A tooth extraction is the removal of a tooth from its socket in the jawbone, often necessitated by decay, infection, or overcrowding. The professional who performs the extraction depends on the complexity of the case. Simple removals are handled by your primary dental provider, while more involved situations require the expertise of a specialized surgeon.
General Dentists and Simple Extractions
A General Dentist routinely handles simple extractions in their standard office setting. A simple extraction involves a tooth that is fully erupted, visible above the gum line, and has a stable root structure. This procedure relies on luxation, the gentle loosening of the tooth within its socket.
The process begins with administering a local anesthetic to numb the area. The dentist uses an elevator tool to loosen the tooth by separating the periodontal ligaments holding it in place. Specialized extraction forceps then grasp the tooth crown and carefully remove it from the socket. This non-surgical approach is quick and typically involves a short recovery period.
Specialist Care for Complex Extractions
When an extraction is complex, a referral is made to an Oral and Maxillofacial Surgeon (OMFS). This specialist handles teeth that are not easily accessible. A common complex case is an impacted tooth, such as a wisdom tooth, which is trapped fully or partially beneath the gum tissue or jawbone.
Complex scenarios also include teeth with fractured roots, teeth broken off at the gum line, or those with unusual root anatomy like severe curves or deep proximity to nerves or sinuses.
The OMFS completes four to six years of additional hospital-based surgical and anesthesia training after dental school. This training qualifies them to perform surgical extractions. These procedures may require an incision into the gum, removal of bone surrounding the tooth, or sectioning the tooth into smaller pieces. Complex procedures often require deeper sedation or general anesthesia, which the OMFS is certified to administer.
Essential Post-Procedure Care
Proper care following the procedure promotes healing and prevents complications like alveolar osteitis, commonly known as dry socket. A gauze pad is placed over the site, and biting down firmly for 30 to 45 minutes helps a blood clot form, which is the foundation of healing. Maintaining this clot is necessary, so patients must avoid actions that create suction, such as smoking or drinking through a straw, for at least 48 hours.
Initial pain is managed with over-the-counter pain relievers or prescribed medication as the local anesthetic wears off. Swelling is a normal inflammatory response and can be minimized by applying an ice pack to the cheek near the extraction site for 15 minutes on and 15 minutes off during the first 24 to 48 hours. Physical activity should be limited during this initial healing phase, and the diet should consist of soft foods to avoid disturbing the wound. After the first 24 hours, gentle rinsing with a warm salt water solution can begin to keep the area clean.