Did you know that 74% of adults required a tooth extraction in their lifetime? This statistic remains high due to an increase in poor dietary choices and continued neglect of proper oral hygiene, even though awareness levels are at an all time high. Permanent teeth are meant to last a lifetime. This is why dentists recommend the various ways of repairing, restoring and saving your natural tooth once it becomes damaged or loose. However, certain situations may require your tooth to be extracted.
What Is A Tooth Extraction?
Tooth extraction, also referred to as dental extraction is the removal of a tooth from its socket in the bone. There are several reasons why your dentist may recommend a tooth extraction. Here are the top 5 reasons:
Trauma or decay
If your tooth is damaged beyond repair, your dentist will recommend its removal. This prevents the decaying tooth from infecting the other teeth in your mouth.
Tooth extraction can be carried out to enhance proper alignment of your teeth. Removing a tooth creates the much-needed space to allow other teeth to move in line. Please note that extractions are a last resort when space cannot be created otherwise to straighten crowded teeth.
When the bacteria that caused your tooth to decay spreads to the tooth’s pulp, it causes infection. Your dentist may prescribe a root canal to help clear and resolve the infection. However, if the root canal and antibiotics do not salvage the situation, your tooth may need extraction.
If your tooth breaks at or near the gum, there may not be enough visible tooth structure to allow restoration. In such a case, the tooth may need to be extracted.
Advanced gum disease
In the latter stage of gum disease, your gum may recede from your teeth. Unfortunately, if your teeth become loose, it may be necessary to have them pulled out.
Procedure For A Tooth Extraction
Step 1: X-ray
Your dentist will take an x-ray of the area to determine the best way to extract the tooth.
Step 2: Numbing your tooth
The second phase includes anaesthetising or numbing up both your tooth, bone and gum tissue around it. The dentist uses an accurate technique for depositing the anaesthetic close to the nerves supplying the tooth (so that the tooth can be extracted painlessly).
Step 3: Extraction process
In this stage, your doctor will need two main tools.
- Extraction forceps
This is a pliers-like tool that your dentist will use to grasp and pull your tooth.
- Dental elevator
This equipment resembles a small screw driver. It is designed to go between a tooth and its surrounding bone. It helps the dentist to expand the socket and separate the tooth from its ligament.
Note that these tools come in various sizes to fit the different sized and shaped teeth.
This stage involves removing the tooth from its socket in the jawbone. A tooth is firmly encased in the gum socket and held in place by the ligament. To remove your tooth, your dentist enlarges the socket to separate the tooth from the ligament. The bones that encase the root of a tooth are relatively spongy. Hence, rocking the tooth back and forth against the socket walls compresses the bones, allowing for a smooth and painless extraction.
Step 4: Closing the space vacated by the tooth
Once your tooth is removed, it leaves an empty socket. Your dentist will scrape the walls of your socket to remove any infection or pathologic tissue. They will then evaluate your socket for any sharp bone edges or sinus complications. After that, they will wash the socket to remove any tooth fragment or loose bone. Finally, they will put gauze in the socket to stop bleeding.
Step 5: Controlling bleeding
Your dentist will place a folded gauze on the site of the tooth extraction and ask you to gently bite down on it to create firm pressure which controls bleeding.
Step 6: Minimizing swelling
In the event of a particularly difficult extraction, your dentist will give you an ice pack to put on your face to reduce swelling.
What You Will Feel During The Extraction
During the tooth extraction process, you will feel the back and forth pressure of your tooth but no pain. But just in case you feel pain, let your doctor know immediately.
How Long Will the Extraction Take?
On average, a simple extraction procedure takes 20 to 40 minutes.
- The numbing process takes 10 – 15 minutes
- The removal process 3 – 15 minutes
- Preoperative and postoperative procedures take anywhere between 5 to 10 minutes each
Tooth Extraction And Dental Implant Treatment
If you are contemplating replacing the extracted tooth with an implant, talk to your dentist beforehand. In many cases, it is possible to place the implant immediately or deferred by a few weeks. It may also be possible to place a bone graft in the socket to prevent the bone shrinking and facilitate implant placement in the future.
What Is The Difference Between A “Simple Extraction” & A “Surgical Tooth” Extraction?
A simple extraction
This type of extraction is performed on a tooth whose structure is visible in the mouth and can be done by a general dentist.
A surgical extraction
A surgical removal is a more complicated procedure that is performed by an oral surgeon. It is done when a tooth has broken at the gum line or when the tooth has not come into the mouth yet. As part of this procedure, the qualified dentist or maxillofacial surgeon makes a small incision into your gum. Sometimes, the surgeon may need to cut your tooth in two or remove some of the bone around it to allow extraction.
What To Do After A Tooth Extraction
Having a tooth taken out is a minor surgery. You should, therefore, expect some mild discomfort. Immediately post tooth extraction, your dentist will give you detailed instructions on what to do. Some of them include:
- Only eat soft and cold foods for the first few days after the procedure
- Gently rinse your mouth with warm salty water after 24 hours to keep the area clean
- Use ice packs to reduce the swelling
- Smoking, forceful spitting and straw use are forbidden post treatment. Doing any of this may remove the blood clot from the extraction location causing you to bleed
- Continue to brush and floss your teeth but avoid the extraction area for a few days post extraction.
- Your doctor may also prescribe an over the counter pain reliever such as ibuprofen for several days
What Risks Are Associated With Tooth Extraction?
Below is a list of risks associated with both a simple and a surgical tooth extraction. They include;
- Dry socket – This condition occurs in about 3% of all tooth extraction cases. Dry socket occurs when a blood clot forms in the hole or when the blood clot breaks off too early.
- Infection – if you do not follow good oral hygiene, you may develop an infection around the extraction area.
- Incomplete extraction– This occurs when part of the extracted tooth remains in the jaw.
- Accidental damage to the teeth or the surrounding nerves
To avoid complications after a tooth removal procedure, make sure to follow your doctor’s post extraction regimen and practice good oral hygiene.
When Should You Contact Your Dentist After An Extraction?
It is normal to feel some pain and discomfort after the surgical anaesthesia wears off. You can also expect some residual bleeding and swelling. However, if the pain and bleeding are still persistent 5 hours after the extraction procedure, it is important that you call your dentist. Other signs that could warrant you to call your dentist include:
- Fever and chills – this could be a sign of an infection
- Nausea or vomiting
- Chest pain, coughs and difficulty breathing
- Redness, inflammation or excessive discharge from the extraction area
- If the swelling around the extraction area becomes amplified
Tooth Extraction Healing Time
After a tooth is extracted, it leaves a hole in the jawbone. In time, this gap becomes smooth and gets filled with bone. While the healing process may take weeks (sometimes months), happily, you should no longer experience any inconvenience after 1-2 weeks of extraction.
Book Your Dental Checkup Today
If you would like to avoid a tooth extraction, we advise regular dental checkups along with twice-daily brushing and flossing of your teeth. You can book your appointment at Savina Dental Clinics (both Malta & Gozo) using this form.
Dr Joseph Xuereb
Dental & Implant Surgeon. Principal
Savina Dental Clinics