Tooth Extractions

Reasons for Dental Extractions

Having a tooth pulled may be necessary for a variety of reasons. Typically. tooth extractions are needed because a tooth has become badly damaged, possibly from decay or trauma and can no longer be repaired. Other reasons may include:

A crowded mouth: By removing teeth, the dentist can create more room in a mouth. Likewise, a tooth that has not erupted or fully erupted (broken through the gum) may be suggested to be removed — this a common reason for wisdom teeth to be removed.
Infection or risk of infection: If an infection extends into the pulp of a tooth and cannot be corrected by root canal therapy, extraction may be the course of action. The same goes if you have a risk of infection and your immune system is compromised, for instance, because of chemotherapy or an organ transplant.

What to Expect with Tooth Extraction

Tooth extractions are common and typically a very safe procedure. But the procedure can allow harmful bacteria into the bloodstream and create an increased risk of gum infection, because of this you may be prescribed an antibiotic before and/or after an extraction. When planning to have a tooth extracted, make sure to tell the dentist your complete medical history, the medications and supplements you take, and if you have any heart complications, an impaired immune system, liver disease, any artificial joints (such as a hip replacement), or a history of bacteria endocarditis.

Tooth Extraction Procedure

Only dentists and oral surgeons perform tooth extractions. Before pulling a tooth, the dentist will provide an injection of local anesthetic to numb the area around the tooth being removed. Occasionally, a dentist may use a stronger general anesthetic. This will cause you to sleep during the procedure and prevent any pain.

If you have an impacted tooth, commonly found with wisdom teeth, the dentist will cut away the gum and bone tissue that cover the impacted tooth, then using forceps, gently grab the tooth and rock it back-and-forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a tooth that is hard to pull must be removed in pieces.

Once a tooth has been pulled, a blood clot will form over the bone and the dentist will cover the socket (the hole where the tooth once was) with gauze and have you bite down on it to help stop the bleeding. The dentist may additionally place a few stitches to close the socket.

If the blood clot in the socket breaks loose, the bone will be exposed and will cause a painful condition called dry socket. If this happens, the dentist may place a medicated dressing over the exposed socket for a few days to protect the bone and socket as a new clot forms.

Some studies have shown a link between oral contraceptives and dry socket. In addition, some medications may prevent a proper blood clot from forming. Ask the dentist if you are at risk.

Cost of Tooth Extractions

The cost of a tooth extraction depends on a variety of factors, and therefore can only be determined with an exam by the dentist. If a tooth extraction requires surgical removal using anesthesia this will cause the price to increase

Emergency Tooth Extraction

It is best practice to try and restore a tooth whenever possible, but emergency or same-day tooth extractions, including emergency wisdom tooth removal, are sometimes necessary.

Aftercare for a Tooth Extraction

After a tooth extraction, the dentist will send you home. Recovery typically takes a few days. Here are a few tips to help ease any discomfort, reduce the risk of infection and speed up recovery.

Take prescribed painkillers and antibiotics as directed by the pharmacist. If over-the-counter pain medication is suggested, like Tylenol, be sure to take it every four hours or as directed to be proactive and stay ahead of the pain.
Bite firmly but gently on the gauze pad placed by your dentist to allow a clot to form in the tooth socket. Leave the pad in place for three to four hours after the extraction. If the pad is becoming blood-soaked, change it out with a new gauze pad once home.
Apply an ice bag, externally, to the affected area immediately after the procedure to keep swelling down. Apply ice in 10-minute increments.
Take it easy and relax for 24 hours after the extraction. Limit any strenuous activity for a couple of days after your procedure.
Avoid rinsing or spitting forcefully for 24 hours after extraction and DO NOT suck from a straw to avoid dislodging the clot that forms in the socket, which will cause a dry socket.
After 24 hours, rinse your mouth out with a solution of salt and water (1/2 tsp. of salt with 8 oz. of water).
DO NOT smoke tobacco.
Keep the head elevated. When lying down prop your head up with a pillow. If lying flat, it may prolong bleeding.
Continue brushing and flossing, very gently, including brushing the tongue. Be sure to avoid the extraction site. Having a clean mouth will help prevent future infection.
Eat soft foods like soup, yogurt, mashed potatoes and applesauce.
Drink plenty of fluids, stay hydrated and keep your mouth moist. Avoid carbonated beverages and alcohol for at least four days following your extractions. Water, juice, milk and Gatorade/PowerAde are the best options for post tooth extraction.

Should You Call the Dentist for a Follow Up?

As a general rule, we recommend you call your local dental office whenever you feel pain or discomfort when evaluating your oral health. After a tooth extraction procedure is completed, it is possible that an infection develops if proper tooth extraction aftercare is not maintained. Should you suspect that you have an infection at the site of the removed tooth/teeth, call your dentist to schedule a follow up appointment and to discuss treatment options for the infection.

FAQs: Tooth Extraction

In addition to the information above, we welcome you to read the below frequently asked questions about tooth extractions for added reference.

How Long Does a Tooth Extraction Take to Heal?

Patients can expect a dental extraction healing time anywhere from two to four days. We recommend this tooth extraction recovery time to patients so that a blot clot at the site of the extracted tooth can form and the area of the gum line where the tooth used to be can heal.

How Painful is a Tooth Extraction?

Prior to the procedure and consulting your treatment plan, your dentist may offer you an anesthetic that will limit the pain you feel. After the procedure, we recommend patients stay ahead of any possible post-tooth extraction pain, either by taking prescribed painkillers and antibiotics, as directed, or by taking over-the-counter pain medication, like Tylenol, as suggested.

What Can You Not Do After a Dental Extraction?

After a dental extraction, we suggest patients follow our tooth extraction aftercare guide mentioned above, which includes avoiding strenuous activities, easing the force of rinsing and spitting when brushing your teeth, and avoiding tobacco products.