The most common reason for a tooth extraction is due to irreparable tooth decay which can cause a toothache and further disease. When the tooth is at a point where it cannot be repaired with a root canal, this where tooth extractions come in to play. Another reason to remove the tooth is to make room in the mouth to allow for the straightening of teeth. A wisdom tooth is also extracted if it is not positioned correctly or cause crowding.

 

Simple Extractions or Surgical Extractions

Simple Extractions

Simple extractions are performed on teeth that are visible in the mouth, usually under local anesthetic, and require only the use of instruments to elevate and/or grasp the visible portion of the tooth. Typically the tooth is lifted using an elevator, and using dental forceps, rocked back and forth until the periodontal ligament has been sufficiently broken and the supporting alveolar bone has been adequately widened to make the tooth lose enough to remove. Typically, when teeth are removed with forceps, slow, steady pressure is applied with controlled force.

 

Surgical Extractions

Surgical extractions involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line or because they have not erupted fully. Surgical extractions almost always require an incision. In a surgical extraction, the doctor may elevate the soft tissues covering the tooth and bone and may also remove some of the overlying and/or surrounding jawbone tissue with a drill or osteotome. Frequently, the tooth may be split into multiple pieces to facilitate its removal.

 

The majority of tooth extraction can be performed while the patient is awake using a local anesthetic. In some cases, there is the option of using general anesthesia.

 

What to expect following a tooth extraction?

 

Following extraction of a tooth, a blood clot forms in the socket, usually within an hour. Bleeding is common in this first hour, but its likelihood decreases quickly as time passes, and bleeding has usually stopped after 24 hours. Smoking is to be avoided for at least 24 hours and it is advised to rinse your mouth with salt water to help prevent infection. Avoid sucking of any type which includes sipping through a straw. The raw open wound overlying the dental socket takes about one week to heal. Thereafter, the socket will gradually fill in with soft gum tissue over a period of about one to two months. Final closure of the socket with bony remodeling can take six months or more.

 

During this time, it is important to think about a tooth replacement option. There are many options for tooth replacement including dentures, bridges, or implants. An extracted tooth leaves an open area in the jaw which, in time, allows the neighboring teeth to drift into the area where the tooth was extracted. This in turn, causes a chain reaction to all the surrounding teeth. Also, if you are considering placing an implant in the future, you should consider asking your dentist to place a bone graft at the time of surgery to preserve the bone width and height.