Tooth extraction is defined as complete removal of a tooth from its socket in the bone.
An extraction of a tooth is performed for positional, structural, or economic reasons. Typically, teeth are removed because they are impacted. Wisdom teeth are commonly known for extraction due to being impacted which means the tooth cannot grow into its normal position in the mouth. Orthodontic treatment is another common reason teeth are extracted. Many times teeth need to be extracted to make more room in the mouth prior to straightening the remaining teeth. As dentists, our main goal is to help preserve the natural teeth as long as possible; however; tooth extraction may be the only option when a tooth is severely decayed or broken beyond our ability to restore it. Extraction is also chosen as an option because it may be the less expensive alternative to a filling or placing a crown.
It is also important to be aware that if an extraction is likely to be difficult, the dentist may refer you to an oral surgeon. An oral surgeon is someone who specializes in difficult or surgical extractions. When it is in your best interest to have a tooth extracted, for whatever reason, we are here to listen to your concerns and help you through the whole process.
Process of Tooth Extraction
A radiographic (x-ray) examination will be done first to assess the position of the tooth roots and the condition of the surrounding bone. This will allow any possible complications to be anticipated. However, before any dental procedure, a thorough medical and drug history will be reviewed to ensure that you are healthy enough to undergo the procedure. In addition, our dentists will discuss your options for anesthesia.
Tooth extraction is usually carried out with local anesthesia, which will numb the tooth to be removed, as well as, the surrounding bone and gum tissue. Additional sedatives might also be used, including oral sedatives (taken in pill form), nitrous oxide (which is inhaled) and/or conscious sedation, which is given intravenously (into a vein). The latter is usually required for more complicated (or multiple) tooth extractions. By the time the conscious sedation medication has worn off, you won't even be aware that the surgery was done.
As your tooth is being removed, steps are taken to ensure the bone that surrounds it isn't damaged. Sometimes, in the process of removing a tooth, a small amount of lab-processed bone-grafting material is placed into the socket to help preserve the bone volume there. This is particularly important when the extraction is going to be followed at some point by the placement of a dental implant, which needs to fuse to existing bone, or orthodontics, which gently moves teeth through bone.
After Care
An important aspect of aftercare is encouraging a clot to form at the extraction site. Therefore, immediately after your tooth is extracted, the socket will be covered with sterile gauze; gentle pressure will be applied for 10-20 minutes to control any bleeding. Sometimes small sutures (stitches) are used for this purpose. It's normal to experience some mild to moderate post-operative discomfort and swelling. The use of ice packs on the outside of your jaw will reduce the swelling. Swelling is a normal part of the healing process; it is most noticeable in the first 48–72 hours after surgery. As the swelling subsides, the patient's jaw muscles may feel stiff. Moist heat and gentle exercise will restore normal jaw movement. However, many symptoms can be controlled by taking a non-steroidal, anti-inflammatory drug such as ibuprofen the day of surgery. Antibiotics may also be prescribed to ensure infection-free healing.