Extractions

Removing a tooth is always a last resort. The first goal is to find a way to save it, through a filling, crown, root canal treatment, or another restorative approach. Extraction is considered when those options are not workable or when the tooth puts the surrounding teeth or your oral health at risk.

Common reasons an extraction may be recommended include:

• Severe decay that has destroyed too much of the tooth to be restored
• Advanced gum disease that has caused significant bone loss around the tooth root
• A fracture that extends below the gumline, so the tooth cannot be restored
• Overcrowding before orthodontic treatment, when removing a tooth is needed to create space
• Impacted teeth, most commonly wisdom teeth, that cannot come in normally and are causing problems

Before anything begins, the area is thoroughly numbed with local anesthetic. You should feel pressure during the procedure but not sharp pain. If you feel pain at any point, say so right away so the dentist can adjust.

After the tooth is removed, a blood clot forms in the socket. This clot is a critical part of healing because it protects the bone and nerve endings underneath while the tissue heals. Dislodging it can lead to a painful condition called dry socket.

For the first 24 hours after an extraction, avoid:

• Smoking or using any tobacco products
• Drinking through a straw (the suction can dislodge the clot)
• Vigorous rinsing or spitting
• Hard, crunchy, or chewy foods near the extraction site

Full written aftercare instructions are given at your appointment. You can also review the office's post-visit instructions.

Dry socket happens when the blood clot is dislodged or dissolves before the socket has had a chance to heal. It can cause significant pain, often spreading into the jaw or ear, and typically starts two to four days after the extraction.

In most cases, leaving a gap where a tooth was removed affects the surrounding teeth over time. The teeth next to the space may gradually drift into it, and the opposing tooth (the one it used to bite against) may shift as well. That can change your bite and make future restoration more complicated.

If you are considering replacing the tooth, options may include an implant-supported restoration, a fixed bridge, or a removable partial denture. The dentist is happy to discuss these at your appointment or at a follow-up visit.