When it comes to dental procedures, tooth extraction — or having teeth “pulled” is among patients’ most dreaded prospects. Also referred to as exodontia, tooth extraction involves removing a tooth from its socket in the jaw bone. Before your dentist considers extraction, every effort will be made to try to repair and restore your tooth. However, sometimes it is necessary.
Reasons for Extraction
- Severe Tooth Damage/Trauma – Some teeth have such extensive decay and damage (broken or cracked) that repair is not possible. For example, teeth affected by advanced gum (periodontal) disease may need to be pulled. As gum disease worsens, the tooth, supported by less surrounding bone, — often loosens to such an extent that extraction is the only solution.
- Malpositioned/Nonfunctioning Teeth – To avoid possible complications that may result in an eventual, negative impact on oral health, your dentist may recommend removing teeth that are malaligned and/or essentially useless (teeth that have no opposing teeth to bite against).
- Orthodontic Treatment – Orthodontic treatment, such as braces, may require the removal of teeth to make needed space for improved teeth alignment.
- Extra Teeth – Also referred to as supernumerary teeth, extra teeth may block other teeth from erupting.
- Radiation – Head and neck radiation therapy may require the extraction of teeth in the field of radiation in order to help avoid possible complications, such as infection.
- Chemotherapy – Chemotherapy weakens the immune system, increasing the risk of tooth infections, heightening the risk of extraction.
- Organ Transplant – Immunosuppressive medications prescribed after organ transplantation can increase the likelihood of tooth infection. As such, some teeth require removal prior to an organ transplant.
The 2 types of Extraction
When you undergo a tooth extraction procedure, your dentist will numb the area with a local anesthetic. You may also receive an anti-anxiety medication or an intravenous sedative. If the dental extraction involves an impacted tooth, the tooth may be broken into pieces before it is removed.
Pulling teeth falls into two basic categories: simple and surgical. Here’s what to expect from each:
- Simple Extractions – A simple tooth extraction involves the removal of a tooth that is visible in the mouth. This could mean removing a badly damaged or decayed tooth, or removing teeth prior to getting braces. General dentists can do simple tooth extractions. When you undergo simple tooth extractions, you will receive local anesthesia. In addition, some dental professionals administer anti-anxiety medication or use conscious sedation for simple cases of pulling teeth. In most cases, over-the-counter pain medication is sufficient for pain management after these procedures.
- Surgical Extractions – A surgical tooth extraction is an operation by an oral surgeon involving removal of teeth that are not visible in the mouth, because they have not come in or because the tooth has broken off. Individuals with special medical conditions may receive general anesthesia when pulling teeth involving surgery. You may also receive prescriptions for pain medication to use immediately after surgical teeth-pulling procedures.
Your dentist will explain how to prepare for your procedure. They’ll ask about your dental and medical history. It’s important to let them know about any medical conditions, allergies or recent surgery, as well as any medicines you’re taking.
Your dentist will discuss with you what will happen before, including any pain you might have. If you’re unsure about anything, ask. No question is too small. Being fully informed will help you feel more at ease and will allow you to give your consent for the procedure to go ahead.
You’ll usually have your tooth (or teeth) removed under a local anaesthetic. This completely blocks pain from your gums, although you’ll still feel pressure. You’ll stay awake during the procedure, so you’ll be aware of what’s happening. If you’re very anxious about having your tooth removed, it might be possible to have a sedative, which relieves anxiety, makes you feel sleepy and helps you to relax.
Having a general anaesthetic for an extraction is usually only an option for young children or adults with learning disabilities. However, your dentist may decide it’s right for you if several of your teeth need to be removed, or the extraction is going to be more difficult than usual.
If you’re going to have a general anaesthetic, your dentist will refer you to a hospital to have your procedure.
- Once you’re sitting comfortably in a chair, your dentist will inject a local anaesthetic into the area around your tooth or teeth. They’ll wait a few minutes to allow the injection to work and ask you a few questions to see if it’s taking effect.
- The roots of your tooth sit in a socket (hole) in your gum. Your dentist will widen your tooth socket and gently loosen your tooth before they remove it. Sometimes your dentist may need to put a stitch in the empty socket to help it heal.
- You’ll feel some pressure in your mouth when you have a tooth removed but it shouldn’t be painful. If you do feel any pain, let your dentist know straightaway.