When it comes to teeth, all dental professionals work hard at saving and preserving your teeth. Sometimes, a tooth is beyond saving by other means. When this happens, it’s recommended to extract the tooth to keep the rest of your teeth healthy. Dentists offer a variety of options for replacing an extracted tooth, such as implants, full-arch restorations, and other customized solutions.
Reasons for Tooth Extraction
There are numerous reasons related to a dental extraction procedure. The most common is a badly decayed tooth. It’s normal for a tooth to wear out and decay over time. This is a normal consequence of nature. However, once a tooth decayed past the acceptable point, it will bring problems to your oral health. It may even make your breath smell bad! To avoid a general compromise of your oral health, your dentist will suggest tooth extraction.
Wisdom tooth should also be extracted because it will obstruct jaw and bite function. Many years ago, our ancestors relied on wisdom teeth to help them chew rougher types of foods. As society progressed, the need for wisdom teeth faded. Some of the common problems brought by wisdom teeth are gum disease, tooth occlusion, and prolonged tooth decay. Keeping the wisdom tooth doesn’t sound so wise, right?
Another key reason is the orthodontic treatment. If the treatment proves to be complicated, your dentist might extract teeth with your permission. Putting braces, for example, might call for extraction in order to keep your teeth aligned perfectly. This is the reason why having dental braces tend to be costly. In this case, you can consider tooth extraction as a secondary procedure.
Preparing for A Tooth Extraction
Before you have tooth extractions performed, you’ll have x-rays taken. The type of x-rays you’ll have will depend on what reason your tooth or teeth are being removed in the first place. For a diseased tooth, a routine tooth x-ray that you normally receive at your bi-annual dental appointments may be sufficient. For removing impacted wisdom teeth, however, full panoramic x-rays may be required so that our doctors see the entirety of the internal structures of your teeth and gums that may be affected by your tooth extractions.
It’s always important that you disclose your full medical history to dentist. Certain patients, such as those with heart conditions or weakened immune systems, may be placed on preventative antibiotics. This medicine is used only as a precaution to prevent infections because doctors are concerned not only with your teeth, but your overall health, too.
Prior to your procedure, you’ll have the option of selecting a sedation dentistry choice that is right for you. dentists offer the following sedation dentistry options for patient’s that require tooth extractions:
- Twilight anesthesia, which is delivered via an IV and will make you relaxed and unaware of the procedure, but still allows you to respond to doctors and nurses.
- General anesthesia, which is also delivered through an IV and will completely knock you out, so you are totally asleep during your oral surgery.
- Local anesthesia, which involves receiving an injection to the surgical site to numb you before your procedure.
- Nitrous oxide, commonly known as “laughing gas,” which makes you feel more relaxed, and a little giggly, without putting you to sleep.
Tooth extraction types
There are two main types of dental extraction, simple extraction and surgical extraction. Simple dental extraction is used to remove teeth that can be seen and are easily accessible, whereas surgical dental extraction typically requires an incision into the connective tissue to gain access to the tooth to be removed. Both types of dental extraction are covered in more detail below.
Simple Dental Extraction
Simple dental extraction involves the removal of teeth that are visible in the mouth. General dentists often carry out this procedure in their dental practices, using a local anesthetic to numb the area and reduce the pain experienced by the patient.
Instruments to elevate the affected tooth and grasp the visible portion are needed, such as an elevator and dental forceps. The elevator is used to loosen the tooth and the forceps to grasp the tooth for its extraction.
The tooth can then be moved back and forth until the periodontal ligament breaks enough to loosen the tooth from the alveolar bone so that it can be removed. This requires applying a controlled force on the tooth with steady pressure from the dental forceps.
Surgical Dental Extraction
Surgical dental extraction involves the removal of teeth that are not easily accessible inside the mouth. This may be because they have not erupted through the gum completely or they have been fractured under the gum line.
In this case, it is necessary to make an incision into the connective tissue surrounding the tooth to gain access to it for extraction. For example, the soft tissues that cover the tooth may be elevated, or a drill or osteotome may be needed to remove some of the nearby jawbone during the extraction procedure.
In many cases of surgical dental extraction, the tooth may need to be fragmented into several pieces to allow it be removed.
Given the more complex nature of surgical dental extractions and the pain that is associated with the procedure, it is typically carried out under general anesthetic by an oral surgeon in a dental hospital setting. However, in some cases, a general dentist may also perform the procedure.
Comparing Simple and Surgical Extraction
Both types of dental extraction help to reduce the overall risk of complications, such as infection, pain, and inflammation.
Overall, simple tooth extractions are preferred whenever feasible, because they are easier to carry out and are associated with fewer adverse effects than surgical tooth extractions. However, there is not usually a choice between the two options; a simple tooth extraction is always carried out if the tooth is accessible but surgical extraction is the only method that will work for teeth that are not visible or easily accessible.
Length of Procedure
The length of your procedure will depend on how many teeth you need extracted, the degree of impaction, curvature of root and level of infection. Tooth extraction procedures typically take 30 to 60 minutes. You can expect to be in our office 1.5 to 2 hours which accounts for consultation, procedure and in-office recovery time. Tell your doctor about any and all prescriptions you are taking before the procedure.
Post Tooth Extraction Care Guide
There are a number of reasons that your dentist might recommend a tooth extraction. Some dental patients suffer from tooth decay; others need to remove teeth hindering orthodontic treatment, whereas various patients simply need wisdom teeth removal. While a tooth extraction can be a serious dental procedure, aftercare is just as critical as the procedure itself. As the dental patient, it is important to understand that pain and the risk of infection can be lessened with proper care.
Care immediately following surgery:
- Keep pressure on the gauze pad that your doctor placed over the surgical area by gently biting down. Dampen the gauze sponge with water if it begins to dry out. Try to maintain constant pressure in intervals of 45-60 minutes, repeating as often as needed, or until bleeding lessens. Change the gauze as needed.
- Keep your head elevated and try to lower your activity level as much as possible.
- 48 hours after surgery, rinse mouth with warm salt water every 1-2 hours. Avoid using any mouthwash containing alcohol as it can irritate the wound.
- Keep your mouth clean by brushing areas around the surgical site, but be sure to avoid sutures. Touching the wounded area in any fashion should be prevented.
- Use ice packs to control swelling by placing them on facial areas near extraction.
- Take all prescribed medications accordingly. If any itching or swelling occurs, contact the practice immediately, or go to the nearest emergency room.
- Try to eat softer foods, preferably high in protein.
- Keep your body hydrated by drinking plenty of fluids, but do not drink through a straw for the next 5-7 days.
- If you are a regular tobacco user refrain from smoking for the next 3-4 days as smoking increases your chances of getting a dry socket as well as an infection.
After your tooth has been extracted, healing will take some time. Within 3 to 14 days, your sutures should fall out or dissolve. For sutures that are non-resorbable, your doctor will schedule a follow-up appointment to remove the stitches for you. Your tooth’s empty socket will gradually fill in with bone over time and smooth over with adjacent tissues.
Possible complications after a tooth extraction
Bleeding after a tooth extraction is entirely normal. A pinkish tinted saliva and subtle oozing is fairly common during the first 36 hours. If bleeding gets excessive, control it by using dampened gauze pads and biting down to keep pressure on the area. As an alternative to gauze pads, a moistened tea bag can be used, as the tannic acid helps blood vessels contract. Apply pressure to the gauze or tea bag by gently biting down for 30 minutes. Please remember that raised tempers, sitting upright, and exercise can all increase blood flow to the head, which can cause excess bleeding. Try to avoid these as much as possible. If your bleeding does not reduce after 48 hours, please call the practice.
Bone sequestra (dead tooth fragments)
Some patients have small sharp tooth fragments that were unable to be completely removed during surgery. During the recovery period, these dead bone fragments, or bone sequestra, slowly work themselves through the gums as a natural healing process. This can be a little painful until the sequestra are removed so please call our practice immediately if you notice any sharp fragments poking through the surgery site.
In the days that follow your tooth extraction, pain should gradually subside. Rarely, patients report that pain increases to a throbbing unbearable pain that shoots up towards the ear. Often this is a case of dry socket. Dry socket occurs when the blood clot becomes irritated and ousted before healing is complete. Food and debris can then get into the socket causing irritation. Tobacco users and women taking oral contraceptives are at a higher risk of getting dry socket. Dry socket is not an infection but does require a visit to our office. If you think you may be suffering from dry socket, please contact the practice immediately.
Because you may have been fasting prior to surgery, your blood sugar levels may be lower than normal. Until your body has had the chance to catch up and process some sugars, you should remember to stand up slowly when getting up from a relaxed position. For somewhat immediate relief, try eating something soft and sugary, stay in a relaxed position, and reduce the elevation of your head.
Many patients report still feeling numb hours after their tooth extraction procedure. An extended lack of feeling around the mouth is normal and can last 10-12 hours after surgery.
Swelling should subside almost entirely within 10 days after surgery. Immediately following your tooth extraction, apply an ice pack to the facial areas near the extraction. Continue using the ice in 15 minute intervals for the first 36 hours. After 36 hours, ice will no longer be beneficial in reducing swelling and moist heat should be used instead. To decrease swelling, apply a warm damp cloth to the sides of your face.
Trismus (difficulty opening and closing mouth)
If you experience a sore jaw and difficulty chewing or swallowing, do not be alarmed. Occasionally patients’ chewing muscles and jaw joints remain sore 3-5 days after surgery. This soreness can also make it difficult to open and close your mouth. Soreness should eventually subside.
How much does a tooth extraction cost?
complex extraction and any additional fixtures (such as crowns, bridges and veneers) will cost more than standard extraction. It is important to arrange a consultation with dentists to discuss your options and a fixed price.