tooth extraction

surgery overview

tooth extraction is the complete removal of a tooth, from the part of the tooth that you can see to the roots that are in the jawbone. damage caused by tooth decay is the most common reason for a tooth's extraction. other reasons for removing a tooth include infection or injury. removing the tooth can help keep an infection from spreading to other parts of the mouth. and some teeth may be removed to prevent or correct crowding in the mouth.

your dentist or an oral surgeon, who specializes in surgeries of the mouth, can remove a tooth. it can be done in the dentist's or oral surgeon's office.

the dentist first numbs (freezes) the area around the tooth. you may also get medicine to help you relax. the dentist uses a special tool to grasp the tooth and lift it out of the tooth socket. you may feel a tug on the tooth as it is being removed. if the tooth breaks while being pulled, or if it doesn't come out in one piece, the dentist uses other tools to remove the rest of the tooth. after the tooth comes out, you will be given a piece of gauze to bite down on. this will help stop bleeding. you may need stitches. you will be told if and when you should come back to have the stitches removed.

you may have some pain, bleeding, or swelling afterward. the dentist may give you medicine for pain. the pain should steadily decrease in the days after the extraction.

a blood clot will form in the tooth socket after the extraction. the clot protects the bone during healing. if that blood clot gets loose or comes out of the socket, you may have a dry socket, which exposes the bone. a dry socket may last for several days and can cause severe pain. if you get a dry socket, your dentist can treat it with medicine.

you and your dentist may want to discuss options to replace the removed tooth. options include an implant, a denture, or a bridge.

what to expect

• while your mouth is numb (frozen), be careful not to bite your tongue or the inside of your cheek or lip.
• be safe with medicines. read and follow all instructions on the label.
  • if the dentist gave you a prescription medicine for pain, take it as prescribed.
  • if you are not taking a prescription pain medicine, ask your dentist if you can take an over-the-counter medicine.
• if your dentist prescribed antibiotics, take them as directed. do not stop taking them just because you feel better. you need to take the full course of antibiotics.
• if you have bleeding, bite gently on a gauze pad. change the pad as it becomes soaked with blood.
• after 24 hours, rinse your mouth gently with warm salt water several times a day. your dentist may recommend other mouth rinses if needed. do not rinse hard. this can loosen the blood clot and delay healing.
• avoid rubbing the area with your tongue or swishing liquid in your mouth. and don't use a straw for the first few days. these actions can loosen the blood clot and delay healing.
• avoid chewing in the area where the tooth was removed until your mouth heals. soft foods like gelatin or soup might be easier to eat and may help you heal.
• if needed, put ice or a cold pack on your cheek for 10 to 20 minutes at a time. try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. put a thin cloth between the ice and your skin.
• do not smoke or use spit tobacco for at least 24 hours after the extraction. tobacco use can delay healing.

learn more

why it is done

a tooth must be removed when decay or an abscessed tooth is so severe that no other treatment will cure the infection. it's also done when gum disease has damaged a tooth so badly that there is no other way to prevent the infection from spreading and damaging nearby teeth and bones.

how well it works

removing the tooth can help keep infection from spreading to other areas of your mouth. in the case of gum disease, removing a tooth prevents the disease from spreading and damaging nearby teeth and bones.

risks

some dental work can cause bacteria in the mouth to enter the bloodstream and cause infections in other parts of the body. people who have a hard time fighting off infections may need to take antibiotics before and after dental surgery. you may need to take antibiotics if you:

• have certain heart problems that make it dangerous for you to get a heart infection called endocarditis.
• have an impaired immune system.
• had recent major surgeries or have man-made body parts, such as an artificial heart valve.

after an extraction, a blood clot forms in the tooth socket. the clot protects the bone while the healing process takes place. if that blood clot is loosened or dislodged, you may have a dry socket, in which the bone is exposed. dry sockets may last for several days and may cause severe pain that sometimes includes ear pain.