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What Is Tooth Extraction?

A dental extraction / tooth removal / tooth extraction is the removal of tooth from its socket in the alveolar bone.

What are the reasons for tooth extraction?

Permanent teeth are meant to last a lifetime, but they may need to be extracted for a number of reasons like:

• Decay of Tooth – A tooth that has been badly damaged by decay and cannot be repaired.
• Trauma – Tooth that has been broken due to trauma and cannot be restored.
• A crowded mouth – Sometimes dentists pull teeth to prepare the mouth for orthodontia.The goal of orthodontia is to properly align the teeth, which may not be possible if your teeth are too big for your mouth.
• Infection – When infection extends to the pulp and is so severe that antibiotics or Root Canal Treatment do not cure it, extraction may be needed to prevent the spread of infection.
• Risk of infection – When the immune system is compromised due to chemotherapy or organ transplant, the risk of infection in a particular tooth may be reason enough to pull the tooth.
• Periodontal (Gum) Disease – In gum disease, an infection of the tissues and bones that surround and support the teeth can cause loosening of the tooth and it might need to be extracted.
• Braces – In preparation for orthodontic treatment (braces).
• Impacted Wisdom Tooth – An impacted wisdom tooth may not be able to break through the gum (erupt) because there is not enough room in the mouth for it. Impaction of such third molar tooth may lead to inflammation, infection, bone resorption. To prevent the complication such tooth might need to be extracted.
• Fracture – When the tooth is fractured or there is a tooth in the fracture line.
• Radiation – Patient receiving radiation therapy to the head and neck area may require extraction of teeth in the field of radiation.
• Cosmetic – Teeth of poor appearance or teeth which is unsuitable for restoration may need to be removed for cosmetic reasons.
• Supernumerary, supplementary or malformed teeth may need to be extracted.

What are the types of tooth extraction?

Extractions are categorized as “simple” or “surgical”.
Simple extractions are performed on teeth that are visible in the mouth and require only the use of instruments to elevate and/or grasp the visible portion of the tooth. The tooth is lifted and loosened using an elevator and removed from the socket with the help of dental forceps.
Surgical extractions involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line or because they have not erupted fully. Surgical extractions almost always require an incision. In a surgical extraction the doctor may elevate the soft tissues covering the tooth and bone and may also remove some of the overlying and/or surrounding jawbone tissue with a drill or osteotome. Frequently, the tooth may be split into multiple pieces to facilitate its removal.

What should you tell the dentist before undergoing dental extraction?

If you have a condition that puts you at high risk for developing a severe infection, you may need to take antibiotics before and after the extraction.
Before having a tooth pulled, let your dentist know your complete medical history, the medications and supplements you take, and if you have one of the following:

• Damaged or man-made heart valves
• Congenital heart defect
• Impaired immune system
• Liver disease (cirrhosis)
• Artificial joint, such as a hip replacement
• History of bacterial endocarditis

What instructions need to be followed after dental extraction?

Recovery after dental extraction typically takes a few days. The following can help minimize discomfort, reduce the risk of infection, and speed recovery.

• Painkillers are prescribed by dentist for 3-5 days with first dose being taken usually before the anaesthesia wears off. Most pain disappears after a couple of days.
• Antibiotics may need to be taken as prescribed by the dentist. This is given to prevent infection.
• Bite firmly but gently on the gauze pad placed by your dentist to reduce bleeding and allow a clot to form in the tooth socket.
• Apply an ice bag to the affected area immediately after the procedure to keep down swelling. Apply ice for 10 minutes at a time. If your jaw is sore and stiff after the swelling goes away, try warm compresses.
• Relax for at least 24 hours after the extraction. Limit activity for the next day or two. When lying down, prop your head with pillows. Lying flat may prolong bleeding.
• A gentle rinse with warm salt water, started 24 hours after the surgery, can help to keep the area clean. Use one-half teaspoon of salt in a cup of water. Most swelling and bleeding end within a day or two after the surgery. Initial healing takes at least two weeks.
• Eat soft and cool foods, such as soup, pudding, yogurt the day after the extraction. Gradually add solid foods to your diet as the extraction site heals.
• Do not use a straw or spit or rinse mouth forcefully till 24 hours after surgery. These actions can pull the blood clot out of the hole where the tooth was.
• Continue to brush and floss your teeth, and brush your tongue, but be sure to avoid the extraction site. Doing so will help prevent infection.
• Do not smoke on the day of surgery. Do not smoke for 24 to 72 hours after having a tooth extracted as it can inhibit and delay the healing process.

When am I expected to call the Dentist?

It is normal to feel some pain after the anesthesia wears off and for swelling and residual bleeding to appear for upto 24 hours after tooth extraction. But a patient is expected to call or visit a dentist if she / he experiences any of the following:

• if either bleeding or pain is severe and lasts for more than four hours after the tooth is pulled.
• In case of signs of infection, including fever and chills is noticed.
• If the patient has nausea or vomiting.
• If there is redness, swelling, or excessive discharge from the affected area.
• If the patient has cough, shortness of breath or chest pain.
• If the swelling gets worse instead of better.
• If the patient has trouble swallowing.
• If the tongue, chin or lip feels numb more than 3 to 4 hours after the procedure.
• If the extraction site becomes very painful as this could be an early sign of having developed a dry socket.

FAQs on tooth extraction