Dental Extractions

What is a dental extraction?

Dental extraction, or more commonly known as getting a tooth pulled, is the removal of the tooth from the socket in the bone. While your dentist will most likely try to save the tooth by filling, crown or other treatment, sometimes the affected tooth may be broken or damaged by decay beyond repair, which makes a dental extraction necessary.

Why is extraction necessary?

Break or Decay: A tooth that has not been properly cared for and allowed to decay beyond repair will need to be removed. The same can be said of a tooth that has been too badly damaged through some form of trauma to be repaired.

Overcrowding: Your dentist will sometimes recommend an extraction in order to make room for other teeth to erupt through the gum, or in preparation for a proper alignment by an orthodontist.

Infection/Risk of Infection: If tooth decay or damage is so great that it extends to the center of the tooth where nerves and blood vessels are housed, bacteria can enter leading to or creating risk of infection. Often this type of damage can be repaired through a process called a root canal or by antibiotics but if neither method is successful, extraction may be required to prevent the spread of infection. Risk of infection is magnified if your immune system is compromised, so in this instance your dentist may recommend forgoing treatment and opting straight for extraction.

Wisdom Teeth: Wisdom teeth that have only partially erupted, become impacted, or have come in crooked often need to be removed to avoid overcrowding or infection. Wisdom teeth usually appear between the ages of 16 and 20, but could appear much later in life or even not at all in some instances. It is very important to have your wisdom teeth status checked at each dental appointment.

What does an extraction entail?

A dentist or oral surgeon performs the tooth extraction procedure. Before the procedure begins, your dentist will give you an injection of local anesthetic to numb the area to ensure you will not feel the tooth being removed. If you are anxious or nervous about the procedure, please speak to your dentist prior to the procedure and they may be able to assist you with further medication to relax your body and allow you to sleep through the procedure. This is more common if you are having multiple teeth removed, or if the tooth is impacted. If the tooth is impacted, the dentist will cut away the gum and gently remove it from the socket. On occasion if a tooth is difficult to remove, it may need to be taken out in pieces. Once the tooth is successfully removed, a blood clot will form in the empty socket.  Your dentist will pack the socket and may be required to place a few stitches to close the extraction site. These are usually self-dissolving and do not require a return visit. Biting down on the gauze/packing will help to stop the bleeding, and you should expect to do so for several hours after the procedure. If the blood clot happens to break loose it can cause a painful condition called dry socket. If this happens, call your dentist immediately and they will put on a dressing to protect it for a few days until a new clot forms.

It is completely normal to feel some pain after the anesthesia wears off. You should also expect to see some swelling and residual bleeding for up to 24 hours after the procedure. While these residual effects are expected, if you experience severe pain or bleeding for more than four hours after your procedure you should call your dentist. It is also recommended that you call your dentist office if you experience any of the following:

  • Fever and/or chills
  • Nausea or vomiting
  • Excessive redness and/or swelling
  • Excessive discharge from the affected area
  • Chest pain or shortness of breath
  • Severe cough

If all goes well, you can expect to recover within one to two weeks. The following tips will assist you in minimizing discomfort and encourage faster recovery period:

  • Take pain medication as prescribed by your dentist.
  • Apply an ice pack to minimize swelling.
  • Avoid rinsing or spitting for 24 hours after the extraction to avoid accidently dislodging the blood clot. After 24 hours you may rinse your mouth with warm salt water to encourage healing.
  • Do not smoke
  • Eat soft foods and stay away from foods that may lodge in the socket (example: rice)
  • Do not lay flat as it may inhibit bleeding
  • Continue to brush and floss your teeth, but be careful to avoid extraction site.