Tooth extraction: When is a dental extraction necessary?

When a tooth has become so extensively decayed or damaged that it cannot be saved, our dentist may recommend extracting it. Often, a tooth extraction can help alleviate pain and discomfort. Dentists use the most advanced dental technologies to ensure  optimal comfort and efficiency during your treatment. The type of tooth extraction procedure depends on whether the tooth is fully erupted or is partially or fully impacted. You may require a simple extraction procedure or a surgical extraction for more difficult teeth.

In the event that you need multiple teeth extracted or missing one or more teeth, dentists offer several replacement options. High quality restorations will restore the form and function of your mouth.

When tooth extraction is necessary?

When tooth extraction is necessary

A patient has two sets of teeth – milk teeth and permanent teeth.  Milk teeth are the first set of teeth that the body produces.  When these set of teeth fall off, the second set of teeth which are the permanent teeth replaces the milk teeth.

Permanent teeth are meant to last a lifetime. However, teeth extraction may be necessary for the following instances:

Irreparable tooth damage due to severe decay

This happens when tooth decay reaches the center of the tooth which is the pulp.  The bacteria produced by the decay can invade the pulp and cause an infection.

In which case, a root canal procedure may help treat the infection. However, if the infection is severe, extraction may be performed to avoid the infection from spreading. dentists will examine your affected tooth and recommend the best dental option. Whether a root canal treatment or a tooth extraction, dentistsare sure to provide the safest, most comfortable and a painless procedure that suits your dental need.

A viable solution to periodontal disease

Periodontal disease is an infection of the gums, periodontal ligaments, alveolar bone and other structures surrounding the teeth. The earliest stage of periodontal disease is gingivitis which is an infection of the gums. The more severe kind of periodontal disease affects the periodontal ligaments and the alveolar bone.

Periodontal disease is caused by a bacteria in dental plaque which is a sticky substance that is formed on your teeth several hours after eating and without brushing. Regularly brushing your teeth and visiting your dentist can help prevent periodontal disease.

dentists provide periodontal treatments that will restore the health of your gums and other supporting tooth structures. advanced periodontal therapy programs can help prevent future dental issues.

In some instances, a periodontal disease may result in the loosening of a tooth.  When this happens, tooth extraction is a possible dental option.

dentists aim to restore the patient’s oral health whether their recommendation is for a periodontal therapy or a tooth extraction.

Extraction may help an impacted tooth

Extraction may help an impacted tooth

A tooth is impacted when it is blocked from coming out, or when the gums did not fully erupt preventing the tooth to come out.  This is usually the case for wisdom teeth.

Your dentist may recommend the extraction of the impacted tooth to prevent it from damaging other teeth. Extracting an impacted tooth may also help lower the risk of infection and overcrowding.

dentists are committed to providing exceptional treatments in extracting an impacted tooth. they thoroughly examine the affected area before recommending a tooth extraction and performing the procedure.

dentists use advanced technology like a digital radiograph that shows a more detailed x-ray of your impacted tooth and affected parts of the mouth. With this equipment, patients have less exposure to radiation and are more comfortable to use.

To eliminate teeth overcrowding

The extraction of one or several teeth may be necessary to eliminate the overcrowding in the mouth. This is also recommended when the patient has to undergo an orthodontic treatment and there is no room for the teeth to move and realign.

An orthodontist will check on how crowded your teeth are, and if there is enough room for them to move and give your set of teeth a better alignment. Teeth extractions are recommended when there is not enough space to straighten the alignment of your teeth.

Necessary after an accident

When an accident, like a car collision, happens and the patient requires dental treatment, the first option is always to preserve the teeth. Dental bonding, crowns, bridges or veneers may be recommended.  However, if the dental issue is dreadful, a tooth extraction may be required.

Types of tooth extraction

Types of tooth extraction

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. Other complications associated with both types of dental extraction include:

  • Osteitis or dry socket caused by premature loss of the blood clot that occurs following extraction.
  • Delayed healing may occur with medications such as bisphosphonates or corticosteroids, which should therefore be temporarily ceased before dental extraction to reduce the risk of complications.
  • Osteoradionecrosis or secondary bone death for patients who have a history or radiation treatment in the area of the head and neck.
  • Movement of remaining teeth leading to misalignment of teeth and altered bite, which may damage other healthy teeth.
  • Loss of vertical dimension of occlusion, or collapse of bite, which can lead to changes in the muscle contractions needed to chew and consequent results such as dry lips.

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.

Do teeth extractions hurt?

Typically, during a tooth extraction procedure, sedation is administered to the patient to make them feel relaxed and comfortable. Also, many teeth that are subjected to extraction have nerves that are dead or dying, which means that the affected tooth may not be able to send pain signals out.

Tooth Extraction (Post-Operative Instructions)

Tooth Extraction (Post-Operative Instructions)

Once the procedure is done, detailed at-home care instructions will be given to the patient. To speed up the recovery and avoid any complications, patients must follow the given at-home instructions diligently. However, do know that the recovery period varies from patient to patient.


  • Keep relatively quiet today. Keep head elevated, higher than the heart.
  • The sedated patient may resume normal activities in 24 hours.


  • Someone should stay with the sedated patient for 3-4 hours after surgery.
  • No power tools or other dangerous machinery for at least 24 hours. Pain pills may affect the ability for 3-4 hours after each dose.
  • Legally, you may not drive for 24 hours after sedation and should not sign any important papers.

Gauze packs

  • Change gauze packs every 30 minutes as needed. Discontinue gauzes when bleeding stops, usually 3-4 hours. Do not leave in overnight.
  • A sleeping patient should be aroused to check the gauze every 20 minutes. Never let a patient sleep unattended or for long periods with gauze packs in the mouth.
  • If oozing starts, bite on gauze pack until it stops. You can also use a wet teabag, like gauze and bite down on it (ie. Lipton, not herbal/decaffeinated bags.)


  • The patient can drink at any time. Remove all gauze to drink, then replace gauze packs as needed. No hot drinks; only cold drinks for the first 24 hours.
  • To avoid biting the tongue, the patient can eat as soon as feeling returns and bleeding stops.
  • Cold, soft foods (ice cream, jello, yogurt, pudding, sherbet, cottage cheese) for the first 24 hours. After the first 24 hours you can add warm, soft foods (soups, soft cooked pasta dishes, mashed potatoes, scrambled eggs, cream of wheat). Avoid hard, crunchy foods (bagels, pizza, hamburgers, popcorn, chips). Gradually advance your diet as tolerated.

Pain management

  • Take prescribed pain medication before feeling returns to the involved area. Take medication with milk, ice cream, or anything that doesn’t require chewing.
  • Take pain medication as directed. We recommend you take Ibuprofen 800 mg. every 8 hours, added Percocet (Vicodin) 4-6 hours as needed. Do not take additional Tylenol.
  • Ice packs to the jaw can reduce pain, swelling and/or bleeding the first 24 hours then heat at intervals only.

Quit smoking

Smoking following the procedure is prohibited, as it can be a reason for different complications. Smoking can also cause the formed blood clot to dislodge, which leads to a painful dry socket. This blood clot plays an essential role in the healing of the wound. Additionally, several complications may occur if the patient smokes after teeth extractions, such as high blood pressure, dizziness, dry socket, risk of getting an infection, and slower healing process.

Care of the mouth after tooth extraction

  • To help prevent a “dry socket”, no smoking, rinsing, spitting, brushing for 24 hours.
  • 24 hours after surgery, begin brushing teeth and start rinsing with warm salt water.

Miscellaneous instructions

  • If dentists gave you an IV medication for swelling, it will wear off between the second and third day. You may feel more discomfort than previously experienced. This is normal; however, if pain increases or is not alleviated with pain medicine, call the office.