral surgeon. If necessary, an extracted tooth can be replaced with a bridge or dental implant.

Why Does My Tooth Need to Be Extracted?

Dentists will do everything they can to save your natural tooth. However, when your dentist recommends an extraction it’s usually because the tooth is too damaged to be saved or leaving the tooth in will cause more harm than good. Here are a few reasons why your tooth needs to be extracted:

  • It has tooth decay beyond repair. Tooth decay works when bacteria in your mouth has produced acid that wears away at your enamel. It can start as a small cavity or hole in your tooth, which can then get worse if it’s left untreated. If you catch it early, your dentist should be able to restore your tooth with a filling. In some cases, tooth decay has worn at your enamel and structure so much so that there isn’t enough of a healthy area to support a filling or crown. When this happens, your dentist will need to extract the tooth to both alleviate pain and prevent the decay from spreading.
  • Your tooth has been severely damaged. When a tooth has been chipped or cracked in an accident, your dentist will do their best to restore it using a dental bond, crown, or sometimes even a root canal. However, when the chip or crack extends into the tooth pulp (the innermost layer of your tooth), the tooth might not be repairable. Your dentist will first try to restore the tooth but at times this isn’t possible, especially if infection of decay set in after the fact.
  • You have an abscessed tooth. You’ll want to avoid an abscessed tooth at all costs. An abscessed tooth is a tooth that is extremely infected, rotting from the inside. Both the tooth pulp and tissue have deteriorated, causing infection that can spread to the rest of your body. Generally dentists use a root canal to restore the tooth. In more serious cases, your dentist will need to extract the tooth to prevent the infection from spreading.
  • Your teeth are too crowded or misaligned. Healthy teeth may need to be removed when they are causing more damage to the rest of your teeth. This can result from teeth being crowded or misaligned. Some patients have jaw bone structures that cannot accommodate all of their teeth. Your dentist may suggest the removal of one or more teeth if they are causing dental issues, or if you are looking to undergo orthodontic treatment. Usually this is done in a patient’s teen years.
  • You have wisdom teeth that need to be removed. When people think of tooth extraction, often wisdom teeth come to mind. Wisdom teeth can be another cause behind crowding or misaligned teeth, and in some cases your dentist will recommend their removal. Even if there is room, at times they may erupt at an improper angle, pushing into other, healthy teeth.

How is a Tooth Extracted?

Patients tend to fear tooth extractions, but with modern technology you won’t feel anything at the dentist office during your extraction. There are two types of extractions which will change processes depending on its type. An easy way to think about it is a simple extraction will remove a tooth that’s already erupted through the gums, and a surgical extraction will remove a tooth that remains under the gum line.

What is a simple extraction?

A simple extraction removes a tooth that lays above the gum line. Your dentist will first apply a local anesthetic to your gums surrounding the tooth that’s being removed. You shouldn’t be able to feel anything after the area goes numb. If you do, tell your dentist so they can apply more anesthetic. Afterwards, your dentist may also provide you with laughing gas or an oral sedative to help calm your nerves and make the process much smoother.

Once you are completely numb, your dentist will use a tool called an elevator to lift the tooth up, exposing the ligament that holds it into place. They will rock the tooth back and forth, wiggling it free from the socket. Once it is fairly loose, they’ll use forceps to extract the tooth from the socket. If your tooth was exceptionally large, your dentist may apply a few stitches to hold the socket closed. This can also help stop the bleeding. They will also apply a pack of gauze to help absorb any excess blood. Simple extractions are a fairly quick and easy process, and patients can drive themselves home once the bleeding has stopped. If you have taken an oral sedative, you’ll have to have a ride home arranged prior to your appointment.

What is a surgical extraction?

When a tooth hasn’t erupted your dentist or oral surgeon will perform a surgical extraction. For this type of procedure, you will need to be put under with an IV anesthetic so that you are unconscious during the whole process. Once you are completely out, your dentist will start to cut away the bone and connective tissue that are responsible for holding your tooth in place. If the tooth is particularly large, it may need to be broken into chunks and removed one piece at a time. The socket will be stitched closed to stop the bleeding and speed up the healing process. After the procedure, you’ll wake up and will need to have someone to drive you home, as well as listen to your oral surgeon about any aftercare instructions. The anesthesia should wear off within a few hours.

How to Care for Your Tooth Extraction

To help with any pain or discomfort, your dentist will typically prescribe you pain medication that you can take following your extraction. The extraction site will be vulnerable to any hard foods or substances, so you’ll want to stick to eating soft foods. Once you start to feel stronger in that region of your mouth, you can start to introduce harder foods into your diet, being careful when you chew. Most patients can resume their normal diet after a few weeks.

How to Care For Your Extraction Site

It’s important to keep the extraction site where your tooth has been removed as clean as possible. One way to do this is to regularly rinse your mouth with salt water a few times a day. This helps reduce swelling, and will help kill any bacteria lingering around. You should continue to brush your teeth as you normally would, but be gentle where your empty socket is. To help alleviate pain and swelling, you can place a cold compress on the outside of your cheek or sip chilled beverages throughout the day. It’s also good to sleep with your head elevated to reduce inflammation.

It’s important not to drink from a straw or smoke when you are recovering from a tooth extraction. Performing any kind of suction action will dislodge the clot that’s formed in the empty socket which can lead to a painful condition known as dry socket. Having dry socket will slow down the healing process, and you’ll need to return to your dentist to apply dressing and ensure further infection doesn’t happen.

If it’s an abscessed tooth or severe tooth decay that’s led to your tooth extraction, you may be prescribed antibiotics to help you recover. The antibiotics will fight of infection in both the extraction site and any surrounding tissues. If you are prescribed antibiotics, be sure to finish the full treatment.

Replacing Your Extracted Tooth

With some extractions, you’ll want a replacement to restore both appearance and function to the area. However, in other cases a tooth replacement is not necessary. For example, if you’ve had wisdom teeth removed or other teeth that have caused crowding or misalignment, you won’t need to have a false tooth made to replace it.

However, if you have suffered from decay, abscess, or an accident you’ll want to have your tooth replace once your socket has healed. One option patients can use is what’s called a dental implant. Due to advancements in dental technology, dental implants allow your dentist or oral surgeon to surgically implant a metal screw into your jaw bone where your tooth once was. A porcelain crown will be placed over the screw that looks and feels like a real tooth. Having a dental implant will help prevent your socket from deteriorating and will act just like a natural tooth does. You’ll also be able to eat and drink with it just as you normally would.

Another option patients can choose is a dental bridge. A dental bridge works in the same way, but no screws are placed into your jaw line. A crown is placed on the tooth or teeth that have been extracted to give you function of a normal tooth. Generally dental bridges use dental cement to hold your false tooth in place.

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