Your dentist may recommend a tooth extraction if your tooth is broken or damaged by decay and cannot be saved. Tooth extraction, also known as exodontia, is the process of pulling a tooth from its socket in the bone. It is usually recommended as a last resort treatment if the damaged tooth cannot be fixed with a filling, crown, or other dental treatment. In extreme circumstances, a dentist may need to pull a tooth if a patient is experiencing tooth pain that worsens with chewing, swollen gums, or jaw pain. However, such instances are rare.
Your dentist may recommend a tooth extraction under the following circumstances:
Crowding. If your teeth are too crowded, some teeth may be extracted to create space for the remaining teeth. Similarly, if a tooth cannot break through the gum (erupt) because there is no room in the mouth, your dentist may recommend pulling it.
Crowding may also be due to a malposed tooth (faulty position of the tooth) or supernumerary teeth (more than the average number of teeth are present).
Compromised Immune System. If your immune system is compromised for any reason (after receiving chemotherapy or having an organ transplant), your risk of infection is usually high and may warrant a tooth extraction.
Impacted Tooth/Infection. An impacted tooth, such as a wisdom tooth (the third and final set of molars that most people get in their late teens or early twenties), sometimes gets stuck and can’t grow normally in the mouth. Tooth extractions are recommended in such cases because this condition can cause recurrent gum tissue infections around wisdom teeth (pericoronitis).
Periodontitis/Gum Disease. People with unhealthy gums that start receding and forming pockets are at risk of bacterial growth that can cause inflammation and bleeding in the gums. Bacteria can seep inside the gums and cause an infection. In severe cases, this can lead to tooth loss if the gums become so weak that tooth attachment becomes fragile. In such cases, the tooth will need to be pulled.
Trauma. Sometimes, trauma can create conditions that make tooth extraction a necessity. This can include instances where the patient has a jaw fracture sustained in an accident where the teeth are directly involved in the fracture line.
Tooth decay can severely damage a tooth when it extends to the center of the tooth and affects the nerves and blood vessels. When this happens, bacteria in the mouth can cause terrible infections. A root canal may be recommended to resolve the problem. However, if an infection doesn’t clear after antibiotic treatment, Dr. Weishoff will have to pull your tooth to prevent the spread of infection.
Tooth extraction is usually a safe procedure. However, patients with certain medical conditions are at a higher risk of developing an infection because the procedure can introduce harmful bacteria into the bloodstream or gum tissue. To minimize your risk, Dr. Weishoff always reviews your medical and dental history and any medications or supplements you might be taking.
If patients have any of the following medical conditions, they are at higher risk of developing an infection.
If you have any of these conditions, Dr. Weishoff may have you take antibiotics before and after the extraction to lower your risk of infection.
A local or general anesthetic is administered before the procedure to numb the area around the tooth. For a simple extraction where the tooth can be seen in the mouth, Dr. Weishoff uses an elevator (instrument) to loosen the tooth and then removes the tooth with forceps. However, if you have a broken or impacted tooth, she may need to perform a surgical extraction.
Once the tooth has been removed, a blood clot forms in the socket. Gauze is then packed onto the socket, and the patient is instructed to bite down on the gauze to stop the bleeding. Sometimes, stitches may be required to stop the bleeding.
After tooth extraction, the treated area is sore. Pain can also radiate to adjacent teeth, gums, and the face. This type of pain is known as referred pain. Older patients on aspirin or steroid therapy may experience some bruising.
It usually takes 3 to 4 weeks for the soft tissue to heal after tooth extraction.
After tooth extraction, Dr. Weishoff recommends the following aftercare instructions: