Tooth extraction means the removal of a tooth from its socket in the jawbone.
When a tooth is broken or decayed dentists try to repair it with fillings or other procedures. But the teeth that cannot be repaired may need to be removed. Some extractions are performed in circumstances where it is clear that it must be done to improve or preserve oral health. The main reasons for tooth extraction are:
- Severe dental caries that had compromised the integrity of the tooth.
- Infection of a tooth due to the decay extending into the pulp
- Abscess formation (swelling) due to collection of pus from an infected tooth
- Periodontal disease (gum disease) causing mobile teeth
- Crowded teeth, before orthodontic treatment
- Impacted wisdom teeth
- Failed root canal treatment
- Risk of infection in immune-compromised patients (chemotherapy, organ transplant patients etc.)
Before removing the tooth local anesthesia injection is given to numb the area. More than one injection might be needed according to the location of tooth. Local anesthesia blocks the pain but patients may still feel slight pressure. If more than one tooth are extracted the dentist may advise to use general anesthesia. General anesthesia may also be used in patients with disabilities or young children, depending on the circumstances.
Few minutes after injecting the local anesthesia the tooth and surrounding structures are checked for its effect. Once the area is adequately numb the dentist will widen the tooth socket using specific movements for each tooth. Then it is pulled out using dental forceps designed for the purpose. In some cases sutures (usually self dissolving) are placed. A pack of gauze pad is placed in to the socket and patient is asked to bite on it for about 45 minutes to stop the bleeding and facilitate clot formation.
After extraction care should be taken not to bite the lip or tongue because it will take several hours for the anesthesia to wear out completely and biting may cause injury. After anesthesia wears off there will be pain and it can be treated using painkillers like Ibuprofen. Avoid rinsing or spitting for at least 6 hours after extraction. Avoid hot food for 24 hours after extraction to prevent disintegration of the clot. Ice packs can be used to minimize swelling. Warm salt water rinses after 24 hours can help the wound heal better. You can brush and floss the other teeth as usual after extraction but care should be taken not to dislodge the clot by vigorously cleaning the extraction site.
Time taken for the procedure depends up on the difficulty of extraction. Simple extractions can be completed in few minutes. But surgical extractions, especially the complicated ones as in wisdom tooth removal, may take more than 20 minutes. X-rays are taken before wisdom tooth extractions.
The costs of tooth extractions depend on the level of difficulty to remove the tooth. Simple extractions may cost $ 100 and above; up to $250 in some complicated cases. Surgical extractions can cost more than that. Insurance companies usually cover up to 80 % of the charges if the extraction is not for cosmetic purpose. It is important to note that this coverage varies with insurance providers and dentists.
- It is very important to let the dentist know your complete medical history before a dental extraction to avoid complications.
- Extraction of a tooth should be performed only after all other options to preserve the tooth are exhausted.
- Dislodging the clot can cause a very painful condition called “dry socket” after three days of extraction.
- A small amount of bleeding is normal but consult your dentist if there is unusual bleeding after an extraction.
- Initial healing after an extraction will take place in one to two weeks. Bone formation and socket closure will take months to complete.