Tooth Extractions

Tooth Extractions: What to Expect 

Tooth extractions sound intimidating, but they are a routine procedure performed by dentists and oral surgeons. Knowing what to expect makes the experience less stressful.

Your dentist determines if you need an extraction and whether he or she will do it or refer you to an oral surgeon.

You receive an injection of local anesthesia that keeps the area around the affected tooth numb during the extraction. There are instances in which you need a general anesthetic, but this isn’t common for simple extractions.

Although tooth extraction is sometimes called “having a tooth pulled,” extraction is a blend of rocking and pulling called luxation. The movement gradually opens the space in the bone where the tooth sits and breaks the small fibers that connect the tooth to the bone. 

A simple extraction can take just a minute or so depending on the roots of the tooth. If the roots are spread out, or someone needs a surgical extraction, the procedure takes longer.

Extracting Impacted Teeth

Sometimes impacted teeth need to be extracted, which involves cutting away gum and bone tissue before removing it.

Once cut, forceps grab the tooth and rock it back and forth until it loosens and comes out. Some hard-to-pull teeth come out in pieces.

After the tooth is out, the dentist or surgeon puts a piece of gauze on top of the socket to control the bleeding. A blood clot should form. Stitches might be needed to seal the gum over the site of the extraction.

Most tooth extractions heal quickly, and there are few complications.

However, it is possible to develop a dry socket. Dry socket is a painful condition that occurs when the blood clot that formed over the extraction dissolves or dislodges and exposes the bone. If this happens, you’ll need to return to the dentist for a protective dressing that allows the formation of a new clot.

Reason for Tooth Extractions

There are several reasons why teeth need to be extracted. For example:

• Unfixable damaged or decaying tooth pain
• Crowding that interferes with procedures intended to align teeth
• The inability of a tooth to erupt because there is no room for it in the mouth
• Infection from decay or damage that affects tooth pulp and a root canal cannot fix
• Risk of infection due to a compromised immune system and a problem tooth
• Periodontal disease that has advanced to the point that teeth are loose

Types of Tooth Extractions

There are two different types of extractions. Your dentist will explain which type you need and let you know if you need to visit an oral surgeon. 

Simple Extractions

Simple extractions are those performed without an incision or any other special tooth removal techniques. Most dentists perform simple extractions, but there are some simple extraction cases referred to oral surgeons.

Most simple extractions require only a local anesthetic to numb the area around the affected tooth, including the gum, jaw bone, and teeth. The process is not painful, but you’ll feel a lot of pressure during the removal process.

Some dentists refer patients in need of more complicated tooth extraction to an oral surgeon. For example, broken or decaying teeth, teeth that cannot be grabbed with forceps, and fragile teeth often require surgical removal. A tooth’s shape, size, and position also affect whether someone needs simple or surgical extraction.

There are rarely any serious complications from a simple extraction, and they tend to heal within ten days.

Surgical Extractions

Teeth can be removed by an oral surgeon or a general dentist.

An oral surgeon has specialized knowledge and experience to perform this type of removal safely. General dentists are also qualified to perform tooth extractions. Surgical extractions tend to take longer, and the procedure may include the use of a general anesthetic.

Just how complicated a surgical extraction depends on several factors, including:

• Location and position of the tooth
• Length and curvature of the roots
• Presence of previous root canal treatments (makes roots brittle and more likely to break)
• The thickness of the bone around the affected tooth
• Patient’s overall physical health

Removal of gum tissue and/or bone is needed in many surgical extractions.

Wisdom Teeth Extractions

Wisdom teeth are one of the most common reasons people have teeth extracted.

Wisdom teeth are the four adult teeth located at the back top and bottom of the mouth. It’s common for wisdom teeth to have difficulty erupting because there is not enough space in the mouth.

They often cause pain, infection, and other dental problems.

Many people have their wisdom teeth extracted as a precautionary measure to avoid future dental health problems. This is especially true for impacted wisdom teeth. The growth of a wisdom tooth is problematic if it is growing at an angle and affecting other teeth or if it is trapped in the jawbone. 

Tips: Preparing for a Tooth Extraction

Knowing how to prepare for a tooth extraction eases anxiety about the procedure and ensures the removal goes as smoothly as possible.

Keep in mind, like all medical procedures, the healthier you are, the better your odds at a full recovery with as few complications as possible. Eating healthy and getting enough exercise is the best way to prepare your body to heal from any procedure or trauma and fight off potential infections.

To prepare for tooth extraction, you’ll want to:

• Refrain from using OTC medications and supplements that act as blood thinners. Speak to your doctor if you are using prescription blood thinners.
• Eat a normal meal on your typical schedule to ensure normal blood sugar levels. If you are opting for laughing gas (nitrous oxide), then you should not eat anything for at least 2 hours prior to the procedure. You don’t want to feel stuffed during the procedure, but you won’t be able to eat for several hours after. So, you need enough to ward off nausea from hunger and keep you full until you can eat. Most dentists recommend waiting about five hours before eating soft foods.
• Ask your dentist to explain the extraction process step-by-step before he or she begins. This way, you’ll know what happens. Don’t be afraid to ask questions or express our concerns once the procedure starts. 

Risks & Complications of Tooth Extractions

Tooth extractions are a standard dental procedure and usually occur without any significant complications. However, like all medical procedures, there are risks. 

The most common risk of tooth extraction is a dry socket. Although dry socket is painful, if treated quickly, it’s rarely serious.

Some of the most serious risks associated with tooth extraction include:

• Jaw fracture
• Damage to teeth surrounding the extracted tooth
• Sinus hole when the tooth extracted is in the upper back of the mouth
• Ongoing numbness that, in very rare cases, can be permanent

Recovery Timeline 

It doesn’t take very long to recover from an extracted tooth. However, it’s important to ease back into your routine after extraction to avoid unnecessary risks and pain.

During the first and second days after an extraction, you might experience mild bleeding. This will stop once a blood clot forms.

During the first 24 to 48 hours after the extraction, it’s essential to:

• Get plenty of rest
• Change gauze when needed
• Avoid rinsing
• Do not drink out of straws
• Do not spit
• Do not suck on anything
• Use cold compresses to ease swelling and pain
• Keep your head elevated
• Avoid sneezing and blowing your nose
• Do not smoke
• Use an ice pack
• Use OTC pain relievers to reduce pain and inflammation
• Take any other prescription or OTC pain medications your dentist recommends
• Eat only soft foods, including yogurt, Jello, pudding, smoothies, etc.

It can take up to 2 weeks for the extraction site to heal, even if there were no complications. During this time, you’ll want to continue eating mostly soft foods and/or avoid biting and chewing on the extraction site. 

You can return to brushing and flossing as usual, but avoid the area of the extracted tooth until you are sure it has completely healed. Instead, gently rinse with salt water once you know the blood clot has formed to reduce your risk for infection.

Your doctor might have additional instructions for you to follow.