Detailed Procedure Guide: Tooth Extractions
What is a tooth extraction?
A tooth extraction is the removal of a natural tooth from the jaw. It’s a very common oral surgical procedure, sometimes referred to as “having a tooth pulled.”
A tooth extraction may be necessary because of tooth decay, tooth fracture, gum disease, trauma to the mouth or infection.
What is the process for extracting a tooth?
A tooth extraction is typically a quick and easy outpatient procedure, except when the tooth is broken, below the surface, or impacted, in which case the process can be much more involved.
In the past, dentists focused on getting the tooth completely out of the jaw and there was little to no consideration given to bone preservation or future dental implants.
Today, dentists are concerned with limiting extraction trauma and preserving as much of the surrounding bone as possible. This helps facilitate future implant placements.
Before pulling a tooth your dentist will give you a local anesthetic to numb the area around the tooth that will be removed.
After the tooth has been pulled, your dentist will place a gauze pad into the socket. In some cases s/he may place a few stitches to close the extraction site.
How do you determine if you need a tooth extracted?
Determining whether you need a tooth extracted can only be determined by having a dental exam.
There are a number of reasons why a tooth might need to be extracted. Decay can grow deep into the tooth, invade the nerve, and cause an endodontic infection.
Other times periodontal disease—an infection of the tissues and bone that surround and support the teeth—can erode the surrounding bone to the point where the tooth or teeth become loose and need to be extracted.
Symptoms of tooth infection may include:
- Throbbing tooth pain
- Throbbing pain in the jawbone
- Sensitivity to pressure in the mouth
- Sensitivity to hot or cold food and drink
- Cheek swelling
- Bad breath
- An unpleasant taste in your mouth
When a tooth is badly decayed or becomes infected, a root canal—where the nerve and tissue are removed and the inside of the tooth is cleaned and sealed—can sometimes save a tooth.
Other times, an extraction is the only option to relieve pain and infection.
Average cost of a tooth extraction
The cost for a tooth extraction typically ranges from $100 to $300 per tooth, depending on a variety of factors, including the condition of the tooth, gum health, and the overall difficulty of the extraction.
If immediate post-extraction grafting is needed to preserve the bone for future implant placement, these charges are generally separate from the extraction fee.
Preoperative advice and tips
Many tooth extractions are done on an emergency basis and as a result, preoperative preparations are often minimal.
But the preoperative process generally includes:
- A consultation with your dentist, at which time he or she may request that you start or stop taking specific medications
- X-rays, which help your dentist evaluate the condition of the tooth and surrounding area
- Your dentist may prescribe an antibiotic before a tooth extraction
You should tell your dentist if you have any medical conditions, including hypertension or diabetes.
Also, if you smoke you should stop smoking to help promote healing and minimize the possibility of a dry socket.
A dry socket is a painful yet easily treatable condition that can occur when the blood clot that forms in the wake of an extraction is dislodged or dissolves, leaving the bone and nerve exposed to air, food and drink
CBCT scans (or 3-D X-rays) are a great help when planning for an extraction or other oral surgery.
Anatomical landmarks such as nerves, arteries, bony structures, and sinuses can be mapped and avoided during the extraction procedure.
X-rays can also aid in the postoperative grafting process and lead to better bone grafts and stronger implants.
Anesthesia: Can you be put under sedation for a tooth extraction?
Millions of teeth are extracted every year using local anesthetic (Lidocaine) only, but some people prefer to be sedated.
Complex surgical extractions, preoperative infections, multiple extractions and patient anxiety are reasons why you may choose to be sedated.
Is this a same-day procedure?
Yes. And dentists are accustomed to having patients arrive at the office in need of an emergency tooth extraction, either because of pain or infection.
Teeth can often be removed and even grafted at the same appointment using nothing more than local anesthetic (Lidocaine).
Post-extraction tips and advice for proper healing
Postoperative instructions are provided in the wake of a tooth extraction.
It is imperative that you follow these instructions closely, both to ensure proper healing and to avoid postoperative complications, such as a dry socket or infection.
Do not smoke for several days (minimum), and also avoid using straws to drink as this can cause a dry socket.
You are also encouraged to rinse with warm saltwater two to three times a day to prevent infection and encourage gingival healing. Consistently rinsing with saltwater has been shown to help facilitate the healing process.
Duration of recovery
With tooth extractions, recovery varies from patient to patient and according to the difficulty of the extraction itself.
While tooth extractions are traumatic by nature dentists are skilled at limiting trauma when pulling teeth.
Most extraction sites heal within a few days, but more difficult extractions can leave large bone sockets or holes that heal more slowly. Surgical extractions typically require immediate bone grafting and may also take longer to heal.
It is extremely important that you follow all postoperative instructions and avoid smoking.
Prescription pain medications are generally needed for pain control during the first few days after treatment.
Sometimes an infected tooth can be saved by doing a root canal but in many cases an extraction is the only option to relieve pain and infection.
But having a tooth pulled is nothing to be ashamed of. According to the Centers for Disease Control and Prevention (CDC), by the age of 50 the average person has lost eight teeth. The CDC also tells us that 18.6 percent of adults aged 65 and over are edentulous—that is, they have lost all of their natural teeth.
While there may not be many alternatives for saving a damaged tooth, dental implants are far and away the best way to replace missing teeth.