What is Tooth Extraction?

Tooth extraction is the removal of a tooth from the bone inside the mouth.

Why we Extract Teeth:

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Many times, when a tooth has been broken or damaged by a cavity, it can be fixed with a filling, crown or root canal. However, sometime, the damage is so extensive that the tooth cannot be repaired. This is the most common reason for extracting a tooth.

  • Some people have extra teeth that can block other teeth from coming into the mouth.
  • People getting braces have to remove some teeth in order to make room for the teeth that are being straightened.
  • Before receiving radiation treatment to the head and neck, some teeth may need to be extracted to avoid future complications.
  • Wisdom teeth are commonly extracted in young adults because they can easily become stuck in the bone (impacted) and will create an area in the mouth that is very difficult to keep clean. This can irritate the gum and the other teeth causing pain and swelling.

What you should Know before taking a tooth out Your dentist will review your medical and dental history and get x-rays of the area to prepare for the removal of the teeth.

If you are having multiple teeth removed or all of your wisdom teeth removed, you may need a panoramic x-ray. This x-ray takes a picture of all your teeth at once and can help with locating wisdom teeth that cannot be seen in other x-rays.The panoramic x-ray will also show the relationship of your teeth to the sinuses, nerves and other structures within your mouth.
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Sometimes, you may need antibiotics before an extraction if any of the following are present:

an infection in the area of the tooth.
If you have a weak immune system
if you have specific medical conditions such as heart problems

How is Tooth Extraction Done?

This is one of the most common questions my patients ask me. Technically, we don’t “pull out” a tooth. We loosen it slowly by applying pressure in the areas surrounding the tooth. This can be done with various instruments at the time of the extraction. The “pulling out” is the final step in the extraction when the tooth is loose enough inside the bone.

In some cases, the tooth may be too broken down or may be below the gum and the bone. In these instances, we may cut the gum and the bone to be able to access the tooth and loosen it. This is called a surgical extraction. Follow-up Most of the time, after a simple extraction, you will not feel much discomfort. You can take some anti inflammatory medication for several days. You may experience some swelling for a day or two that will subside quickly. Some of my patients do not have any pain at all and do not need any medication after their extractions.

You will be asked to bite on some gauze for at least 20 minutes and extra gauze will be provided. To minimize swelling, you can put some ice on your face on the area of the extraction. Also, it is best to stick with soft foods for the first day and do regular rinses with warm salt water starting 24 hours after the surgery.

For Surgical extractions, however, there is typically more post-operative discomfort. I typically prescribe antibiotics as well as pain medications to minimize the chance of an infection. Also, I like to see my patients one week after the surgery to remove any stitches and to make sure the area is healing well.

Some of the most common reasons for delayed healing of the extraction site are smoking and excessive spitting after surgery. Also, you should avoid drinking through a straw and chewing on hard foods for a day or two. Risks As with any type of surgery, extractions can have some unwanted results.

The most common are infections but it is rare if you have a healthy immune system

Possible Complications

Accidental damage to teeth and restorations close to the extraction site
part of the root being left in the jaw – this root may have to be removed later or it may be left under the bone.
Breaking of the jaw due to the pressure during the extraction – this can happen more commonly in older people with osteoporosis.
A hole in the sinus after removal of upper teeth – usually small holes heal by themselves, however, larger holes may need a referral to a specialist.
Lasting numbness in the lower lip or chin – this happens because of injury to the nerves during the surgery and numbness can be permanent in some cases.
Dry socket – this happens when the blood clot inside the bone does not form and the bone does not heal. It typically happens in smokers or in women on birth control pills. It can be very painful and will need several additional treatments to help the bone heal and to make you comfortable.