What is a tooth extraction?

Indications and Procedures

A tooth may have to be extracted for one of several reasons. Impaction is a condition in which a developing tooth is forced into an adjacent tooth, blocking its progress; the impacted tooth can threaten the health and proper alignment of nearby teeth if it is not extracted. The occurrence of crooked or misaligned teeth may also require surgical removal. In tooth decay, dental tissue weakens in a gradual process and can eventually be destroyed. Decay usually begins in the outer layer of the tooth, penetrates to the underlying dentin, and kills the innermost tissue (pulp) of the tooth. Tooth extraction is necessary if this process of decay cannot be halted.

The extraction of teeth is one of the most common procedures in dentistry. Dentists usually perform simple extractions, but they often refer patients needing more complicated procedures to oral surgeons.

In simple extractions, the dentist first applies a local anesthetic to deaden the area surrounding the tooth that is to be pulled. Then, the dentist uses forceps and short levers to loosen the tooth in its socket. The tooth is removed in one piece by breaking the ligaments that hold the tooth in place. Once the tooth has been extracted, the dentist cleans the empty socket and ensures that the blood flowing from the socket is clotting properly. The socket is dressed to protect it and help it heal.

The oral surgeon may use a general anesthetic with a patient needing a complex extraction. The surgeon may need to cut through gum and bone to gain access to the tooth requiring extraction. The tooth may be cut into small pieces before it can be removed. Sutures may be required to close the wound.

The pain caused by extraction usually peaks a few hours after the procedure. Patients are given analgesics (painkillers) and are encouraged to keep the head elevated and to use an ice pack.

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