Natural teeth are ideal for biting, chewing and, maintaining mouth and jawbone structure, which is why a dentist’s first priority is to help restore, save, and repair your natural teeth. However, sometimes a tooth extraction is unavoidable. In this post, we take a look at what a tooth extraction is and what you should expect.
What is a tooth extraction?
If a tooth has been broken or damaged by decay, your dentist will try to fix it with a filling, crown, or other dental treatment. But, when there’s too much damage for the tooth to be repaired, the tooth may need to be removed from its socket in the bone. This removal is a tooth extraction procedure. It is usually done if a tooth is too damaged to be fixed by other treatments.
What are reasons for pulling teeth?
Although permanent teeth are meant to last a lifetime, there are a number of reasons why tooth extraction may be needed. A very common reason is that a tooth that has become too badly damaged, from trauma or decay, to be repaired and saved. Other reasons include:
- A crowded mouth: Sometimes dentists pull teeth to prepare the mouth for orthodontia. The goal of orthodontia is to properly align the teeth, which may not be possible if your teeth are too big for your mouth. Likewise, if a tooth cannot erupt, or break through the gum, because there is no room in the mouth for it, your dentist may recommend extraction.
- Infection: If tooth decay or damage extends to the pulp — the center of the tooth containing nerves and blood vessels — bacteria in the mouth can enter the pulp, leading to infection. This can often be corrected with root canal therapy (RCT), but if the infection is so severe that antibiotics or RCT cannot cure it, extraction may be necessary to prevent the spread of infection.
- Risk of infection: If your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant), even the risk of infection in a particular tooth may warrant pulling the tooth.
- Periodontal (Gum) Disease: If periodontal disease — an infection of the tissues and bones that surround and support the teeth — have caused loosening of the teeth, it may be necessary to the pull the tooth or teeth.
- Wisdom teeth: Also called third molars, wisdom teeth are often extracted either before or after they come in. These teeth commonly come in during the late teens or early 20s. They need to be removed if they are decayed, cause pain, or have a cyst or infection. These teeth often get stuck in the jaw, or impacted, and do not come in. This can irritate the gum, causing pain and swelling. In this case, the tooth must be removed. If you need all four wisdom teeth removed, your dentist will likely take all of them out at the same time.
What should I expect with tooth extraction?
Dentists and oral surgeons (dentists with special training to perform surgery) perform tooth extractions. Before pulling the tooth, your dentist will give you an injection of a local anesthetic to numb the area where the tooth will be removed. If you are having more than one tooth pulled or if a tooth is impacted, your dentist may use a strong general anesthetic. This will prevent pain throughout your body and make you sleep through the procedure.
If the tooth is impacted, the dentist will cut away gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces.
Once the tooth has been pulled, a blood clot usually forms in the socket. The dentist will pack a gauze pad into the socket and have you bite down on it to help stop the bleeding. Sometimes the dentist will place a few stitches — usually self-dissolving — to close the gum edges over the extraction site.
Sometimes, the blood clot in the socket breaks loose, exposing the bone in the socket. This is a painful condition called dry socket. If this happens, your dentist will likely place a sedative dressing over the socket for a few days to protect it as a new clot forms.
What do I do after my tooth has been pulled?
Following an extraction, your dentist will send you home to recover. Recovery typically takes a few days. The following can help minimize discomfort, reduce the risk of infection, and speed up recovery:
- Take painkillers as prescribed.
- Bite firmly but gently on the gauze pad placed by your dentist to reduce bleeding and allow a clot to form in the tooth socket. Change gauze pads before they become soaked with blood. Otherwise, leave the pad in place for three to four hours after the extraction.
- Apply an ice bag to the affected area immediately after the procedure to keep down swelling. Apply ice for 10 minutes at a time.
- Relax for at least 24 hours after the extraction. Limit activity for another day or two after this.
- Avoid rinsing or spitting forcefully for 24 hours after the extraction to avoid dislodging the clot that forms in the socket.
- After 24 hours, rinse with your mouth with a solution made of 1/2 teaspoon of salt and 8 ounces of warm water.
- Do not drink from a straw for the first 24 hours.
- Do not smoke, which can inhibit healing.
- Eat soft foods, such as soup, pudding, yogurt, or applesauce the day after the extraction. Gradually add solid foods to your diet as the extraction site heals.
- When lying down, prop your head with pillows. Lying flat may prolong bleeding.
- Continue to brush and floss your teeth and brush your tongue, but be sure to avoid the extraction site. Doing so will help prevent infection.
Do you have questions about tooth extraction? Call Hartnett Dental to schedule an appointment with your dentist today! (716) 649-6633.