Dental extraction, more descriptively, tooth pulling, is a procedure in which the tooth is removed from the mouth, i.e. from the dental socket in the alveolar bone.
Why Is It Performed
The most common reason for dental extractions is the presence of severe tooth decay. The teeth that is removed is usually so badly damaged that it simply cannot be restored in any way.
Other reasons, much less frequent than removal due to decay, are various traumas to the tooth, usually as a result of accidents. This includes fractured teeth. Teeth can also get infected, and when root canal therapy fails, extraction is often used as a last resort.
Third molars, or “wisdom teeth” as they are called, can grow impacted and cause issues with other, surrounding teeth if not dealt with properly. These teeth risk getting infected and are sometimes, but not as a rule, removed prophylactically.
Orthodontic treatment may also require removal of some teeth in order to avoid crowding. This is not employed as commonly, and usually only in severe cases.
In some cases, the cost of treatment of the tooth is so high that it’s better to extract the tooth. This is usually a result of late treatment of severe decay.
Unlike in the past, when this procedure entailed severe pain and risks, today dental extractions are very simple and in most cases painless procedures. They are performed as outpatient procedures with the application of local anesthetic and the help of forceps that are used to pull the teeth out.
In some cases, especially with wisdom teeth, surgical approach may be needed with more extensive cutting and drilling needed. In this case, general anesthesia may be required and the recovery takes more time.
Dentists do not like to extract teeth, as in a way it represents failure of both the patient and the dentist to manage the condition. Of course, sometimes a tooth just cannot be saved, but in most cases every removed tooth is a little tragedy in itself. Sure, one missing tooth may not be a huge problem, but it could be an indication that something is not right in the approach to dental health of the patient.
The patient should be advised that proper dental health habits are the bare minimum in order to minimize the risk of developing dental problems. Regular check-ups should be a necessity, the more frequent the better, but certainly no less than once a year. This leaves the dentist with the ability to spot caries while still in its early stages, allowing for painless and easy removal, thus saving the tooth and its function.
After the procedure, there is some risk of developing an infection. In some cases, a course of antibiotics will be prescribed right after the procedure. This has shown to reduce the risk of infections by more than two thirds, but the practice is controversial due to the risk of antibiotic resistance.
Regular smokers should refrain from smoking for as long as possible, as smoking prolongs recovery time and results in an increased number of complications. Over-the-counter painkillers can be used to manage pain. However, if the pain becomes severe, it could be an indication that a complication has developed and it should be evaluated by a dentist.
Bleeding right after the extraction is common and is managed by the application of pressure with a gauze. Dry socket syndrome may also develop when the blood clot that forms in the empty alveolar socket is disturbed. It is painful and can result in inflammation.
Depending on the location of the tooth, the patients can opt to replace the missing tooth or leave the area as is. The ideal treatment is to get a dental implant with an artificial crown, as the resulting replacement tooth is closest in function to the natural tooth. Dental bridges and dentures are also often considered due to their lower upfront costs. Dentures are especially used if the number of missing teeth is substantial and any other therapy would be either too expensive or invasive.