Tooth Extraction

A tooth extraction, also known as exodontia, is one of the most common dental procedures and may be performed by the patient’s regular dentist or an oral surgeon, depending on the circumstances. Tooth extractions, during which the tooth is removed from its socket in the bone, may be necessary because of disease, trauma or overcrowding of teeth.

Reasons for a Tooth Extraction

There are many reasons teeth may have to be extracted. Extraction may be required if:

  • Wisdom teeth are causing problems
  • Decayed teeth are spreading infection
  • Broken teeth can’t be successfully repaired
  • Teeth are overcrowded or growing in inappropriate places
  • Teeth are loosened by periodontal (gum) disease

Teeth frequently require extraction in preparation for orthodontic work. Some dentists believe in extracting wisdom teeth before they have grown full roots to prevent difficulties later in life.

Preparations for a Tooth Extraction

It is important that the dentist or oral surgeon have a complete medical history of a patient undergoing a tooth extraction. The dentist must be informed of all medications and supplements the patient takes and of any underlying medical conditions, such as heart problems or defects, joint replacements, or a compromised immune system. In situations in which the patient is at heightened risk of infection, the dentist may want to prescribe a course of antibiotics before the oral surgery.

Tooth Extraction Procedures

Once the dentist has determined that one or more teeth must be removed, X-rays are taken to assess the situation with precision. Tooth extractions, depending on their complexity, and on the age, condition, and comfort of the patient, may be performed under local or general anesthesia. There are two basic types of tooth extractions.

Simple Extractions

When a tooth is completely visible in the mouth, the extraction is a relatively simple procedure, most often performed under a local anesthetic. In a simple extraction, the dentist uses forceps to remove the tooth, then places a sterile gauze pad over the wound, instructing the patient to bite down in order the stop excessive bleeding.

Surgical Extractions

When a tooth has not fully descended into the mouth, or is impacted, a condition common with wisdom teeth, or when a tooth has broken at the gum line, the dentist has to perform a more complicated procedure. Gum and tissue may have to be cut away and the dentist may have to rock the tooth back and forth to loosen it. In some instances in which the tooth is broken, the dentist may have to remove it in pieces. Surgical extractions usually require general anesthesia, particularly if more than one tooth is involved.

After the procedure, the patient’s mouth may have to be stitched, usually with self-dissolving stitches.

Recovery from a Tooth Extraction

Patients typically recover from a simple tooth extraction quickly, although surgical extractions may take a week or two for complete recovery. Immediately after the extraction, patients are told to bite down on a gauze pad to stop the bleeding. It is normal for patients to experience pain after a tooth extraction. They are instructed to take the following steps, particularly during the first 24 hours after oral surgery, to alleviate discomfort and promote healing:

  • Take anti-inflammatory medication
  • Apply ice
  • Rinse with warm salt water
  • Avoid hot liquids and hard foods
  • Limit activities
  • Avoid forceful rinsing, spitting or sipping through a straw

Patients may be prescribed antibiotics to stave off infection and usually return to the dentist’s office for a follow-up appointment during which healing will be evaluated and any remaining stitches will be removed. Because the absence of a tooth can result in the shifting of other teeth, which affects the bite, the dentist will likely advise replacing the missing tooth (or teeth) with a bridge, a denture, or a dental implant.

Complications of Tooth Extraction

Tooth extraction is considered a very safe procedure, but, as with all medical and dental surgeries, there is some risk of complications. While rare, dental extractions can result in: damage to adjacent teeth or to the jaw, infection, or adverse reaction to anesthesia.

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