Oral Surgery

When Is Tooth Extraction Necessary?

In many cases,  you can repair teeth that are broken or damaged by decay with a filling, crown, or other dental treatment. Sometimes, though, the damage is too severe to repair, so your dentist will recommend extraction.

Here are some other reasons tooth extraction might be necessary:

• Decay or infection has reached deep into the tooth
• Trauma or injury
• There isn’t enough room for all the teeth in your mouth
• Baby teeth don't fall out in time for the permanent teeth to come in
• Orthodontic treatment might require tooth extraction to create room for the teeth as they move into place
• Wisdom teeth, also called third molars, are often extracted either before or after they come in

Preparation

Before removing a tooth, your dentist will thoroughly review your medical and dental history and take the appropriate X-rays. X-rays reveal the length, shape, and position of the tooth and surrounding bone. From this information, your dentist can determine the best way to remove the tooth or whether to refer you to an oral surgeon.

Before removal during a simple extraction, they will numb the area around your tooth using local anesthetic. However, during a more complicated removal, called a surgical extraction, your oral surgeon might administer intravenous (IV) anesthesia, which can range from conscious sedation to general anesthesia, which will put you to sleep. If this is the case, arrange for someone to drive you home after the procedure and stay with you until the effects wear off.

Tooth Extraction Process

There are two types of extractions you might have:

1. A simple extraction is the removal of a tooth that is visible in your mouth. It’s common for a general dentist to perform simple extractions. During a simple extraction, your dentist will numb the tooth and gum tissue and loosen the tooth with an instrument called an elevator before removing it with dental forceps.
2. A surgical extraction is a more complex procedure used for a tooth that may have broken off at the gum line or has not come into the mouth yet. Oral surgeons usually perform surgical extractions; however, general dentists can perform them as well. During a surgical extraction, the doctor will make a small incision (cut) into your gum and remove the underlying tooth.