Tooth extraction is a common dental procedure involving the removal of a tooth from its socket. It is often necessary to maintain or restore oral health, alleviating pain, preventing infection, and addressing dental issues.
Who Performs Tooth Extractions
Tooth extractions are performed by general dentists and oral surgeons, depending on case complexity. General dentists handle simple extractions, involving visible, easily accessible teeth. These include loose teeth or those removed without significant surgical intervention.
Oral and Maxillofacial Surgeons undergo four to six years of specialized surgical training after dental school. They manage complex extractions, such as impacted wisdom teeth, teeth broken below the gumline, or those with unusual root structures. Oral surgeons also administer various types of anesthesia, including IV sedation and general anesthesia, for involved procedures.
Reasons for Tooth Extraction
Several conditions can necessitate a tooth extraction. Severe tooth decay is a primary reason, particularly when cavities progress beyond repair by fillings or root canals. Advanced periodontal disease, or gum disease, can also lead to extraction as it destroys supporting bone and tissues, causing teeth to loosen.
Impacted teeth, such as wisdom teeth not fully erupting due to lack of space, require removal to prevent pain, infection, or damage to adjacent teeth. Overcrowding, where insufficient jaw space exists for all teeth, may also necessitate extractions, particularly for orthodontic treatment to create room for proper alignment. Dental trauma, such as a severely fractured or damaged tooth, can make extraction the only viable option if the tooth cannot be salvaged.
The Extraction Process
The tooth extraction process begins with anesthesia to ensure patient comfort. For simple extractions, local anesthesia numbs the tooth and surrounding gum tissue, allowing the patient to remain awake but pain-free. In complex or surgical cases, oral surgeons may use intravenous (IV) sedation or general anesthesia, inducing a deeper state of relaxation or unconsciousness.
Once numb, the dentist or oral surgeon uses specialized instruments. An elevator gently loosens the tooth by wedging it between the tooth and surrounding bone, expanding the socket. Forceps then grasp the loosened tooth and remove it from its socket. For surgical extractions, an incision may be made to access the tooth, and it may need to be sectioned into smaller pieces for easier removal. After removal, the site is cleaned, and if a surgical extraction was performed, stitches may be placed to aid healing.
Aftercare and Recovery
Proper aftercare is important for recovery following a tooth extraction. Immediately after the procedure, a gauze pad is placed over the extraction site; biting down for 30 to 45 minutes helps form a blood clot. Managing pain and swelling is also part of aftercare; over-the-counter pain relievers can be used, and applying an ice pack to the face for 20-minute intervals can help reduce swelling.
Patients should maintain gentle oral hygiene, avoiding vigorous rinsing or spitting for at least 24 hours to prevent dislodging the blood clot. Eating soft foods for the first few days, such as yogurt, applesauce, and mashed potatoes, is recommended, while hard, crunchy, or sticky foods should be avoided. Avoid using straws and smoking, as suction can disrupt the blood clot and lead to a painful condition called dry socket. Most feel better within a few days, with the extraction site healing significantly within one to two weeks, though bone healing can take several months.