Extractions

Tooth extraction, the removal of a tooth from its socket in the bone, is a common dental procedure performed when a tooth is extensively damaged, diseased, or otherwise problematic and cannot be saved through other restorative treatments. While our primary goal is always to preserve natural teeth, there are circumstances where an extraction becomes the most prudent course of action for a patient's overall oral health. Understanding why and how extractions are performed can help alleviate any apprehension.

One of the most frequent reasons for extraction is severe tooth decay that has progressed to the point where it has destroyed too much tooth structure to be repaired with a filling, crown, or even a root canal. If the decay has reached the pulp and caused irreversible infection, and root canal therapy is not feasible or desired, extraction might be necessary to prevent the spread of infection to other teeth or surrounding bone. Similarly, extensive trauma to a tooth, such as a severe fracture that extends below the gum line, can also necessitate removal if the tooth cannot be adequately restored.

Periodontal disease, also known as gum disease, is another significant cause of tooth extraction. In advanced stages, gum disease can cause the supporting bone and tissues around the tooth to deteriorate, leading to tooth loosening. When a tooth becomes so loose that it poses a risk of infection or affects chewing ability, extraction may be the only option to prevent further damage to the jawbone.

Impacted wisdom teeth are another very common reason for extraction. Wisdom teeth, or third molars, are the last teeth to erupt, usually between the ages of 17 and 25. Often, there isn't enough space in the jaw for them to erupt properly, leading them to become "impacted" – meaning they are trapped beneath the gum line or are erupting at an awkward angle. Impacted wisdom teeth can cause pain, swelling, infection, damage to adjacent teeth, or contribute to crowding. In such cases, surgical extraction is recommended to prevent these complications.

Before an extraction, a thorough examination, including X-rays, is performed to assess the tooth's position, the bone structure, and the proximity to nerves or sinuses. This allows the dentist to plan the most appropriate and safest extraction technique. Local anesthesia is administered to numb the tooth and surrounding area, ensuring the procedure is pain-free. For patients with dental anxiety, sedation options, such as nitrous oxide (laughing gas) or oral sedatives, can be discussed to help them relax.

Extractions can be categorized as simple or surgical. A simple extraction is performed on a tooth that is visible in the mouth and can be removed with elevators (to loosen the tooth) and forceps. Surgical extractions are more complex, typically involving teeth that are impacted, broken beneath the gum line, or have unusual root structures. This may involve making a small incision in the gum tissue, and sometimes removing a small amount of bone or dividing the tooth into sections to facilitate removal.

Post-extraction care is crucial for proper healing. Patients are advised to bite gently on a gauze pad to control bleeding, avoid rinsing vigorously, strenuous activity, and consuming hot or alcoholic beverages for the first 24 hours. Soft foods are recommended, and pain medication may be prescribed. Swelling and discomfort are normal for a few days. The dentist will provide detailed post-operative instructions to prevent complications like dry socket. While an extraction removes a problem tooth, it's often recommended to consider replacement options like dental implants or bridges to maintain bite alignment, prevent adjacent teeth from shifting, and preserve jawbone health. Our team ensures that extractions are performed with the utmost care, prioritizing your comfort and discussing all future restorative options.