An infected tooth occurs when bacteria invade the pulp, the innermost part of the tooth containing nerves and blood vessels. This invasion often happens through deep cavities, cracks, or chips. If untreated, the infection can spread, forming an abscess—a pocket of pus that causes pain and swelling. While professional dental treatment is required, extraction is a viable option, though not always the first. A thorough dental evaluation determines the most appropriate treatment plan.
When Tooth Extraction is Considered
A dentist may recommend extracting an infected tooth when other treatments are not feasible or have failed.
One reason is severe decay or extensive structural damage that cannot be repaired with restorative procedures like fillings. This includes deep cracks extending below the gum line or significant fracturing.
Extraction is also considered if the infection has led to a large abscess or cyst around the tooth root, indicating deep bacterial spread. If root canal therapy has been unsuccessful, extraction may be the definitive solution. This prevents the infection from spreading to adjacent teeth, the jawbone, or into the bloodstream.
Advanced gum disease (periodontal disease) can compromise a tooth’s support structures, leading to loosening and making extraction necessary if the tooth cannot be stabilized.
A patient’s overall health may also make extraction a safer choice. For example, individuals with compromised immune systems might have a higher infection risk, making extraction preferable to prevent complications.
Exploring Alternatives to Extraction
Before considering extraction, dentists explore alternatives to preserve the natural tooth.
Root canal therapy is the most common and effective alternative for an infected tooth. This procedure involves removing the infected or inflamed pulp from inside the tooth, cleaning and disinfecting the internal canals, and then filling and sealing them. The goal is to eliminate the infection at its source while maintaining the tooth’s structure and function.
Antibiotic treatment may be prescribed to reduce swelling and control infection, especially if an abscess is present. However, antibiotics alone are not a permanent solution because they cannot eliminate the infected pulp tissue within the tooth. The infection will likely return if the source is not addressed through a procedure like a root canal or extraction.
Other alternatives exist depending on the infection’s extent and damage. Pulp capping involves placing a protective material over exposed pulp to encourage healing, typically for less severe infections. Endodontic surgery, such as an apicoectomy, might be considered if a root canal has failed, involving the surgical removal of the root tip and surrounding infected tissue.
The Tooth Extraction Process for an Infected Tooth
The process of extracting an infected tooth begins with a thorough assessment by the dentist, often including dental X-rays.
Before the procedure, the area around the affected tooth is numbed with a local anesthetic. Sedation may also be offered to help anxious patients relax.
Extraction can be either simple or surgical, depending on the tooth’s condition and position. A simple extraction is performed on a visible tooth, gently loosening it from its socket.
If the tooth is severely decayed, fractured at the gum line, or impacted, a surgical extraction may be necessary. This might involve making a small incision in the gum tissue to access the tooth or dividing the tooth into smaller sections for easier removal.
After the tooth is removed, the dentist cleans and disinfects the tooth socket. A blood clot will form in the empty socket, which is important for healing. Gauze is placed over the extraction site, and the patient is instructed to bite down gently to control bleeding and promote clot formation. Stitches may be used to close the gum tissue, particularly after a surgical extraction.
Post-Extraction Care and Potential Concerns
Proper post-operative care is important following an infected tooth extraction.
Managing pain and swelling is a primary focus. Over-the-counter pain relievers and ice packs applied to the cheek can help. Swelling is normal for a few days.
Preventing a “dry socket” is a specific concern. This painful condition occurs if the blood clot in the empty socket dislodges or dissolves, exposing the underlying bone and nerves. Patients should avoid strenuous activities, spitting, vigorous rinsing, or using straws for the first 24-48 hours.
Maintaining oral hygiene is also important, typically involving gentle rinsing with warm salt water after the first 24 hours to keep the area clean.
Dietary recommendations include soft foods for the first few days, avoiding hot, spicy, or crunchy items. Patients should also avoid smoking, as it impairs healing and increases the risk of infection and dry socket.
While some mild bleeding and discomfort are expected, contact the dentist immediately for:
Persistent or worsening pain
Excessive bleeding
Swelling that increases after a few days
Pus or discharge from the site
A foul taste or odor
A fever