When Tooth Extraction is Necessary
Dentists will do all they can to save a tooth but sometimes a tooth extraction is necessary to prevent further damage.
If you have a tooth that is badly decayed or broken, your dentist will try to fix it with a filling, crown, or other dental restoration. But when a tooth is beyond repair, it needs to be removed from its socket in the jaw bone – the dental alveolus. This applies to kids as well as adults because primary (baby) teeth are subject to the same issues as permanent (adult) teeth.
There are two types of extractions: simple and surgical. A simple extraction entails loosening the tooth and then using forceps to remove it. With the more complex procedure of a surgical extraction, a small incision is made in the gum to allow for the removal of a broken or impacted tooth.
Simple extractions are usually carried out with a local anesthetic while surgical extractions are generally done with general anesthesia.
When Tooth Extraction is Necessary for Adults
Your permanent teeth are meant to last a lifetime. However, many adults in the U.S. lose teeth through injury, decay, or gum disease. When one or more teeth are missing, it impacts your oral health as well as your appearance.
Each of your teeth plays a role in helping you to talk and eat properly, and the loss of just a single back tooth can warp your mouth out of shape and make you look older. Missing teeth also allow bacteria and plaque to accumulate in areas that are difficult to clean, which can result in gum disease and the loss of even more teeth.
Tooth extraction in adults may be necessary when:
Decay causes severe damage
Tooth decay begins when acids created by bacterial plaque soften tooth enamel. In severe cases, the decay breaks through the enamel and the underlying dentin layer right into the pulp in the center of a tooth, causing infection among nerves and blood vessels. In some cases, antibiotics or a root canal may provide a solution, but if the infection is severe, an extraction may be necessary to prevent the infection from spreading.
Your mouth is overcrowded
Extraction of one or more teeth may be necessary to eliminate overcrowding in your mouth. Crowded teeth make brushing and flossing difficult, which can result in gum disease and an increased risk of cavities. Other problems of crowded teeth include:
- Abnormal wear on your teeth.
- Greater risk of injury if teeth protrude.
- Difficulties in chewing your food properly.
- Speech impairment.
- Bad breath.
Extraction may also be necessary if you need braces as an adult and overcrowding means there is no room to reposition your teeth.
A tooth becomes impacted
Impaction occurs when a tooth stays enclosed within the gum or jaw bone or only partially erupts through the gum line. This is prevalent with wisdom teeth. Incomplete eruption of a tooth allows bacteria to get into the area and cause infection. Teeth that emerge crooked or only partially erupt can also result in painful crowding.
Dental issues resulting from impacted teeth can lead to overall health problems including:
- Headaches caused by bite irregularities.
- Spreading of the infection to other areas of your body.
You’ve suffered a mouth injury
If you need dental treatment after an accident such as a traffic collision, the first option will be to preserve damaged teeth with restorative procedures. If the damage is significant, however, extraction may be necessary.
You’re at greater risk of infection
If your immune system is compromised by medical treatments such as chemotherapy, the risk of infection in a particular tooth may justify extraction.
Gum disease has loosened teeth
Extraction may be necessary if gum disease has infected the soft tissues and bones supporting and surrounding your teeth, causing them to become loose.
When Tooth Extraction is Necessary for Children
According to the American Dental Association (ADA), reasons for tooth extraction in children include a traumatic dental emergency and severe decay.
Other cases that may warrant tooth removal for a youngster include:
- When they can’t remove a stubborn baby tooth themselves.
- A baby tooth has developed an abscess.
- When extraction is necessary as part of orthodontic treatment.
As with adult teeth, dentists will do everything possible to save a baby tooth. Primary teeth are important in your child's development. They reserve space for their permanent teeth to emerge and enable them to eat and speak properly.
If a baby tooth is lost prematurely, there’s a risk of permanent teeth that have already emerged shifting into the gap, making it difficult for other adult teeth to emerge and resulting in crowding or crooked teeth.
To overcome this problem if a tooth extraction is necessary, your child’s dentist may recommend a device to maintain space for the underlying adult tooth to grow into.
What Happens After a Tooth Extraction?
Recovery after having a tooth pulled generally takes a few days. The following measures can help to reduce the risk of infection, minimize discomfort, and speed up recovery.
- For half an hour after the extraction, bite down on the gauze pad placed by your dentist. This will help to form a blood clot.
- When lying down, prop up your head with pillows. Lying flat can prolong bleeding.
- Don’t eat for a couple of hours. Afterward, stick to soft foods for the rest of the day.
- Once bleeding subsides, drink plenty of lukewarm or cold fluids.
- Don't brush your teeth or rinse your mouth for 12 hours.
- Don't use straws or smoke as long as there is bleeding.
- Follow your dentist's instructions on pain relief.
Initial healing after an extraction typically takes one or two weeks as new gum tissue and bone grow into the gap.
Over time, though, a missing tooth can cause remaining teeth to shift, impairing your bite function. A dentist experienced in tooth extractions and follow-up treatment can advise you on tooth replacement options such as:
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