An infected tooth, often called a tooth abscess, is a bacterial infection reaching the tooth’s innermost part, the pulp. The pulp contains nerves, connective tissue, and blood vessels. Bacteria typically invade this area through deep cavities, cracks, or injuries, causing inflammation and forming a pus pocket.
If untreated, a tooth infection can cause severe pain and spread beyond the tooth. It can extend to surrounding bone, gum tissues, or, in rare cases, to other parts of the body. An infected tooth will not heal on its own. Extraction eliminates the bacterial source, providing pain relief and preventing further spread.
The Extraction Process
Tooth extraction involves a procedure to safely remove the affected tooth and any surrounding infected tissue. Before starting, the dentist administers a local anesthetic to numb the area. This prevents pain during extraction, though pressure may still be felt.
Once numb, the dentist loosens the tooth from its socket using specialized instruments. A rocking motion often expands the socket. Procedure duration varies by tooth position and root complexity, but it is generally quick.
The goal is to remove the infected tooth, pus, and infected material from the socket, eliminating the bacterial source. For severe infections, the dentist may also clean the area to remove residual infected tissue.
Immediate Healing and Aftercare
Immediately after extraction, patients can expect some bleeding, swelling, and discomfort as the local anesthetic wears off. Initial healing relies on a blood clot forming in the empty socket. This clot acts as a protective barrier for proper healing.
To manage pain, over-the-counter pain relievers like ibuprofen or acetaminophen are often recommended. Control bleeding by gently biting on a gauze pad over the extraction site for 30-45 minutes, replacing as needed. Reduce swelling by applying an ice pack to the cheek for 10-20 minutes during the first 24-48 hours.
To maintain the blood clot, avoid vigorous rinsing, spitting, or using straws for at least 24 hours. These actions can dislodge the clot, leading to complications. Eat soft foods and liquids for the first few days, avoiding hot beverages and alcohol. Gentle oral hygiene, like carefully brushing teeth while avoiding the extraction site, promotes healing.
Potential Risks and Complications
Tooth extraction carries some potential risks and complications. A common issue is dry socket (alveolar osteitis). This occurs when the blood clot in the socket dislodges or dissolves prematurely, exposing underlying bone and nerves. Dry socket causes intense pain, often radiating to the ear, and may be accompanied by an unpleasant taste or odor, often developing a few days after extraction.
A rare but serious complication is the spread of infection. If the infection was widespread or residual bacteria remain, it can spread. This includes adjacent teeth, the jawbone, or, in severe cases, distant body parts. Symptoms like persistent fever, increased swelling, or difficulty swallowing indicate a spreading infection and require immediate dental attention.
Nerve damage is another rare risk, especially with lower wisdom tooth extractions, where a nerve providing sensation to the lip and chin is nearby. This damage is usually temporary, causing numbness, but can rarely be permanent. For upper molars, a slight risk exists for sinus perforation, a small opening between the extraction site and the maxillary sinus. This often heals naturally but may need treatment if it persists.
Excessive bleeding or swelling not subsiding after 24-48 hours is a concern. Diligently following aftercare instructions minimizes these risks and promotes a smooth recovery.
Other Treatment Options
While extraction is a definitive solution, it is not always the only option for an infected tooth, especially if it can be saved. A common alternative is root canal therapy (endodontic treatment). This procedure eliminates infection from inside the tooth while preserving its structure. During a root canal, the infected pulp is removed, the tooth’s inner chamber is cleaned, disinfected, filled, and sealed.
Antibiotics may be prescribed to control infection, either before a dental procedure or with other treatments. However, antibiotics alone do not eliminate the infection source within the tooth, so they are part of a broader treatment plan. The decision between extraction and other treatments depends on several factors, including the infection’s extent, remaining healthy tooth structure, and the patient’s overall health.
A dentist evaluates these factors to determine the most appropriate action, prioritizing saving the natural tooth when feasible. If the tooth is too damaged or the infection too extensive, extraction becomes necessary.
Life After Tooth Removal
After an infected tooth is removed and the extraction site heals, longer-term oral health considerations arise. The empty space can lead to several oral changes over time. Adjacent teeth may shift into the gap, affecting bite alignment and creating new spaces for food traps, increasing decay or gum disease risk for other teeth.
Jawbone loss is another long-term implication. The bone supporting the extracted tooth no longer receives chewing stimulation, causing it to resorb or shrink over time. This bone volume reduction can impact surrounding teeth stability and alter facial structure.
To prevent these issues, tooth replacement options are recommended. Dental implants, bridges, or partial dentures can fill the gap, maintain remaining teeth alignment, and preserve jawbone density. Replacing the missing tooth also restores chewing ability and prevents changes to facial aesthetics. The choice of replacement depends on individual needs, oral health, and financial considerations.