Tooth Extractions

When is a Tooth Extraction Necessary?

Tooth extraction is often the best option if you are experiencing:

• Severe tooth decay (cavities).
• Overcrowded teeth.
• Severe gum disease.
• An impacted tooth.
• A fractured or broken tooth.

There are many different cases when a tooth extraction is deemed necessary. Although it is a top priority to treat and save your tooth, there are times when this is no longer a possibility or in the patient’s best interest and extraction is the only possibility, including:

Dental Caries (Tooth Decay)

In the case that dental caries have progressed significantly, often there is not enough sound tissue to allow for restoration, leaving the tooth unrestorable. In this case, tooth extraction is the only viable treatment option.

Pulpal/Apical Pathology

A common consequence of dental caries is pulpal and periapical pathology. A tooth with pulpal or apical pathology that cannot be resolved or restored with endodontic treatment would need to be extracted. A tooth extraction in some cases would occur if the patient decided not to do an endodontic treatment but would still like the tooth to be treated.

Severe Periodontal Disease

Severe periodontal disease leads to bone destruction in the maxilla or mandible. When a tooth has lost its bony support, it becomes mobile and irritating for patients. As there are limited options for bony regeneration, extraction is often the most viable treatment option.

Fractured Teeth

Fractured teeth require extraction if they cannot be restored or retained.

Retained Dental Roots

Retained dental roots can be present after crown fractures caused by caries, trauma, or incomplete dental extraction. Some cases allow for the retention of the dental root, either for prosthetic reasons or due to the risk of damaging its surrounding structures when attempting to retrieve them. Although they can potentially cause infection and pain, and therefore are commonly advised for preemptive removal.

Impacted Teeth

Impacted teeth cannot erupt due to a physical barrier, such as other teeth or the jawbone, and are often considered for removal. If left in the jaw, impacted teeth can develop cysts. The decision to either remove or continue to monitor them with X-rays should be made jointly by the patient and dentist. Impaction often occurs with teeth that erupt late, especially mandibular third molars (wisdom teeth), upper canines, and lower premolars.

Supernumerary Teeth

An extra tooth beyond the normal set is most commonly found in the anterior maxilla. These teeth can cause problems like failure of other teeth to erupt, misalignment, crowding, and other issues. If keeping the extra tooth isn’t beneficial, it is usually removed.

Orthodontic Extractions

Teeth are often extracted for orthodontic reasons to create space and help move other teeth into a better position. An orthodontist should decide which teeth to remove.

Pre-prosthetic Extractions

Teeth may be extracted to ensure a better fit for a dental prosthesis or if they are in poor condition and could later affect the prosthesis.

Tooth In a Fracture Line

When a patient has a mandibular fracture, it is assessed with exams and X-rays. If the fracture passes through a tooth, it could cause infection, or hinder healing. If the tooth is broken, it may be removed. This is usually done during surgery to fix the fracture.

Teeth with Associated Pathology

Teeth associated with pathologies, such as cysts of the jaws or malignancies, may be recommended for extraction.

Before Radiotherapy

Before starting radiotherapy, often for head and neck cancers, patients usually need a dental check-up. This helps identify problematic teeth that might cause issues soon. It’s important because tooth extractions after radiotherapy can lead to serious jaw problems, which should be avoided.

Benefits of a Tooth Extraction

Pain Management

A tooth extraction provides relief from the pain caused by damaged or decaying teeth that cannot be fixed with other treatments. When the tooth is extracted, it provides almost immediate relief for pain and discomfort, improving the patient’s quality of life.

Prevents The Spread of Infection

Extracting a severely infected tooth prevents the infection from spreading to other areas of the mouth and body.

Risk Prevention

Extracting teeth that are at risk of complications prevents potential problems like cysts, tumors, or damage to the surrounding teeth.

Improves Your Oral Health

Extracting a damaged tooth helps maintain the health of surrounding teeth and gums while preventing further issues like overcrowding, misalignment, and the deterioration of the jawbone.

Straightforward Procedure

Extracting a tooth is a simple and effective procedure that offers a fast solution to damaged or decaying teeth.

Orthodontic Treatment Aid

Tooth extraction can be an important step before orthodontic treatments because it creates the space needed for proper alignment, especially in the case of overcrowding.

Dental Prosthetic Preparation

For dental prosthetics like dentures or implants, tooth extraction is often necessary to prepare the mouth for the prosthetics and remove damaged or decayed teeth.

Aesthetic Appearance

Extracting severely decayed or damaged teeth can drastically improve the appearance of your smile. Especially when it’s followed by a treatment like implants.

Why It’s Important to Replace a Missing Tooth

Leaving the space open will allow your teeth to move and can cause bone loss. If you need a replacement for an extracted tooth like a bridge or dental implant it most often depends on these factors:

• If your tooth has been extracted from a visible area, you may want a replacement for aesthetic appearance.
• If your tooth was extracted from the back of your mouth, you may need a replacement for functionality reasons like chewing.
• Younger patients may desire permanent solutions, while older patients may prefer a less invasive approach such as dentures.
• Dental implants are permanent and the most natural, therefore more expensive.
• Dental bridges are less expensive, although they may require the alteration of some surrounding teeth.

Tooth Extraction Preparation

We understand that before you get a tooth extraction you may have some questions. Our team at 32ology will guide you through the process to ensure you’re informed about the before, during, and post-procedure and are comfortable throughout.

Before Your Tooth Extraction

• Your dentist will take your complete medical history and note any medications or supplements you are taking.
• Be sure to arrange an extraction date that works with your schedule.
• Prepare for your recovery with ice packs and pain medication.
• Ensure you have soft foods that are easily consumed.

Day of Your Tooth Extraction

• Arrange a ride to and from your appointment if you are being sedated.
• Your dentist will thoroughly clean your teeth, flossing and brushing to remove any plaque or food around the affected area.
• Local anesthesia will be administered to the affected area to ensure your comfort throughout the procedure. (General anesthesia may be used for more complicated extractions).
• Your dentist will use special dental forceps to gently loosen and remove the affected tooth.
• Your dentist will be careful to preserve as much of the surrounding bone and gum tissues as possible.

After Your Tooth Extraction

• Your dentist will ensure that a healthy blood clot is forming and will provide you with gauze to bite on so that pressure is applied to the area.
• Your dentist will discuss how to manage any discomfort after the anesthesia wears off, and any details for prescribed medications.

Post-Extraction Healing Tips

• Ensure you get a lot of rest to help aid your healing process.
• Avoid strenuous activity for at least 24 hours after your procedure.
• Some discomfort is normal post-procedure and is manageable with pain medication that your dentist will prescribe.
• After your procedure, you will receive a detailed recovery guide that will outline the necessary post-procedure care.

Post-Extraction Instructions

• After a tooth extraction, a blood clot needs to form to stop the bleeding and begin the healing process. This is why we ask you to bite on a gauze pad for 45 minutes after the appointment. Or until the bleeding stops.
• Do not rinse or spit for 24 hours after surgery.
• Do not touch the socket or surgical area with your fingers or tongue.
• Use ice packs on the side of your face that the tooth was extracted from for the first 48 hours.
• For mild discomfort, take Tylenol or ibuprofen every 3–4 hours.
• For severe pain, use the medication prescribed to you by your dentist.
• Drink plenty of fluids (do not use a straw).
• You should not smoke for at least 5 days after surgery.
• Avoid strenuous activity and do not exercise for at least 3–4 days after the extraction surgery.
• If the muscles of the jaw become stiff, put warm, moist heat on the outside of your face.
• After the first post-operative day use a warm saltwater rinse following your meals to flush out particles of food and debris that may become lodged in the surgical area. You should do this for the first week.
• Your diet should consist mainly of soft, easily swallowed foods and cool drinks.

Additional Information:

• Continue proper hygiene; floss and brush your teeth daily.
• Contact our office immediately should you experience symptoms such as fever, persistent pain, heightened gum swelling, allergic reaction, or an irregular bite.
• If pain persists, use the prescribed pain relief medications to alleviate discomfort and pain. It is important to start prescribed antibiotics immediately and finish as instructed. Do not consume any alcohol while taking medications.