Tooth Extractions

When tooth removal becomes necessary, it can be a cause for concern. Whether you need a simple tooth extraction, surgical tooth extraction, or wisdom tooth removal, you may have questions about the process and associated risks. This helpful article will provide insight into tooth extraction, types of tooth removals, what to expect during the procedure, and aftercare tips to ensure a successful tooth removal procedure. 

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Why a Tooth Needs To Be Removed

Removing a tooth is always the last resort. A tooth extraction is only done when other treatments, such as tooth fillings, root canal therapy, and crowns, are not possible. Common reasons for tooth extraction include:

• Tooth decay
• Gum disease
• To relieve dental pain
• To protect adjacent teeth from the diseased tooth
• Tooth infection
• Impacted teeth (teeth that are blocked from erupting)
• Severely crowded teeth 
• Orthodontic treatment

Types of Tooth Removal

Understanding the different types of tooth removal procedures can help you feel more comfortable about your procedure. 

There are two types of tooth removal procedures: simple and surgical extractions. 

A simple extraction involves removing teeth that are visible above the gum line and that can be removed without much difficulty. This is a relatively straightforward procedure.

Surgical tooth extraction involves a tooth that is severely decayed, broken or impacted. This type of tooth extraction requires an incision in the gum line to access and remove the tooth. Wisdom teeth are often impacted, meaning it has not come into the mouth as it should, and require surgical extraction.

Why Wisdom Teeth Removal Is Necessary

Wisdom teeth are the third set of molars and the last permanent teeth to erupt in the mouth. In most cases, wisdom tooth removal is necessary to prevent crowded teeth, tooth decay, and infection. When the mouth does not have enough space for the wisdom teeth, they can become impacted or “stuck” in the jawbone, pushing other teeth out of their natural alignment.

How To Prepare for Tooth Removal

Before tooth removal, your dentist will discuss your medical history and complete a comprehensive examination to assess the tooth and surrounding area. X-rays will be taken with the Dentsply Sirona CBCT 3D Radiographic imaging machine, which allows us to see the tooth from all angles and provides an accurate diagnosis.

If you have dental anxiety, speak with your dentist at your consultation. We provide nitrous oxide and oral conscious sedation for if you are nervous about dental procedures or have a strong gag reflex. 

Your dentist will give you pre-surgical instructions to help you prepare for the procedure. These instructions may include the following: 

To prepare for oral surgery, you should:

• Take all of your regular medications with a minimal amount of water, unless you are instructed to do otherwise by a doctor in this office or your primary medical doctor.
• Avoid eating or drinking within 2 hours of the extraction appointment
• Wear comfortable, loose-fitting clothing and a short-sleeved or sleeveless shirt. 
• You will be asked to remove jewelry, dentures, and contact lenses before surgery. 
• Wear flat-soled shoes that support your ankles.
• Avoid alcohol and smoking for 24 hours before surgery. 
• Plan to rest for the remainder of the surgery day. You will not be able to drive a vehicle, operate any machinery, or make important decisions for 24 hours following intravenous anesthesia.
• Do not wear nail polish, excessive makeup, or lipstick on the day of surgery.
• The use of alcohol or recreational drugs can have an adverse effect on the anesthesia medications that we use. Please discontinue the use of such for at least 72 hours before your procedure.

We will have you brush your teeth and rinse your mouth thoroughly to help prevent infection immediately before your surgery.

It is also recommended to use the bathroom about half an hour before your procedure.

To ensure you have a smooth and calm recovery, we recommend that you have the following things prepared ahead of time: 

• Ice packs
• Medications 
• Soft, easy-to-chew food, such as yogurt, cottage cheese, and pudding

What to Expect During a Tooth Extraction Procedure

Before performing a tooth extraction, the area around the tooth will be numbed with local anesthesia. This should make the tooth removal process pain-free. We understand that the needle for local anesthesia is not a pleasant experience for some patients. Because of this, we use a special topical anesthetic and injection techniques to minimize discomfort during the administration of dental anesthesia. The sedation methods discussed with you during your consultation will be used to help you stay calm and relaxed throughout the procedure. 

The tooth or teeth are removed using specialized tools called an elevator and dental forceps. Your dentist will slowly extract the tooth from the socket using steady pressure. You will then be asked to bite down on a gauze compress to help manage the bleeding. The tooth and surrounding area are then cleaned to ensure all fragments and tooth roots have been removed. 

Socket Preservation and Bone Grafting

Socket preservation is a procedure used to preserve the bone and soft tissue that was previously occupied by an extracted tooth. This is done to protect the area from collapse and to preserve the bone for future tooth replacement.  Socket preservation involves grafting material into the tooth’s socket in order to prevent further deterioration of the jawbone, shifting teeth, and helps maintain your aesthetic look. Depending on your oral health needs, your dentist may decide to do a tooth extraction with or without bone grafting.

Recovery After Tooth Removal

It’s normal to experience some bleeding, swelling, and soreness after the removal of teeth. Most people can return to normal activities a day or two after surgery. You will be provided with specific care instructions to help with the healing process. These may include taking over-the-counter pain medication, avoiding certain foods and drinks, using cold packs or cold compress to reduce swelling, and limiting physical activity for the first few days.

Make sure to follow all instructions to ensure a speedy recovery. After tooth extraction, it’s not unusual to feel a slight sensation of pressure at the extraction site when you bite down or chew. 

Recovery Tips

• Take over-the-counter medications on time and as prescribed. 
• Drink plenty of fluids, but avoid hot liquids and alcoholic beverages for at least 24 hours after the extraction.
• Avoid strenuous activity for the first 3-4 days after the procedure.
• Be gentle when brushing and avoid touching the tooth extraction site.
• Avoid smoking, drinking through a straw, or rinsing hard for several days after tooth removal to avoid dry socket.
• Avoid foods that are hard, crunchy, spicy, or chewy.
• Rinse your mouth the day after surgery with warm water and salt every 4 hours. If you suffer from high blood pressure, consult with your dentist beforehand.
• Eat soft foods like applesauce, Jell-O, smoothies, and soup broth. When chewing is comfortable, you can reintroduce solid foods.

Are There Risks?

Tooth extraction is generally a safe procedure, but as with all surgery, there are associated risks. Possible complications may include prolonged bleeding and risk of infection. Damage to the jawbone, dry socket, or nerve damage are also potential complications, although rare.

• Dry socket (alveolar osteitis) is a complication that occurs when the blood clot at the extraction site is dislodged. Smoking, drinking through a straw, or vigorously rinsing your mouth after tooth removal can increase your risk of developing dry socket.
• There may be some post-extraction bleeding after the procedure. If this happens, take a gauze pad and firmly bite down on it for 30-45 minutes. If the tooth socket continues to bleed, please contact our office.
• Nerve injury is another tooth extraction complication that can occur during a wisdom tooth removal procedure. Depending on the severity of the injury, symptoms may include numbness or tingling in your lips, tongue, chin, and gums. Generally, these resolve over time without treatment; however, if they do not improve, you should contact us as soon as possible.

Summary

• A tooth extraction is only done when other treatments, such as tooth fillings, root canal therapy, and crowns, are not possible.
• There are two types of tooth removal procedures: simple and surgical extractions. 
• Before a tooth is removed, your dentist will go over your medical history, perform a comprehensive exam, and take x-rays. 
• The procedure involves numbing the area, removing the tooth with dental tools, and cleaning the area to ensure there are no remaining fragments or tooth roots. 
• You will be able to return to normal activities a day or two after surgery.

Frequently Asked Questions