What it is
A tooth has a crown, the part visible above the gum, and roots anchored in sockets in the jawbone by a band of fibers called the periodontal ligament. An extraction frees the tooth from those attachments and removes it from the socket.
A simple extraction removes a tooth that is fully visible above the gum. A surgical extraction is used when a tooth has fractured at the gumline, has not fully erupted through the gum, or has curved roots, and the dentist may make a small incision in the gum or divide the tooth into sections. Dr. Itoafa determines which approach your tooth requires after an examination and an X-ray, and if your case would be better handled by an oral surgeon, he will say so.
When you might need it
Extractions are typically performed when the prognosis is hopeless. The usual causes are extensive decay that leaves too little sound tooth to rebuild, a fracture below the gumline, and severe periodontal disease that has destroyed the supporting bone. An injury, or a wisdom tooth that is stuck, sore, or crowding its neighbors, can also lead to removal.
Dentists try to retain natural teeth, so removal normally follows consideration of a root canal, a crown, or periodontal treatment. A failing tooth left in place can allow infection to spread into the surrounding gum and bone, so pain, swelling, or a loose tooth is a reason to call the office.
What happens at each visit
The first visit usually consists of an examination and an X-ray. The dentist assesses the tooth and the bone around it, explains why removal is recommended, and reviews the options for replacement. Tell the office about your health history, medications, and allergies, since each can change the plan.
For the removal, the area is anesthetized locally. The dentist loosens the tooth within its socket and lifts it out, and you will feel pressure and movement. Report any sharp pain so that more anesthetic can be given. You then bite on gauze to control bleeding, and a stitch sometimes closes the gum. You receive aftercare instructions, and a follow-up visit is added when the case calls for one.
Materials and what to expect afterward
A blood clot forms in the empty socket. It protects the underlying bone and nerve endings and begins the healing, so the aim for the first day is to leave it undisturbed. Do not rinse, spit, or use a straw, and avoid smoking and vaping, which slow healing and make a dry socket more likely. Keep gauze in place with gentle pressure.
Mild soreness, swelling, and slight oozing are normal early on. A cold compress on the cheek reduces swelling. After the first day, rinse gently with warm salt water and follow the dentist's directions for pain relief. Call the office if bleeding does not slow with pressure, if you develop a fever, or if pain worsens after the first few days instead of easing, since that can indicate a dry socket.
Once a tooth is lost, neighboring teeth can drift into the gap. The replacement options are a dental implant, a bridge, or a partial or complete denture, and the condition of the bone shapes the plan. An implant may be placed at the time of the extraction or later, after the bone has healed. If the socket was not well preserved, procedures such as ridge augmentation may be needed first.
Why Dutch Creek Dental
Dr. Mike Itoafa has owned Dutch Creek Dental since 2018, and the practice has been on West Coal Mine Avenue for more than 30 years. Most extractions are done in this office. Complex cases, such as impacted wisdom teeth, are referred to an oral surgeon, a specialist whom Dr. Itoafa trusts.
Common questions
Does an extraction hurt?
The area is anesthetized first, so you should feel pressure and movement rather than sharp pain. Tell the dentist if you feel sharp pain. Soreness afterward is common and usually eases over a few days.
How long does healing take?
Healing varies from person to person. Soreness usually eases within a few days, the gum closes over the socket in the weeks that follow, and the bone beneath continues to remodel for several months.
What is a dry socket?
A dry socket, clinically called alveolar osteitis, occurs when the blood clot is dislodged or dissolves too early and exposes the bone. It causes pain that intensifies a few days after the extraction. Call the office if you suspect one.
When can I eat after an extraction?
Wait until the numbness has worn off, so that you do not bite your cheek or tongue. Begin with soft, cool foods, and avoid hot drinks, hard or crunchy food, and straws until the dentist advises otherwise.
What should I tell the dentist before an extraction?
Tell the office about every medicine and supplement you take, any heart or joint condition, any allergy, and any pregnancy. Do not stop a prescribed medicine without asking the dentist or your physician first.