An extraction is the removal of a tooth. Some extractions are “simple”, and others are “surgical”. Teeth are held in the jawbones by the attachment of ligaments and gum tissue. When dentists extract a tooth, they are detaching it from those connecting tissues and removing it from the jawbone.
Why Are Extractions Necessary?
Extractions are necessary to remove the threat of dangerous infections in the body. When a tooth has a poor or hopeless long-term prognosis, extracting it is the only way to ensure no long-term problems develop.
There are several scenarios that give a tooth a poor or hopeless long-term prognosis:
- A cavity so large that there is not enough healthy tooth structure left over to support a crown
- Severe gum disease that has destroyed all of the surrounding bone
- A crack that spreads onto the root of the tooth
- A cavity located in an area of the tooth that is impossible to keep clean and cavity-free (for example, on the root surface below the gums)
Sometimes a tooth has a slightly better prognosis even though it has a dangerous infection. When the nerve and blood vessel tissue in the hollow chamber of a tooth become infected, you have two treatment options:
- Extraction – remove the entire tooth
- Root Canal Treatment – remove the infected tissue within the tooth
If you have enough healthy tooth structure to save the tooth, we will give you the choice between extracting the tooth and saving it with a root canal. If you choose to extract the tooth, we will always give you multiple options to replace it, such as a dental implant with a dental crown.
How Extractions Work
As we stated earlier, the dentist detaches the tooth from its connection to the jawbone. The simplest explanation is that we make the tooth loose by applying pressure to it. Through three dimensional x-ray technology, we know the exact structure of the tooth’s roots, and we use that knowledge to apply the right pressure.
Ironically, the healthier the structures around the tooth are, the more difficult the tooth is to extract. When disease has eroded the gum and bone around a tooth, it is actually very simple to extract.
The Extraction Process
During a tooth extraction, you should feel no pain! We use local anesthetic to make the entire area around the surgical site completely numb. This numbness does not remove the sensation of pressure, though.
As the dentist works to remove your tooth, you may feel pushing or pressure. If you feel any pain at all, you simply tell us, and we will do whatever is necessary to make you comfortable. Sometimes that involves adding more local anesthetic, and sometimes it simply means taking a break from the pressure.
If the thought of a tooth extraction makes you anxious, we can provide anti-anxiety medication, which is preferable to being sedated during the extraction.
Healing from a Tooth Extraction
Following your dentist’s post-operative instructions closely is the most important step in the healing process. In order to heal properly, the socket (which previously held the tooth’s roots) must fill with blood and form a clot. Most of your post-op instructions are aimed at protecting that blood clot.
A blood clot from an extraction socket that dislodges or dissolves leads to a condition known as “dry socket”. Dry socket is extremely painful and usually preventable. These important post-op instructions work to lower your risk for dry socket. The first two protect against dislodging the blood clot with a sucking force, and the next two protect against dissolving the blood clot with fizzy drinks or alcohol.
- No drinking through straws
- No smoking
- No carbonated drinks
- No alcoholic drinks (including mouthwash with alcohol)
Smoking, trauma, using straws, and poor oral hygiene have all been demonstrated to increase your risk of dry socket. So be sure to follow these instructions closely!
Another important aspect of healing involves supporting your overall immune health. Make sure to eat a healthy, balanced diet that is low in sugar while you are healing from any surgery!