Tooth Extractions

Unfortunately, we can’t save every tooth. In some instances, we may have to remove one or multiple teeth due to a multitude of reasons. Whatever the case, for most patients, the actual procedure for extracting the tooth is routine. Any deviations just depend on where the soon-to-be removed tooth is located, and how its roots are structured.

For instance, it is significantly easier to remove a front tooth with one, straight root, compared to extracting a back molar with several roots. One case that is particularly tricky is an impacted wisdom tooth, as they are not visible to the naked eye. Impacted teeth are below the surface and don’t have enough room to emerge due to other teeth in its way. Therefore, getting to the actual tooth itself while navigating multiple root systems can become difficult.

Teeth are not affixed to bone structure; they are actually connected to the bone by fibers that make up the periodontal ligament. With careful planning and execution, we can free the tooth from these fibers and remove it without too much discomfort or difficulty. At the end of the day, having a tooth removed should not be a scary or painful experience if the procedure is done by a seasoned professional, like Dr. Brumbach.

Why Would We Extract a Tooth?

There are a number of reasons for removing a tooth. We’ve outlined some of the reasons below and the advantages and disadvantages to each:

• Trauma or Disease — While our main priority is to preserve your teeth, sometimes an extraction is necessary in order to maintain function and overall health. Otherwise, if we can place a crown or perform a root canal, we will definitely consider those options before proceeding. However, in some cases, we may decide it is best to extract the tooth and replace it with a durable, long-lasting dental implant.
• Orthodontic Treatment — Crowding is a condition where there are too many teeth for the size of the jaws. In order to make more room for teeth to emerge and align, we consult with the orthodontist and may extract certain teeth for optimal alignment.
• Impacted Wisdom Teeth — Identifying and removing impacted wisdom teeth can prevent future damage to nearby healthy teeth, bone structure and gum tissues. Additionally, it can prevent damage to nerves and blood vessels. It is best to remove impacted teeth as early as possible before the roots have time to fully develop.
• Baby Teeth — In order for permanent teeth to emerge normally, baby teeth have to be in the right position and sequence. If for some reason baby teeth are not in the right place, removing the baby tooth could be necessary in order to prevent the necessity of orthodontic treatment in the future.

The Tooth Extraction Procedure

Before we can get started on extracting a troublesome tooth, we will need to take an x-ray in order to study the tooth’s position, its root structure and its bone structure. Our goal is to identify any issues that may cause complications during the procedure. We also complete a medical and drug history to make sure that you are in good enough health for this type of treatment. Finally, we will go over your anesthesia options.

Typically, we use local anesthesia to numb the teeth and nearby bone and gum tissue prior to removal. However, in addition to the anesthetic, we may also utilize an oral sedative (pill form), or nitrous oxide. In more complicated or difficult situations, we may use conscious sedation, administered intravenously. Most patients do not experience negative side effects from these types of sedatives, and often don’t even remember the surgery!

During the extraction, we are very cautious to not damage the bone structure surrounding the tooth. Like we mentioned above, our goal is to preserve as much of your tooth as possible, including the bone. In some instances, it may be necessary to put a certain amount of lab-processed bone-grafting material into the tooth socket in order to help keep the bone volume, especially if we plan to place a dental implant in its place. A dental implant needs to fuse to existing bone in order to function correctly.

What Happens After a Tooth Extraction?

After we’ve completed the removal, we cover the empty socket with gauze and apply pressure in order to slow down and eventually stop the bleeding. Dr. Brumbach may opt to stop the bleeding with small stitches instead, depending on the case. Swelling, discomfort, and some pain is standard post-surgery. These symptoms can be treated with an over-the-counter anti-inflammatory (like ibuprofen) and an ice pack to help with the swelling. Antibiotics may also be prescribed in order to prevent infection while you are healing. You should feel back to normal after a couple of days! Until then, avoid hard, crunchy, spicy foods and focus on incorporating softer foods into your diet to manage pain.