One of the fears associated with going to the dentist is that the dentist will end up pulling one or more teeth.
This fear often will prevent us from going to the dentist for our regular check ups and cleanings necessary for good oral hygiene. The truth is that dental extractions are just another part of good oral hygiene and are quite uncommon compared to the number of simple examinations that we should be exposed to. Let’s look at some of the reasons and procedures involved in dental extractions and oral surgery.
There are basically two reasons why your dentist might decide that you have a tooth, or several teeth, pulled. A tooth extraction might be necessary when a tooth is damaged beyond practical repair. Teeth that are not well positioned or nonfunctional may also need to be extracted.
Broken, cracked, or extensively decayed teeth should probably be extracted. The conditions that warrant extraction are usually so extreme that regular reconstructive work (i.e. fillings, crowns, etc.) will not be effective. There are several other factors that can play into the decision of pulling a tooth such as long-term treatment and cost of repair.
Sometimes extraction is easier and more cost effective than reconstruction.
Some teeth require treatment of the nerve space between teeth. This procedure, called a root canal, can be complicated by damaged teeth, as indicated before. If a tooth’s roots and nerves are damaged beyond the repair capabilities of the root canal, then extraction may be required.
Severe damage to the gums may also necessitate dental extraction. Advanced periodontal disease (or gum disease) is cause by the improper care of teeth. As gum disease gets worse, the tooth loses the support of the surrounding bone and becomes loose. The gums can no longer hold it in place.
In cases where the bone and/or tooth have become excessively damaged, extraction of the tooth is necessary.
Sometimes the extraction of healthy teeth is required for good oral hygiene. Some teeth that are badly positioned to the point of pain and irritation may need to be extracted simply to alleviate the pain and to prevent further misalignment of more teeth.
The wisdom teeth often fall into this category. The wisdom teeth are at the far rear of the mouth and are difficult to clean. Improper cleaning of the teeth can lead to cavities, tooth decay and periodontal disease. Often, it is simply easier to extract the wisdom teeth as a preventative measure against future problems.
Many times, the wisdom teeth are “impacted” which means that they are in such misalignment that they cannot emerge from the gums in proper or even effective alignment. In some cases, they may even push against other teeth causing the entire mouth to become misaligned. Extracting impacted wisdom teeth can help keep all the teeth in proper alignment.
Often, when orthodontic treatment is required, some teeth, including the wisdom teeth, may need to be extracted to improve the alignment of the teeth. When the size or number of a person’s teeth is not in proportion to a person’s jaw, the strategic extraction of some teeth may be necessary.
Only your dentist can decide if an extraction is necessary. During a routine visit, he/she may decide that an extraction of one or more teeth is needed. He/She may also need to perform and x-ray examination to further evaluate the need for extraction. The dentist might perform the extraction himself/herself or may even refer you to an oral surgeon.
The roots of your teeth are encased in your jawbone itself and held in place by ligaments under the gums. The tooth cannot be simply “pulled.” It needs to be rocked back and forth and rotated in order for the tooth to become worked out of its protection of the jawbone and removed. Naturally, most dentist and oral surgeons anesthetize the patient before undergoing an extraction.
When undergoing an extraction with a “local” anesthetic, you might feel some pressure, but no pain during the procedure. The dentist simply needs to work that tooth loose before it can be removed. If at any time you feel pain during the procedure, tell your dentist and more anesthetic can be administered.
Sometimes a tooth is so firmly anchored in place that it will need to be removed by sections. Sectioning the teeth for extraction is quite commonplace and your dentist should let you know beforehand if this procedure is required. There are no additional considerations or complications associated with sectional extraction.
Naturally, there will be blood when a tooth is extracted. In most cases, the blood can be controlled by placing moist, clean gauze over the extraction site and applying gentle but firm pressure.
The blood needs to clot in the extraction site. Like a scab, this blood clot protects the wound and helps it to heal quickly. You should avoid rigorous rinsing and spitting during the first twenty-four hours after an extraction to ensure the blood clot remains in place. Also, hot liquids tend to dissolve the blood clots, so avoid hot coffee or soup.
Swelling and pain are natural after an extraction and should be expected. These can be alleviated though regular pain medications and through prescriptions your dentist might give you. Your doctor might also give you some antibiotics to take to prevent infections. The pain and swelling should subsist in a couple of days. If the pain continues or if swelling or bleeding becomes excessive, contact your dentist.
A soft food or even liquid diet might be required for the first twenty-four hours following an extraction. You may also want to avoid cleaning the extraction site with a toothbrush and dental floss for a few days following an extraction allowing it to heal completely.
Remember, dental extractions are common and often necessary to maintain good oral hygiene. Review this guide before an extraction and be sure consult with your dentist to get all your questions answered to ease the procedure. Know what to expect before, during and after to minimize the inconvenience to you.
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