There are times when a dental extraction – the removal of a tooth – is necessary. The most common reason for extraction is tooth damage due to breakage or decay.
Common reasons for tooth extraction:
- Tooth decay. At times, a tooth may have so much decay that it puts the surrounding teeth and jaw at risk of decay.
- Dental trauma.
- Periodontal disease
- In orthodontics, if the teeth are crowded, sound teeth may be extracted (often bicuspids) to create space so the rest of the teeth can be straightened.
- Infection or problems with a wisdom tooth.
- Sometimes a baby tooth is misshapen or has long roots that prevent it from falling out as it should, and the tooth should be removed to make way for the permanent tooth to erupt.
When a tooth needs to be removed, your dentist may extract the tooth during a regular checkup or may schedule another visit for this procedure. Simple extractions are performed on teeth that are visible in the mouth, usually under local anesthetic.
The root of each tooth is encased within the jawbone in a “tooth socket,” and your tooth is held in that socket by a ligament. Typically the tooth is lifted using an elevator, grasped using dental forceps, rocked back and forth until the ligament has been adequately broken, and the supporting bone has been sufficiently widened to make the tooth loose enough to remove. Typically, when teeth are removed with forceps, slow, steady pressure is applied with controlled force.
Immediately after the tooth is removed, a bite pack is used to apply pressure to the tooth socket and stop the bleeding. It is important not to disturb the blood clot in the socket. Do not touch the area with a finger or the tongue, avoid vigorous rinsing of the mouth and avoid strenuous activity. If the blood clot is dislodged, bleeding can restart. This is called “dry socket”, which can be very painful and lead to delayed healing. Don’t smoke for at least 24 hours because it impairs wound healing and makes dry socket significantly more likely.
Once a tooth has been removed, neighboring teeth may shift, causing problems with chewing or with your jaw joint function. To avoid these complications, your dentist may recommend that you replace the extracted tooth with an implant or a bridge.