A guide to tooth extractions

A tooth extraction, as its name implies, involves the removal of a tooth which is causing a person pain or some form of dental issue. Here is a brief guide to this procedure.

When is a tooth extraction necessary?

Dentists always aim to protect their patients' teeth and as such, will only perform a tooth extraction as a last resort. However, there are specific circumstances which necessitate the use of this procedure. When, for example, a tooth has been severely fractured as a result of trauma to the mouth and efforts to repair the damage through crowns, fillings or root canals have failed, the tooth may need to be removed and replaced with either a denture or a dental implant.

Likewise, if a person has suffered bone loss as a result of advanced, untreated periodontal disease and some of their teeth, therefore, do not have enough bone support to be held in place, multiple extractions may have to be performed.

Severe infections also sometimes lead to tooth extractions; if a tooth has decayed to the extent that bacteria have been able to enter its pulp, and the resulting inflammation and infection has not responded to antibiotics and root canal therapy, a dentist may advise the patient to have the tooth pulled.

Lastly, people who intend to have braces fitted to fix crooked and crowded teeth will occasionally have one or more of their teeth removed before they begin this process. In these circumstances, extraction may be necessary to create space in the mouth, so that the patient's other teeth have enough room to shift into their correct positions.

Simple vs. Surgical extraction

In instances where the entire tooth that needs to be removed is fully exposed, a 'simple' extraction will be performed; this procedure only requires local anaesthesia and can be carried out by any dentist. However, in cases where the tooth is impacted (i.e. partially trapped underneath the gum) or fractured, it may be necessary to surgically remove the tooth. Surgical extractions are normally performed by an oral surgeon and may require the use of general, rather than local, anaesthesia.

What steps should a patient take immediately after having a tooth extracted?

It is normal for the affected area of the mouth to bleed for a little while after this procedure has been carried out. Patients may be advised to keep a piece of clean medical gauze pressed against the wound site for the first thirty minutes or so after one of their teeth has been extracted, so as to help slow and eventually stop the flow of blood.

Temporary swelling and soreness around the mouth is another common side-effect of this procedure. Placing an ice pack against the affected side of the face can help to minimise swelling. Soreness may persist for a few days after the extraction. If this bothers the patient, their dentist may provide them with a prescription for strong painkillers or advise them to take over-the-counter analgesics.

Most dentists and oral surgeons recommend that their patients avoid eating for a few hours after having a tooth removed. During the first few days after this procedure, it is generally best for people to consume soft foods which will not irritate the wound site.