Tooth extraction is the removal of a tooth from its socket in the bone.
If a tooth has been broken or damaged by decay, the Dentist will try to fix it with a filling, crown or other treatment. Sometimes, though, there’s too much damage for the tooth to be repaired. In this case, the tooth needs to be extracted. A very loose tooth also will require extraction if it can’t be saved, even with bone replacement surgery (bone graft).
Here are other reasons:
- Some people have extra teeth that block other teeth from coming in.
- Sometimes baby teeth don’t fall out in time to allow the permanent teeth to come in.
- People getting braces may need teeth extracted to create room for the teeth that are being moved into place.
- People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
- People receiving cancer drugs may develop infected teeth because these drugs weaken the immune system. Infected teeth may need to be extracted.
- Some teeth may need to be extracted if they could become a source of infection after an organ transplant. People with organ transplants have a high risk of infection because they must take drugs that decrease or suppress the immune system.
- Wisdom teeth, also called third molars, are often extracted either before or after they come in. They 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 (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, they are usually taken out at the same time.
The Dentist will take an X-ray of the area to help plan the best way to remove the tooth.
There are two types of extractions:
- A simple extraction is performed on a tooth that can be seen in the mouth. The Dentist loosens the tooth with an instrument called an elevator. Then the dentist uses an instrument called a forceps to remove the tooth.
- A surgical extraction is a more complex procedure. It is used if a tooth may have broken off at the gum line or has not come into the mouth yet. The Dentist makes a small incision (cut) into your gum. Sometimes it’s necessary to remove some of the bone around the tooth or to cut the tooth in half in order to extract it.
Most extractions can be done using just an injection (a local anesthetic). You may or may not receive drugs to help you relax. During a tooth extraction, you can expect to feel pressure, but no pain.
You will be given detailed instructions on what to do and what to expect after your surgery. Having a tooth taken out is surgery. You can expect some discomfort after even simple extractions and the Dentist will prescribe medication as needed.
If you need stitches, the Dentist may use the kind that dissolve on their own. This usually takes one to two weeks. Rinsing with warm salt water will help the stitches to dissolve. Some stitches need to be removed by the dentist.
You should not smoke, use a straw or spit after surgery. These actions can pull the blood clot out of the hole where the tooth was. Do not smoke on the day of surgery. Do not smoke for 24 to 72 hours after having a tooth extracted.
A problem called a dry socket develops in about 3% to 4% of all extractions. This occurs when a blood clot doesn’t form in the hole or the blood clot breaks off or breaks down too early.
In a dry socket, the underlying bone is exposed to air and food. This can be very painful and can cause a bad odor or taste. Typically dry sockets begin to cause pain the third day after surgery.
Dry socket occurs up to 30% of the time when impacted teeth are removed. It is also more likely after difficult extractions. Smokers and women who take birth control pills are more likely to have a dry socket. Smoking on the day of surgery further increases the risk. A dry socket needs to be treated with a medicated dressing to stop the pain and encourage the area to heal.