Tooth Extractions
A tooth extraction is the removal of a tooth from its designated socket in the jawbone. This can be done non-surgically or surgically, depending on the tooth that needs to be removed.
Why are Tooth Extractions Needed?
If a tooth has been broken or damaged in any way by decay, your dentist will try to fix it with a filling, crown, or other restorative treatment. Sometimes the damage is too much for the tooth to be repaired. In this case, the tooth will need to be extracted. A tooth affected by gum disease will require extraction if it can’t be saved, even with gum and bone replacement surgery.
However, there are other reasons as to why a patient may need a tooth extraction, including:
- Crowding – Some patients may experience the overcrowding of teeth; the crowding may be so severe that new teeth are unable to grow. If this becomes a problem, dentists suggest a tooth extraction to prevent the current teeth from blocking the new teeth. Sometimes, baby teeth will not fall out in time in order for the permanent teeth to come in.
- Orthodontics – If a patient is a candidate for braces, we may recommend a tooth/teeth extraction so that the remaining teeth or erupting teeth have room to align properly.
- Wisdom Teeth (3rd molars) – Most times, wisdom teeth are extracted around the time they come in, which usually falls during the late teens or early 20s. There are many cases where they may grow improperly; for example, they may be shifted or turned in a way that can interfere with your other teeth or cause discomfort. If that is the case, we will recommend having them removed. They also need to be removed if they are decayed, cause pain or have signs of a cyst or infection. In addition, wisdom teeth often become impacted or stuck in the jaw. This prevents them from fully coming in; this can irritate the gum, causing pain and swelling. In this type of situation, we recommend that the tooth is removed.
- Supernumerary Teeth – Some patients have extra teeth in their mouth that may require extraction.
- Radiation and Other Cancer Treatments – Patients that are receiving radiation to the head and neck may need to have the teeth in the field of radiation extracted. In addition, patients receiving cancer drugs may develop infected teeth because these drugs weaken the immune system; these infected teeth may require an extraction.
- Medical Reasons – Some teeth need to be extracted if they could become a source of infection after an organ transplant. Patients with organ transplants have a higher risk of infection because they must take drugs that decrease or suppress the immune system. In addition, if you expect to have treatment with intravenous drugs like bisphosphonates for a medical condition such as osteoporosis, be sure to see us first; if you have teeth that need to be extracted, it should be done before drug treatment begins. Having a tooth extraction after bisphosphonate treatment increases the risk of osteonecrosis in the jaw.
Tooth Extraction Procedure
There are two main types of tooth extraction performed, depending on your situation:
- Simple Extraction – A simple extraction is non-surgical; after applying a local anesthetic, we will use a special instrument called an elevator to gently loosen the tooth within its socket. Then we will remove the tooth completely with an instrument called forceps. A simple extraction is performed on a tooth that can be seen in the mouth and is commonly performed by general dentists.
- Surgical Extraction – A surgical extraction is a more complex procedure. It is used to extract teeth that have been broken at the gum line, or teeth that have not fully grown in. After administering a local anesthetic, we will make a small incision into your gum to remove the tooth completely. Sometimes it is necessary to remove some of the bone around the tooth or to cut the tooth in half in order to extract it.
We may prescribe antibiotics for you to take before and after the surgery. They will most likely be given if:
- You have any infection at the time of surgery.
- You have a weakened immune system.
- You have a longer surgical procedure.
- You have certain medical conditions.
You may receive intravenous (IV) anesthesia, which can range from conscious sedation to general anesthesia. After the extraction, someone will need to drive you home and stay there with you. We will provide you with post-surgery instructions that you must follow to ensure a speedy and safe recovery. If you have any questions or concerns, please do not hesitate to ask us before you leave the office or give us a call.
