Dental Extractions: What to Expect and Why They’re Necessary

Tooth extractions are a common dental procedure, but they can feel daunting if you don’t know what to expect. Whether your extraction is planned or the result of a dental emergency, understanding the process can help you feel more prepared and at ease.

Below we’ll cover everything you need to know about tooth extractions, from why they may be necessary to the process itself.

Reasons for tooth extractions

Dentists typically recommend tooth removal for a variety of reasons, including:

• Severe tooth decay: When a cavity progresses to the point that it damages a tooth beyond repair, an extraction might be necessary to prevent further complications like infections.
• Periodontal disease: Advanced gum disease can weaken the structures supporting a tooth, making extraction the best option to preserve the surrounding teeth and gum tissue.
• Crowding and orthodontic treatment: In some cases, teeth may need to be removed to create space for proper alignment during orthodontic treatment, ensuring a straight and healthy smile.
• Impacted teeth: Wisdom teeth and other teeth that are unable to fully emerge can cause pain, infection or damage to neighboring teeth, warranting their removal.
• Trauma or injury: Teeth that are severely cracked, fractured or damaged from accidents may not be salvageable and need extraction to maintain oral function.
• Infection risk: In patients with compromised immune systems or other health conditions, removing a problematic tooth can help prevent infections that might otherwise spread.
  

In the hands of a skilled dentist or oral surgeon, extractions can pave the way for a healthier and more comfortable smile. 

Extraction procedure

Understanding what happens during a tooth extraction can help ease any anxiety and prepare you for the process. While every case is unique, most extractions follow these general steps:

1. Preparation and numbing

Before the procedure, your dentist or oral surgeon will review your medical history and take x-rays to assess the tooth and surrounding structures. A local anesthetic is then applied to numb the area, ensuring you remain comfortable throughout the procedure. For more complex extractions, such as impacted teeth, sedation options may be offered.

2. Loosening the tooth

For a simple extraction, the dentist uses a tool called an elevator to gently loosen the tooth from the surrounding gum and bone. This step makes it easier to remove the tooth with minimal pressure.

3. Removing the tooth

Once loosened, the tooth is carefully removed using forceps. In surgical extractions, a small incision may be made in the gum tissue, and the tooth might be broken into smaller pieces for easier removal. 

4. Stopping bleeding

After the tooth is removed, the dentist will place gauze over the extraction sit to control bleeding and promote clot formation, which is crucial for proper healing. 

5. Closing the site (if necessary)

In cases of surgical extractions, dissolvable stitches may be used to close the gum tissue and protect the area as it heals.

Potential risks and complications

While tooth extractions are generally safe when performed by a qualified dentist or oral surgeon, like any medical procedure, they come with some potential risks and complications. Being informed about these possibilities can help you recognize early signs of issues and seek prompt care if needed.

• Pain and swelling: Mild discomfort and swelling are common and typically subside within a few days, but over-the-counter pain relievers and cold compresses can help manage them.
• Infection: Persistent pain, swelling, fever or discharge are signs of infection. Proper oral hygiene and any prescribed antibiotics can help prevent or address this risk.
• Dry socket: This occurs when the blood clot protecting the site is dislodged or dissolves too early, exposing the underlying bone and nerves. Dry socket can cause intense pain and delay healing, but it can be treated by your dentist with special dressings and medication.
• Nerve damage: Rarely, neighboring teeth, gums or nerves may be affected during the procedure. This is more common with complicated extractions like impacted wisdom teeth. Your dentist takes precautions to minimize this risk. 
• Sinus issues: For upper teeth close to the sinus cavity, there is a slight chance of creating a sinus opening during extraction. If this happens, your dentist will provide appropriate treatment to resolve the issue. 
• Delayed healing: Certain factors like smoking, poor oral hygiene or underlying health conditions like diabetes can slow the healing process. Following your dentist’s aftercare instructions is crucial for a smooth recovery.

Recovery and after care

Proper recovery and after care are essential for a smooth healing process after a tooth extraction. By following your dentist’s instructions and taking steps to care for the extraction site, you can minimize discomfort and avoid complications.

Manage pain and swelling

After the procedure, it’s normal to experience some soreness and swelling. Use over-the-counter or prescribed pain relievers as directed, and apply a cold compress to the outside of your cheek in 15-minute intervals to reduce swelling.

Protect the blood clot

The blood clot that forms at the extraction site is crucial for healing. Avoid activities that could dislodge it, such as spitting forcefully, drinking through a straw or smoking for at least 48 hours.

Practice gentle oral hygiene

Keep your mouth clean by gently rinsing with warm salt water 24 hours after the extraction. Avoid brushing or flossing directly around the extraction site for the first few days to prevent irritation.

Stick to soft foods

Eat soft, cool foods like yogurt, applesauce, mashed potatoes or smoothies for the first couple of days. Gradually reintroduce solid foods as the site heals, but avoid chewing on the side of the extraction until it feels comfortable.

Follow up with your dentist

Attend any scheduled follow-up appointments to ensure the site is healing properly. If stitches were used, your dentist may need to remove them or check their progress if they’re dissolvable.

Alternatives to extractions

While tooth extractions are sometimes necessary, dentists explore all available options to save your natural tooth whenever possible. Depending on the condition of your tooth, these alternatives may be considered:

• Fillings or crowns: For teeth damaged by decay or minor fractures, restorative treatments like fillings or crowns can often repair the tooth and restore its function without the need for extraction.
• Root canal therapy: If the tooth’s pulp (inner tissue) is infected or damaged, root canal therapy can remove the infection while preserving the tooth structure. This is a common alternative to extraction for saving teeth with extensive decay or injury.
• Periodontal treatments: In cases of gum disease, scaling and root planing or gum surgery can address underlying issues, strengthen the tooth’s support and potentially save it from extraction.
• Orthodontic adjustments: If crowding is an issue, orthodontic solutions like braces or aligners may reposition teeth to make room, reducing the need for extraction in certain cases.

When to seek emergency care

While most tooth extractions are planned and routine, certain situations may require urgent attention, including:

• Intense, unrelenting pain or bleeding
• Swelling, redness, fever, chills or pus at the extraction site
• Pain radiating to the ear, jaw or temple
• Difficulty breathing or swallowing
• Broken or dislodged blood clot
• Numbness or tingling in the tongue, lips or chin

When in doubt, it’s always better to err on the side of caution. If you experience any unusual symptoms or discomfort after a tooth extraction, reach out to your dentist or an emergency dental clinic to ensure your recovery stays on track.