Extractions

The more you know about how dentists pull teeth, the more uneventful your extraction process will likely be.

As disconcerting as the idea of having a tooth pulled may be for some, there are times when it's a simple fact of life that matters dictate that a tooth must be extracted. For people who find themselves in this situation, we'd like to offer the information found these pages.

From experience, we know that if a dental patient knows what to expect in regards to the tooth extraction process and understands some of the basic oral surgery principles involved, then the more likely that their extraction procedure, and the healing process that follows, will be uneventful. This is because they will be more relaxed, more cooperative and more likely to actually follow their dentist's post-operative instructions.

Beyond the above, our pages also discuss other matters that are typically on people's mind, such as: How much does it cost to have a tooth pulled? Post-operative considerations including - healing times, aftercare instructions for both the first 24 hours and beyond, and post-extraction complications (bleeding, swelling, dry sockets). We also discuss surgical tooth extractions and medical issues and concerns as they apply to extracting teeth.

Why might a person require a tooth extraction?

There are a number of reasons why your dentist might recommend that you have a tooth, or even several teeth, extracted. Listed below are some of these reasons:

1) A tooth extraction might be indicated if repairing a damaged tooth is not practical.

a) Broken, cracked, or extensively decayed teeth can be extraction candidates.

Some teeth will have extensive decay (dental caries) or else will have broken or cracked in such an extreme manner that an extraction might be considered the best, or at least a reasonable, solution. Of course there will be a number of factors that will come into play with any specific situation. In some cases the obstacles that present themselves might be so formidable that a repair for the tooth is simply not possible. In other cases the cost of needed dental treatment or else a questionable long-term outlook for the success of the treatment may be the reason an extraction is chosen.

b) Teeth that are unsuitable candidates for root canal treatment should be extracted.

Some teeth may require treatment of the nerve space that lies within them (root canal treatment) in order to make a repair. While most teeth typically are candidates for root canal treatment there can be complicating factors that remove this option. If this is the case and needed root canal treatment cannot be performed then the extraction of the tooth is indicated.

c) Teeth associated with advanced periodontal disease (gum disease) may need to be pulled.

By definition, teeth that have experienced the effects of advanced periodontal disease (gum disease) are teeth whose supporting bone has been damaged. In general, as periodontal disease worsens, a tooth is supported by less and less surrounding bone, often to the point where the tooth becomes loose. In those cases where significant bone damage has occurred and a tooth has become excessively mobile extraction of the tooth may be the only option.

2) Malpositioned or nonfunctional teeth may need to be extracted.

Some teeth are extracted because they are malpositioned. As an example, sometimes when wisdom teeth come in they lie in a position that proves to be a constant source of irritation to the person's cheek (by either rubbing against the cheek or causing the person to bite it). As a solution, a dentist may suggest that the offending wisdom teeth should be extracted.

Some teeth might be extracted because they provide very little service to the dental patient but do offer risk for becoming problematic. A common example is a wisdom tooth that has come in but has no matching tooth to bite against. Wisdom teeth are typically in a region of the mouth that is hard to clean, thus placing them and their neighboring tooth at greater risk for decay and periodontal disease. Depending on the precise circumstances that they find, a dentist may advise their patient that removing a nonfunctional tooth might be in that patient's best long-term interest in regards to maintaining good oral health.

Impacted teeth are often extracted. Impacted teeth are teeth whose positioning in the jaw bone is such that they cannot erupt into normal alignment. So by definition, impacted teeth are malpositioned and because they are malpositioned they are often nonfunctional. This combination of factors makes impacted teeth common candidates for extraction.

3) Tooth extractions may be required in preparation for orthodontic treatment (braces).

When orthodontic treatment is performed for a patient the dentist is trying to perfect the alignment of the patient's teeth but they can only do so within the confines of the size of the person's jaws. Especially in those cases where a large discrepancy exists between the size of the patient's jaws and the needed space required for the improved alignment of their teeth, some strategically located teeth may need to be extracted.

When might a tooth extraction be a bad idea?

During their examination of your teeth and mouth it is possible that your dentist will be able to recommend one or more alternative treatments to having a tooth extraction. While extracting a tooth might be less expensive than the other treatment options your dentist proposes, it may not be the least expensive treatment in the long-run.

When a tooth is removed its neighboring teeth will tend to shift, sometimes significantly. Any alignment changes that do occur can have a major impact on your dental health. Removing even a single tooth can lead to problems associated with chewing ability or jaw joint function. Additionally, teeth whose alignment has changed can become traps for food or be harder to clean thoroughly, thus placing them at greater risk for tooth decay and gum disease.

So to avoid these types of complications, in most cases your dentist will probably recommend to you that you replace any tooth that has been extracted. Replacing a tooth after an extraction with an artificial one can easily cost more than the alternative of not extracting a tooth and instead rebuilding it.