Dentists and oral surgeons (dentists with special training to perform surgery) perform tooth extractions. Before pulling the tooth, your dentist will give you an injection of a local anesthetic to numb the area where the tooth will be removed. If you are having more than one tooth pulled or if a tooth is impacted, your dentist may use a strong general anesthetic. This will prevent pain throughout your body and make you sleep through the procedure.
If the tooth is impacted, the dentist will cut away gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces.
Why tooth extraction?
Tooth extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become unrestorable through tooth decay, periodontal disease or dental trauma especially when they are associated with toothache. Crowded Tooth, Infection and Risk of Gum disease are primary reasons where Dental surgeon recommends a tooth extraction. If periodontal disease – an infection of the tissues and bones that surround and support the teeth – have caused loosening of the teeth, it may be necessary to the pull the tooth or teeth.
Surgical Vs Simple Extraction
Extractions are often categorized as “simple” or “surgical”.
- Simple extractions– Simple tooth extractions are done on teeth that are easily seen in the mouth, usually under local anesthetic. They require only the use of dental instruments to elevate and/or grasp the visible portion of the tooth. The route of approach is solely from inside the tooth socket within the jaw bone. Typically when teeth are removed with forceps, slow & steady pressure is applied with controlled force.
- Surgical extractions– Surgical extractions almost always require an incision. In a surgical extraction the doctor may elevate the soft tissues covering the tooth and bone and may also remove some of the overlying and/or surrounding jaw bone tissue with a drill or osteotome. Surgical extractions are usually performed under a general anesthetic. In the surgical method, an incision is almost always required. Here bone is removed around the tooth by dissection though the jaw bone after the overlapping soft tissues are retracted as a gum flap.
Post extraction Comfort and Care
It is always important to closely follow your dentist’s after-care instructions to speed recovery.
- Relax for at least 24 hours after the extraction. Limit activity for the next day or two.
- Avoid rinsing or spitting forcefully for 24 hours after the extraction to avoid dislodging the clot that forms in the socket.
- After 24 hours, rinse with your mouth with a solution made of 1/2 teaspoon salt and 8 ounces of warm water.
- Do not drink from a straw for the first 24 hours. Do not smoke, which can inhibit healing.
- Eat soft foods, such as soup, pudding, yogurt, or applesauce the day after the extraction. Gradually add solid foods to your diet as the extraction site heals.
You should also expect some swelling and residual bleeding. However, if either bleeding or pain is still severe more than four hours after your tooth is pulled, you should call your dentist.