Tooth Extractions

What is a dental extraction?

A dental extraction involves the removal of a tooth from your mouth, whether it's due to it being broken down, infected, or blocked from coming out, such as with a wisdom tooth.

What are the reasons tooth extractions may be necessary?

Some of the reasons that a tooth extraction might be necessary could be due to a tooth that has a large cavity in it, and unfortunately, it's so broken down that we can no longer fix it. Another reason could be that it's infected and the infection is too severe for us to fix it. Another common reason would be with wisdom teeth, where we don't have enough room for them to come out, so they're what we would call impacted teeth, and we need to remove them so that they don't damage surrounding teeth and the bone in that area. Another common situation would be children's teeth that just don't want to fall out and need a little extra help so that we can allow the adult tooth to come in properly.

What are the types of tooth extraction?

When it comes to tooth extractions, there's three main types. The first one would be a simple extraction, so that's when we're able to remove the tooth in one whole piece. It's a relatively straightforward procedure. The next one would be what's called a surgical extraction, so that's where the tooth is unfortunately broken down. We don't have enough of it to grip on to actually get it out, so we have to go in there and remove a little bit of the bone surrounding the tooth so that we have enough for us to hold on to. The last type is the removal of impacted wisdom teeth, so that one's going to be a little bit more involved, where the tooth is actually blocked from coming out and requires us to go in there, remove a bit of bone, and cut the tooth into a few pieces so that we can get it out.

When would braces require tooth extraction?

Usually, if somebody has very severe crowding, sometimes removal of premolar teeth is an option for us to create space in order to line everything up properly. That's usually going to be a last resort because we do want to hold on to as many teeth as possible, but severe crowding is an issue, this can be a feasible option. Another area in which extraction might be required is that if we have some baby teeth that are stuck in the mouth and just don't want to come out, sometimes the orthodontist will want us to remove the baby teeth so that we can create space for the adult teeth to come in.

Is tooth extraction and filling advisable for young children?

Parents will often ask us if a tooth extraction is advisable for younger children, and it depends on the situation. With baby teeth, if we do have a cavity that's gone into the nerve and started to cause an infection, then yes, removal of that baby tooth is generally going to be the best option.

If I have gum disease, when would tooth extraction become necessary?

It depends on the situation and the severity of the gum disease. One common issue that we can have is that when gum disease gets more severe, it can start to cause quite a bit of pain around the tooth, and that is generally going to be a time that we want to remove that tooth to make sure that our patients are healthy. If we are concerned that the gum disease is starting to affect neighboring teeth, we may want to get that tooth removed because it's unfortunately just too far gone and we can't fix the tooth at that point. We don't want you to end up in a situation where instead of losing one tooth, you're losing multiple teeth.

Are all tooth extractions considered oral surgery?

If the tooth is able to come out in one piece, it's generally not considered a surgery because we are able to simply remove it and nothing else needs to be done. In situations where the teeth are more broken down or they're impacted, it would be considered a minor surgery because we do have to cut the gums back to create a flap and then remove a little bit of bone so that we can get that tooth out.

Where should I go if I need an emergency tooth extraction?

If you need an emergency tooth extraction, we would be happy to help you. Just give us a call and we will try to get you in as soon as possible. If the office is closed, one option would be to go to a local hospital, where they have oral surgeon residents on hand and they would be able to help you with this extraction. Generally, we want to try to make sure that we don't get to that point. We always like to take care of it promptly here in the office.

How long does a tooth extraction procedure take?

That really depends on the tooth. If we have a tooth that only has a single root and it’s relatively easy to remove, we can usually get that out within about 10 minutes once you are numb. If it's something that's more involved, like impacted wisdom teeth, and we have to remove all four teeth, that's going to be a bit of a lengthier appointment because it does take a little bit more time to get those out.

Will I need dental implants after a tooth extraction?

It depends on which tooth that we removed, but generally, we do want to replace those teeth with something and a dental implant is a very good option. The main reason that we want to replace missing teeth is because your teeth are all designed to carry a certain load, and if we start removing some of them, other teeth have to work harder. That can lead to them wearing down and chipping or cracking over time. Another common problem that can happen is once we remove that tooth, there's nothing in that space, so the teeth behind it are generally going to start drifting into that space. Teeth from the top can also start moving down because our teeth are always erupting, so when we remove the opposing teeth, there's nothing holding it in place, and that can create issues with how your bite is lining up and lead to teeth wearing down prematurely or cracking. That's something that we definitely want to avoid because it is very expensive for us to fix that problem down the road.

Will a dentist put me to sleep during tooth extractions?

That's generally decided on a case by case basis, but usually we don't need to put patients to sleep for tooth extractions. At our office, we offer what's called nitrous oxide or laughing gas sedation. The nice part about that is that you are still awake during the procedure, but it helps to take the edge off so you're not feeling as anxious during the procedure. For patients who are very anxious, typically those who need to have four impacted wisdom teeth removed, we can refer you to an oral surgeon for IV sedation. That's not the same as going to sleep, but it is going to help even more so that you don't remember that procedure and don't have as much anxiety during the procedure.

How do I brush my teeth after a tooth extraction?

I always tell patients to brush their teeth as normal, just stop half a tooth short of the area where we removed the tooth. It is going to be tender in that area for the first few days, so I recommend avoiding it for that period of time. Once things are starting to feel a little bit better, you can use your best judgment as to how you're going to clean the area. One thing to always remember is that the body is very good at healing itself, so we don't want to go around digging in that extraction socket as that's only going to delay healing. You want to allow your body to heal normally the way that it should.

What should I know about tooth extraction aftercare and recovery?

Whenever we take a tooth out, we will thoroughly go over all the things that we should do in order for you to recover properly. We also make sure that we give you a handout that you can take home, so that will also lay everything out so you can refer to that as you need. Of course, if you do have any further questions, you can always give us a call at any point and we'd be happy to help you.

Why should one avoid rinsing after getting a tooth extraction?

Generally, within the first 24 hours of removing your tooth, we want you to avoid anything that's going to create pressure in your mouth. The reason for that is that once your tooth is out, the body is going to start its healing process. Part of that healing process is forming a blood clot. During the first 24 hours, that blood clot is fairly unstable, and if we do things that create pressure in your mouth, such as rinsing, drinking through a straw or spitting, that can actually dislodge that blood clot and then end up causing something called dry socket. We want all our patients to avoid that because unfortunately, dry socket can be quite painful, and we want you to recover uneventfully.

What is a dry socket and how can I avoid it after a tooth extraction?

A dry socket is when we lose the blood clot that's inside the socket, and that allows the underlying bone to be exposed to air. That's what causes the pain associated with dry socket. In addition to not rinsing for 24 hours, not spitting, and not drinking through a straw, the other really big thing to avoid is smoking. Ideally, we don't want you to smoke for 72 hours, and that's going to significantly help to reduce the risk of you developing dry socket.

How long should I wait to exercise after a tooth extraction?

After a tooth extraction, we advise that patients should wait about 24 hours before they exercise. Just as the other things that I just listed, if you are exercising and increasing your blood pressure, it can cause dislodgement of the blood clot, so it's generally advised to avoid that for 24 hours.

How long should it take to recover from a tooth extraction?

Recovery length ties in with how easily the tooth came out. If we were able to remove it in one piece, you can generally expect some discomfort for about 24 to 48 hours that can be managed with some over-the-counter medications such as extra strength Tylenol or Advil. If it's going to be something that's more involved, like the removal of impacted wisdom teeth, I always recommend that patients have at least two days off from work or school so that they can fully recover at home. That's also going to involve us giving you some prescriptions for antibiotics and a painkiller to ensure you are comfortable after the procedure. With impacted wisdom teeth, you can expect a bit of discomfort generally up to about a week or so. Everyone is going to be different and some people are going to recover easier. Some might have a little bit of a harder time, but we'll work with you to make sure that you're as comfortable as possible.

When should I schedule an appointment for a tooth extraction?

As soon as possible. We always want to keep in mind there's a reason that we're doing the tooth extraction and that's generally going to be because the tooth is very broken down and possibly starting to get infected. We want to get that tooth out of there so that your body is able to heal and it doesn't have to continually fight off those bacteria and be in an unhealthy state.

If you do have any further questions or you are ready to take action, please give us a call at 1-204-259-3804 and we'd be happy to help.

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