There are a number of reasons why your dentist might recommend that you have a tooth, or even several teeth, extracted. Listed below are some of these reasons:
A tooth extraction might be indicated if repairing a damaged tooth is not practical.
a) Broken, cracked, or extensively decayed teeth can be extraction candidates.
Some teeth will have extensive decay (dental caries) or else will have broken or cracked in such an extreme manner that an extraction might be considered the best, or at least a reasonable, solution. Of course there will be a number of factors that will come into play with any specific situation. In some cases the obstacles that present themselves might be so formidable that a repair for the tooth is simply not possible. In other cases the cost of needed dental treatment or else a questionable long-term outlook for the success of the treatment may be the reason an extraction is chosen.
b) Teeth that are unsuitable candidates for root canal treatment should be extracted.
Some teeth may require treatment of the nerve space that lies within them (root canal treatment) in order to make a repair. While most teeth typically are candidates for root canal treatment there can be complicating factors that remove this option. If this is the case and needed root canal treatment cannot be performed then the extraction of the tooth is indicated.c) Teeth associated with advanced periodontal disease (gum disease) may need to be pulled.
By definition, teeth that have experienced the effects of advanced periodontal disease (gum disease) are teeth whose supporting bone has been damaged. In general, as periodontal disease worsens, a tooth is supported by less and less surrounding bone, often to the point where the tooth becomes loose. In those cases where significant bone damage has occurred and a tooth has become excessively mobile extraction of the tooth may be the only option.
Malpositioned or nonfunctional teeth may need to be extracted.
Some teeth are extracted because they are malpositioned. As an example, sometimes when wisdom teeth come in they lie in a position that proves to be a constant source of irritation to the person's cheek (by either rubbing against the cheek or causing the person to bite it). As a solution, a dentist may suggest that the offending wisdom teeth should be extracted.
Some teeth might be extracted because they provide very little service to the dental patient but do offer risk for becoming problematic. A common example is a wisdom tooth that has come in but has no matching tooth to bite against. Wisdom teeth are typically in a region of the mouth that is hard to clean, thus placing them and their neighboring tooth at greater risk for decay and periodontal disease. Depending on the precise circumstances that they find, a dentist may advise their patient that removing a nonfunctional tooth might be in that patient's best long-term interest in regards to maintaining good oral health.
Impacted teeth are often extracted. Impacted teeth are teeth whose positioning in the jaw bone is such that they cannot erupt into normal alignment. So by definition, impacted teeth are malpositioned and because they are malpositioned they are often nonfunctional. This combination of factors makes impacted teeth common candidates for extraction
Tooth extractions may be required in preparation for orthodontic treatment (braces).
When orthodontic treatment is performed for a patient the dentist is trying to perfect the alignment of the patient's teeth but they can only do so within the confines of the size of the person's jaws. Especially in those cases where a large discrepancy exists between the size of the patient's jaws and the needed space required for the improved alignment of their teeth, some strategically located teeth may need to be extracted.
When might a tooth extraction be a bad idea?
During their examination of your teeth and mouth it is possible that your dentist will be able to recommend one or more alternative treatments to having a tooth extraction. While extracting a tooth might be less expensive than the other treatment options your dentist proposes, it may not be the least expensive treatment in the long-run.
When a tooth is removed its neighboring teeth will tend to shift, sometimes significantly. Any alignment changes that do occur can have a major impact on your dental health. Removing even a single tooth can lead to problems associated with chewing ability or jaw joint function. Additionally, teeth whose alignment has changed can become traps for food or be harder to clean thoroughly, thus placing them at greater risk for tooth decay and gum disease.
So to avoid these types of complications, in most cases your dentist will probably recommend to you that you replace any tooth that has been extracted. Replacing a tooth after an extraction with an artificial one can easily cost more than the alternative of not extracting a tooth and instead rebuilding it.
If you are instructed to wear your retainer for only a part of the day, keep it in its case when it’s not being worn, so it won’t be damaged or lost
Depending on the way your retainer is made, your orthodontist may even instruct you to keep it in a moist environment when you’re not wearing it.
Tooth extraction aftercare: Common post extraction instructions.
Aftercare during the first 24 hours following your tooth extraction.
Post-extraction bleeding.
- Stopping the bleeding from a tooth extraction site.
- Protecting the blood clot. / Preventing dry sockets.
Post-extraction swelling.
- Minimizing post-tooth extraction swelling.
Controlling post-dental extraction pain.
- Over-the-counter and prescription pain medications.
Post-tooth extraction do's and don'ts.
- Smoking.
- Physical activity.
- Eating.
- Brushing your teeth.
- Taking prescribed antibiotics.
Tooth extraction aftercare - Part II.
- Tooth extraction aftercare - Beyond the first 24 hours.
After your extraction, make sure you follow your dentist's instructions.
After your tooth extraction your dentist will provide you with a set of aftercare instructions to follow so to minimize the potential for any postoperative problems. In general there will be instructions regarding things to do, and not to do, during the first 24 hours after your extraction and then another set of instructions (discussed on our next page ) regarding things to do, and not to do, after the initial 24 hour period has past. Remember, those things you do or do not do during this first 24 hour period will set the stage for the healing process as it progresses over the days to come.
Usually a dentist's instructions regarding aftercare during the first 24 hours following a tooth extraction will include directions pertaining to the topics found on this page. Before following any of the directions found on this page, you should print them out and show them to your dentist and ask them if these instructions apply to your specific situation. Your dentist may find reason to revise, add to, or delete from these generalized instructions, depending on your specific needs. In all cases, if you have a concern or feel you have developed a complication associated with your tooth extraction you should contact your dentist.
Stopping post-tooth extraction bleeding.
Some bleeding may occur for some time after your tooth extraction. In most cases this bleeding can be effectively controlled and stopped by placing a piece of moist clean gauze over the empty tooth socket, and then biting firmly on this gauze for 45 minutes to an hour. Make sure that the gauze is positioned so when you bite down it applies pressure directly onto the extraction site. If you bite down and your teeth come together fully you may not be placing much pressure on the gauze.
It is both firm pressure and maintaining this pressure over a prolonged period of time (45 minutes or so) that are important factors when this technique is used. Don't keep changing the gauze, just put some in and then clamp down on it for 45 minutes to an hour.
If the bleeding seems to persist, a slightly moistened tea bag can be a very effective substitute for gauze. One of the components of tea (black tea, the regular stuff you would make iced tea from) is tannic acid. Tannic acid can aid in the formation of blood clots and this technique can be very effective. (Same instructions as above, just substitute the tea bag for the gauze.)
If a small amount of bleeding persists after 45 minutes then repeat these instructions. If heavy bleeding is still present then contact your dentist.
A blood clot needs to form in the empty tooth socket.
The blood clot that forms in the extraction socket is an important part of the healing process, so be careful not to do anything that will dislodge it. Remember, events that occur during this time frame will affect the healing process for days to come. (It is thought that the development of " dry sockets" is related to the loss of blood clots.)
This means you should avoid vigorous rinsing or spitting during the first 24 hours after your tooth extraction. Also, creating suction, such as that produced by using a straw or smoking, can dislodge the blood clot that has formed. Hot liquids will tend to dissolve blood clots, so stay away from hot coffee or soup.
Minimize activities that might make it harder to control the bleeding from the extraction site.
So to reduce the amount of bleeding which occurs, and so to promote the formation of a blood clot in the tooth socket, avoid strenuous exercise or other such activities for 24 hours after your tooth has been extracted. If you lie down, use an extra pillow so to elevate your head.
Swelling may occur after a tooth extraction.
We discuss this subject in greater detail here: Post-tooth extraction swelling.
The trauma created by the tooth extraction process can cause swelling. This swelling might present itself as a slight fullness that you can feel but is not readily apparent to others, or at the other extreme a clear enlargement of facial tissue. In general, the more difficult the extraction has been the more likely swelling will occur.
Any swelling that does occur can be kept to a minimum by placing ice on your face in the area where the extraction has taken place. Position the ice on your face for 10 minutes, and then leave it off for the next 20 minutes. Repeat this cycle as you feel is necessary for up to 24 hours after the extraction.
Minimize smoking after a tooth extraction.
Those people who smoke tend to have more complications with extraction site healing (including the development of " dry sockets") than people who don't. If you can avoid smoking for the first 48 hours after your tooth extraction, it will be to your benefit.
Post extraction discomfort and the use of pain medications.
You may not experience much pain after your tooth has been extracted. If you do, for minor pain your dentist might suggest the use of non-prescription drugs such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil). You will, of course, need to read and follow the directions and warnings that accompany these products so you know that their use is appropriate for you and your circumstances.
Alternatively, if your dentist has prescribed prescription pain relief medication for you and you have decided to take it, make sure you read and adhere to the precautions and directions associated with the use of this product. If you have any questions about your medicine, the manner in which it should be taken, or else problems associated with taking your medicine, you should discuss them with your dentist or pharmacist.
The pain reliever your dentist prescribes may contain a narcotic (such as codeine). If so, most narcotic pain medications will have a tendency to upset your stomach, so it is usually best to take them with food. Narcotics can also make you drowsy or act strangely. If you take narcotics, you should let those around you know you are doing so. Also, you should limit your activities (driving, operating machinery, etc...) while taking narcotics. Ask you dentist or pharmacist for specific instructions.