While most people would prefer to keep their natural teeth for their entire life, it is sometimes necessary to have a tooth pulled in adulthood if it becomes damaged or decayed and cannot be repaired, or if there is a risk that a tooth may lead to serious infection and could negatively impact other areas of the mouth. Patients who have overcrowding in their mouth and lack the space to fit all their adult teeth may also need to have one or more teeth pulled so other teeth have room to align properly.
Tooth Infection and Extraction
Teeth are made up of three layers, the hard layer of enamel on the outside, a softer layer of dentin below the enamel, and the softest layer in the center, called the pulp. The pulp extends all the way through your tooth and connects to the jawbone, and is the location of all the nerves and blood vessels in the tooth. If you have a tooth infection that extends to the pulp, bacteria can get into that part of the tooth and cause serious pain and infection. In the early stages of infection you may be able to get it fixed with a root canal, but in severe cases where antibiotics and/or a root canal do not cure the infection, you may need to have the tooth extracted to prevent the infection from spreading.
Individuals who have a compromised immune system, such as those receiving chemotherapy treatments or preparing for an organ transplant, might also need to have a tooth extracted simply due to the risk of infection. It’s important to discuss your overall health history, your risk of infection, medications and supplements you are taking, and any current treatments you are undergoing with your dentist so you can make the best decision to preserve optimal dental and physical health. Some important conditions to discuss with your dentist prior to the procedure include:
- Damaged heart valves, or man-made heart valves
- Congenital heart defects
- Compromised immune system
- Cirrhosis (liver disease)
- Artificial joints or other past surgeries
What to Expect
At The Dental Clinic at Roseman University, our student dentists, faculty dentists, and oral surgeons can perform tooth extractions. For single tooth extractions your student dentist will give you a local anesthetic that numbs the area where he or she will remove the tooth. If you are having several teeth extracted or the tooth is not easily accessible from above the gum line (it is impacted), your dentist may recommend that you go under general anesthesia in our oral surgery department. This prevents you from experiencing too much pain and allows you to sleep through the entire procedure.
To extract the tooth your student dentist or dentist will use forceps to grasp the tooth, then gently move it back and forth until it is loose enough to come out. If the tooth is difficult to pull, your dentist may use tools to cut the tooth into pieces and remove it in smaller sections.
After Your Procedure
Once the tooth is removed, your dentist will put a gauze pad into the empty socket and ask you to bite down on it to stop the bleeding and allow your body to form a blood clot. In some cases your student dentist may also place stitches along the gum line; generally these are dissolving stitches so you don’t have to come back to get them removed.
Recovery from a dental extraction takes a few days, and during that time you can take prescribed or over-the-counter painkillers as instructed. You may also want to apply an ice pack to the area to reduce swelling and discomfort. It’s important that you rest for at least 24 hours after the procedure, avoiding any heavy lifting or aerobic activity for a few days, and avoid smoking since it can prevent healing.
If the blood clot comes out of the socket after the surgery it can lead to a painful condition called dry socket, and you will need to return to the dentist for follow-up treatment. It’s important to follow your dentist’s instructions following your procedure to properly care for the area where your tooth was extracted to avoid this and other problems.
Be on the lookout for any signs of infection such as fever, chills, nausea, vomiting, redness, or excessive swelling, and call your dentist right away if you see any of these things.
As the tooth extraction heals, new bone and gum tissue will fill in the gap where the tooth was previously. In some cases a tooth extraction can cause existing teeth to move or shift, so your dentist may recommend replacing the tooth (or teeth) with bridges, dentures, or implants.