Tooth Extraction

What is a tooth extraction?

Dental tools with tooth after tooth extraction procedureA tooth extraction is a dental procedure in which a dentist removes a tooth anchored within a patient’s mouth. Extractions do not occur for “baby” teeth that naturally loosen and detach from the jawbone. A tooth extraction is the removal of a firmly anchored tooth for a variety of reasons.

Why would a tooth need to be pulled?

Reasons include:

  • Crowded teeth
  • Trauma
  • Decay
  • Infection, or risk thereof
  • Gum disease
  • Problematic wisdom teeth

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before after

Slide to see before and after tooth extraction.

How to pull out a tooth?

There are two types of dental extractions: simple extractions and surgical extraction.

A simple extraction consists of a dentist removing a tooth that is visible and accessible within the mouth. They begin by administering an anesthetic to the tooth and surrounding area to numb it. Then the dentist will widen the gums surrounding the tooth using an instrument called an “elevator.” Once space has been created around the tooth, the dentist will then use an instrument known as “extraction forceps” to detach the tooth from the jawbone and ligaments. Finally, the tooth is removed from the gums and mouth completing the extraction. After the actual extraction has commenced, there are several closing procedures that are necessary to promote safe-health and proper healing. The post-extraction process involves cleaning out the socket, removing debris and pieces of bone, compress the socket to reshape the jawbone, evaluate the sinus cavity, control bleeding and close the extraction site.

A surgical extraction is a much more complex procedure than the “simple” extraction. This procedure is necessary in cases where a tooth has broken, needs to be sectioned (cut in pieces), has long or curved roots, is impacted or has yet to enter the mouth. Surgical extractions are typically performed by oral surgeons but sometimes are administered by general dentists. The surgery can consist of several or all of the following:

  • Incisions that create tissue flaps
  • Trimming bone around the tooth
  • Sectioning (cutting) the tooth in several pieces

Whatever methods are administered to complete the extraction the end result is the trouble-tooth being extracted. Closing measures include cleaning the opened area, closing incisions, lessen bleeding, and promote clotting. Your surgeon will inform you of any post-op instructions. For more information on tooth extractions, please see this article here. 

Tooth Extraction Risks 

After a tooth extraction, a problem called “dry socket” can develop, but this occurs in less than five percent of abstractions. This happens when a blood clot does not form or breaks off too early. It results in exposure of the underlying bone to air and food, which can be very painful. Typically a dry socket is experienced by patients who use a straw or smoke with 48 hours of the extraction and "pull out" the blood clot. Other possible risks are damage to teeth surrounding the extraction site as well as the risk of infection. Please see Colgate's article for more information. 

How long for a tooth extraction to heal?

It depends on whether it is a simple or surgical extraction. Both extractions will consist of regular bleeding for the 24 hours after removal. Some spotty bleeding could last for a few days after depending on the size of the opening and the care you tend to it. Both procedures will cause soreness and swelling. Both instances will also come with a recommendation of painkillers (prescribed medication usually accompanies surgery).

The duration of pain, bleeding, and swelling may be longer for the surgical removal than the simple one. Ice placed on the face can combat swelling. Overall, recovery varies on the severity of the procedure and the hole left by the removal. Pain, bleeding, and swelling should all lessen significantly, if not completely, after a week or so. The tissue should heal fully in about three to four weeks. And finally, the bone may take up to 6 months to fully recover, but it is not something you will know is happening, nor will it prevent you from daily eating and chewing.

What to eat after tooth extraction?

You should wait to eat until the numbness has worn off to avoid aggravating the wound. In the first 24 hours after the procedure, a liquid diet is recommended. After the 24 hour period passes, it may be okay to start eating soft, cool foods. For a while, one should avoid any hot, spicy, or crunchy foods. Until significant healing has taken place, you should chew on the opposite side of the mouth that the tooth extraction was performed on. If there are multiple extraction locations, the liquid diet may be the safe choice for as long as possible. Blended, liquid, or creamy foods are all good options. It is important to maintain proper nutrition to promote a healthy immune system to assist healing. And make sure to drink plenty of water!

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