Dental Extractions

Dental Extractions and When Tooth Removal Is Necessary

A dental extraction (also referred to as tooth extraction, exodontia, exodontics, or informally, tooth pulling) is the removal of teeth from the dental alveolus (socket) in the alveolar bone.

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.

Tooth extraction is usually relatively straightforward, and the vast majority can be usually performed quickly while the individual is awake by using local anesthetic injections to eliminate painful sensations.

Sometimes wisdom teeth are impacted (stuck and unable to grow normally into the mouth) and may cause recurrent infections of the gum (pericoronitis). In orthodontics if the teeth are crowded, sound teeth may be extracted (often bicuspids) to create space so the rest of the teeth can be straightened.

At what point is it necessary to extract teeth?

You and Dr. Khemani may decide that a tooth extraction is necessary for various reasons, such as severe decay, advanced periodontal disease, irreparable breakage, poor positioning in the mouth, or in preparation for orthodontic treatment. Removing a tooth can affect your chewing ability, jaw joint, and tooth alignment, impacting your overall dental health.

To prevent these issues, Dr. Khemani will typically explore alternatives to extractions and discuss options for replacing the extracted tooth.

The Extraction Process

Before the extraction, the dentist will use a local anesthetic to numb your tooth, jaw bone, and surrounding gums.

During the extraction, you may experience pressure as the tooth is rocked firmly to widen the socket for removal. This pressure should not be painful, as the anesthetic will prevent the transmission of pain signals while still allowing you to feel pressure.

If you do feel any pain during the extraction, please inform us immediately.

Performing a tooth sectioning

Sectioning of teeth is a common procedure used when a tooth is firmly anchored in its socket or has a curved root that prevents easy removal. The dentist will cut the tooth into sections and remove them one at a time.

After Extraction Home Care

Bleeding

There may be some bleeding after the tooth extraction. To control it, place a moist gauze over the empty socket and bite down firmly for 45 minutes. It is crucial to allow a blood clot to form in the socket to aid in the healing process, so be careful not to dislodge it. Avoid rinsing or spitting for 24 hours after the extraction, and refrain from using a straw, smoking, or consuming hot liquids.

Swelling

If you experience swelling, you can apply ice to your face for 10 minutes, then remove it for 20 minutes. Repeat this process as needed for up to 24 hours.

Pain and Medications

If you are in pain, you can try using over-the-counter pain relief medications like acetaminophen or ibuprofen.

Eating

To ensure proper healing after your extraction, avoid chewing near the extraction site. Refrain from consuming hot liquids and alcohol for the first 24 hours. It may be best to stick to a liquid diet during this time.

Brushing and Cleaning

Following the extraction, refrain from brushing the teeth near the extraction site for one day. After that, you can gently resume cleaning. Avoid using commercial mouth rinses as they may irritate the site. Starting 24 hours after the extraction, you can rinse with salt water (1/2 teaspoon in a cup of water) after meals and before bed.

Dry Socket

Dry socket is a condition that occurs when a blood clot does not form properly in the socket after a tooth extraction, or if the clot becomes dislodged, resulting in delayed healing. Following post-extraction instructions can help prevent dry socket. Symptoms of dry socket include a dull throbbing pain that typically starts three to four days after the extraction, moderate to severe pain that radiates from the extraction site, a bad taste or bad breath, and a dry appearance at the extraction site. Dr. Khemani can apply a medicated dressing to the dry socket to help alleviate the pain.

Healing

After a tooth extraction, a hole will be left in your jaw bone where the tooth used to be. Over time, this hole will fill in and smooth out with new bone growth. This healing process can take several weeks or months. However, after 1-2 weeks, you should no longer experience any discomfort.