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Tooth Extraction: Procedure and Prevention
Sara M. George

 

Our teeth are  incredibly strong . In fact, tooth enamel is the hardest substance in the human body! Unfortunately, they aren’t immune to  decay and damage or the effects of advanced  periodontal disease . When a tooth can’t be saved through such treatments as  a root canal or has undergone severe trauma, it becomes necessary to remove it. Other reasons extraction may be necessary include  wisdom teeth that crowd other teeth as they emerge – or remain impacted beneath the gum line – and when there are too many teeth to allow  orthodontic treatment (braces or  Invisalign® ) to be successful.

 

 

We at  24/7 Local Dentist understand that tooth extraction is the procedure that people dread the most. However, choosing to neglect the issue that led to the need for extraction will soon cause worse pain and a further decline in your dental health, as well as your  overall health . For example, having an undetected tooth infection increases your risk of heart disease by 2.7 times.

 

If you have painful memories of tooth extraction in years past, today’s techniques provide a much more comfortable experience. Knowing what to expect during a modern-day tooth extraction can ease your anxiety and prompt you to seek the timely treatment that will result in a good outcome.

 

Of course, prevention is always preferable to losing a tooth. We’ll look at oral hygiene best practices to help you  keep your teeth healthy for life , as well as safety measures to protect teeth from loss due to trauma. But despite your best efforts, extracting a tooth may become necessary at some time.

 

Reasons for Dental Extractions

 

As mentioned earlier, there are many reasons a tooth may need to be extracted. Our blog post – “  Why Would You Need a Tooth Extraction? ” – covers the leading causes for removal, which include the following:

 

  • Advanced periodontal (gum) disease in which surgical treatment is not an option or expected to be successful.
  • A tooth with an infected root or root tip is a poor candidate for a root canal or apicoectomy .
  • Impacted wisdom teeth , as well as erupted wisdom teeth that crowd other teeth.
  • Preparation for braces when more space is needed for teeth to properly align.
  • Not enough room in your mouth for the number of teeth you have.
  • A primary (“baby”) tooth has not fallen out to allow the permanent tooth to erupt.
  • Severe damage or trauma, such as a sports injury or serious accident.
  • Receiving radiation therapy to the head or neck area.
  • A weakened immune system – particularly from either cancer medication treatments or organ transplant medications – makes teeth vulnerable.

How a Tooth is Extracted

 

There are  two types of tooth extraction procedures: a simple extraction and a surgical extraction. The first type is typical for a fully erupted tooth above the gum line; the second is used for a tooth broken off at the gum line, or an impacted tooth.

 

But before either type of procedure is performed, your dentist or oral surgeon will take your medical history. This includes such important information as prescription medications you are on, medications you are allergic to, and any underlying medical conditions you may have. If you take a prescription blood thinner, your dentist may tell you to stop taking it a few days before, as the medication could cause excessive bleeding during the procedure. In the case of infection, your dentist may prescribe antibiotics to begin before the procedure.

 

Before the extraction, you’ll be given a local anesthetic. A simple extraction consists of an injection directly into the gum near the tooth that will be removed. Your dentist may apply a topical numbing agent to your gum just prior to injection to make this part of the procedure more comfortable. Your dentist will make sure the site is completely numb before beginning. Our entire team at 24/7 Local Dentist places the comfort of our patients at the highest priority and strives to ensure that you are well-informed and confident at every step of the dental services we provide.

 

 

For a  surgical extraction , you will likely receive both local anesthesia and  intravenous (IV) anesthesia, the latter of which makes you calm and relaxed. You will be in “twilight sleep,” during which you will be unaware of the procedure but can respond to instructions from the dentist or oral surgeon. You also will be told to have someone drive you to and from the appointment, as you won’t be fully alert for several hours post-surgery.

 

For all of this build-up, the simple extraction procedure itself is very straightforward. After confirming that you’re numb, the dentist uses an instrument called an elevator to loosen the tooth, and forceps to remove it. Immediately following the procedure, your dentist will place a gauze piece to keep on the extraction site for up to 45 minutes to limit bleeding while clotting takes place.

After the anesthesia wears off, you can expect some discomfort. Your dentist will recommend over-the-counter pain medicine or prescribe one. Applying an ice pack can help reduce swelling. You should also limit strenuous activity, avoid hot liquids, and drinking through a straw. This is to keep the protective blood clot that will form over the extraction site intact. Dislodging the blood clot exposes the empty socket to air and debris, causing a painful condition known as dry socket. Contact your dentist immediately if this happens! Typically, the discomfort of the extraction should start to lessen within three days. Your dentist will give you a detailed list of aftercare instructions to take home.

Because the circumstances that necessitate a surgical extraction vary widely, your dentist or oral surgeon should be able to walk you through the procedure prior to your appointment. This is the time to ask any questions you may have about how the procedure will be performed, possible complications, etc.

 

 Depending on the reason for extraction , the tooth will need to be accessed in various ways. If it is impacted, the gums and tissue will be cut away so that it can be pulled with forceps. In rare instances, the tooth may need to be cut out in segments. You may feel pressure at times, but not pain. Once the tooth is removed, blood will immediately begin to clot. The dentist or surgeon will assist this process by applying gauze and light pressure. If necessary, self-dissolving stitches may be used to pull the gums over the edges of the extraction site. You will be given a detailed list of aftercare instructions to take home with you.

 

Your Tooth is Gone – Now What?

 

Before your extraction, your dentist will discuss restoration options with you (unless the extraction is to remove extra teeth, of course). Replacing the missing tooth could involve a bridge – crowns on either side of the missing tooth that has a false tooth in the center to bridge the gap. This gives the appearance of a natural tooth and is undetectable. Your dentist may also recommend a dental implant, which our blog post – “  What Happens During Dental Implant Surgery? ” – covers in detail. The option your dentist recommends will be based upon your individual situation.

 

Preventing Tooth Loss

 

Making good oral hygiene practices a part of your daily life can prevent many of the conditions that lead to tooth loss.  Medical News Today provides an excellent list of best practices that include the following:

 

  • Visit your dentist regularly.
  • Brush regularly, but not aggressively; replace your toothbrush every three months.
  • Use fluoride.
  • Floss once a day.
  • Do not smoke or use smokeless tobacco, which causes oral cancer.
  • Drink more water; limit sugary soft drinks and snacks.

 

Tooth loss due to injury is all too common among student-athletes who play contact sports, as well as anyone who participates in physical recreational activities. Always wear a  mouthguard while playing or practicing. And as general advice, don’t use your teeth as a bottle opener!

 

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