Tooth Extractions
Tooth extractions, or the removal of one or more teeth, are usually used as a last resort in dentistry, as keeping the natural tooth in the mouth is ideal. There are many reasons why single or multiple extractions may be performed, including pervasive tooth decay, the impaction of wisdom teeth, or the need to create space for orthodontic devices.
The most significant short-term benefit associated with tooth extraction is the elimination of pain. If a tooth is severely decayed or an infection is present, removing the affected tooth almost immediately alleviates discomfort. However, it should be noted that further procedures are necessary to replace the extracted tooth. Leaving a gap is not a viable option as the other teeth tend to twist out of alignment to fill the space.
Why might I need to have a tooth extraction?
Tooth extractions are incredibly common procedures. It should be reiterated that an extraction is used as a procedure of last resort, when nothing more can be done to save the tooth.
Here is a brief overview of some of the main reasons for tooth extraction:
Deep decay – This is easily the most common reason for tooth extraction, accounting for around two-thirds of all extraction procedures performed. When decay affects the surface of the tooth as well as the pulp, root canal procedures cannot be performed. Root canal therapy is only viable where the general structure of the tooth is in stable condition.
Extra teeth –There are a variety of explanations associated with extra teeth, but most commonly they are baby teeth that do not shed. Extra teeth take up space on the arch, causing nearby teeth to twist out of place. A tooth extraction is necessary in this case to provide enough space for the teeth to properly realign.
Periodontal disease – Often teeth have to be extracted because the gums and underlying bone are so severely eroded that they can no longer hold the tooth in place securely. The cause of bone and gum recession is almost always advanced periodontal disease (gum disease). Poor bone density means that the chance of restoring the natural tooth is minimal.
Prior to braces – Traditional orthodontic braces require enough space to for the teeth to move into ideal alignment. If space cannot be created naturally, a tooth may be extracted as an alternative.
Fractured teeth – Fortunately, dentists are able to save injured teeth in most circumstances with the aid of root canal therapy. However, there are some instances where the tooth has become fractured in a way that makes repair impossible. Your oral health professional will remove the tooth and use a prosthetic replacement in most cases.
How is the extraction procedure performed?
Generally, tooth extraction can be simple in nature or involve more complex surgical processes. Simple extractions are performed on fully emerged teeth after applying local anesthetic to the treatment site. Instruments are used to elevate the tooth and then sever the periodontal ligament. The tooth is then carefully removed with dental forceps.
Surgical extractions are performed on teeth that are either invisible or inaccessible, like un-erupted wisdom teeth. An incision is usually made in the gum tissue and a drill is used to precisely remove some of the adjacent bone tissue. Sometimes, the tooth has to be split into several pieces to completely remove it.
If you have any questions or concerns about tooth extraction, please contact your oral health care provider.
Post Operative Instructions for Dental Extractions
If you've just had a tooth extracted or your dentist has recommended that a tooth be extracted, the following information will help you get through the first few days after your extraction. Should anything occur that seems out of the normal, do not hesitate to call your dentist.
DO NOT DISTURB THE WOUND: In doing so you may invite irritation, infection, and/or bleeding. Be sure to chew on the opposite side for 24 hours and keep anything sharp from entering the wound (ie. eating utensils etc.).
DO NOT SMOKE FOR 12 HOURS: Smoking will promote bleeding, infection and interfere with healing.
BRUSHING: Do not brush your teeth for the first 8 hours after surgery. After, you may brush your teeth gently, but avoid the area of surgery.
MOUTHWASH: Avoid use of rinse and mouthwash unless prescribed. This is to ensure the formation of a healing blood clot which is essential to proper wound healing. Disturbance of this clot can lead to increased bleeding. If the clot is lost, a painful condition called dry socket may occur.
DO NOT SPIT OR SUCK THROUGH A STRAW: This will promote bleeding and may dislodge the blood clot causing a dry socket.
BLEEDING: Some bleeding is normal following an extraction. When you leave the office, you will be given verbal instructions regarding the control of postoperative bleeding. A rolled up gauze pad will be placed on the extraction site and you will be asked to change this dressing every 20 minutes or so depending on the amount of bleeding that is occurring. It is normal for some blood to ooze from the area of surgery. Hold the dressing firmly in place by biting or with finger pressure, for about 20-30 minutes. If bleeding still continues, you may fold a tea bag in half and bite down on it. Tea contains Tannic Acid, a styptic, which may help to reduce the bleeding.
PAIN: Some discomfort is normal after surgery. Analgesic tablets (Le. Aspirin, Tylenol etc.) may be taken under your dentist's direction. Prescription medication, which may have been given to you, should also be taken as directed. Don't take medication on an empty stomach or nausea may result. If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone. If pain continues, call your dentist.
SWELLING: To prevent swelling, apply an ice pack or a cold towel to the outside of your face in the area of the extraction during the first 12 hours. Apply alternately, 20 minutes on then 20 minutes off, for an hour or longer if necessary. The swelling usually starts to go down after 48 hours.
DIET: You may eat regular meals as soon as you are comfortable after surgery. Cold, soft food such as ice cream or yogurt may be the most comfortable for the first day. It is also important to drink plenty of fluids. Don't use alcoholic beverages and avoid hot and spicy foods.
ACTVITIES: Limit yourself to calm activities for the first 24 hours. This keeps your blood pressure lower, reduces bleeding, and helps the healing process. During your healing process, you may have a suture come out or small, sharp bone fragments which will loosen and come through your gum. These are not roots. If these bone fragments are very bothersome, call the office and arrange for them to be removed. Please feel free to call the office to report any condition that appears to be unusual.
We may be reached during regular office hours at (301)265-5292.
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