What Is
It?
Tooth extraction is the removal of a tooth from its socket in the
bone.
What It's Used For
If a tooth has been broken or damaged by decay, your dentist will
try to fix it with a filling, crown or other treatment. Sometimes,
though, there's too much damage for the tooth to be repaired. This
is the most common reason for extracting a tooth.
Here are other reasons:
Some people have extra teeth that block other teeth from coming
in.
People getting braces may need teeth extracted to create room for
the teeth that are being moved into place.
People receiving radiation to the head and neck may need to have
teeth in the field of radiation extracted.
People receiving cancer drugs may develop infected teeth. These
drugs weaken the immune system, increasing the risk of infection.
Infected teeth may need to be extracted.
People receiving an organ transplant may need some teeth extracted
if the teeth could become sources of infection after the
transplant. People with organ transplants have a high risk of
infection because they must take drugs that decrease or suppress
the immune system.
Wisdom teeth, also called third molars, are often extracted either
before or after they come in. They commonly come in during the
late teens or early 20s. These teeth often get stuck in the jaw
(impacted) and do not come in. They need to be removed if they are
decayed or cause pain. Some wisdom teeth are blocked by other
teeth or may not have enough room to come in completely. This can
irritate the gum, causing pain and swelling. In this case, the
tooth must be removed.
Preparation
Your dentist or oral surgeon will ask about your medical and
dental histories. He or she will take an X-ray of the area to help
plan the best way to remove the tooth.
If you are having all of your wisdom teeth removed, you may have a
panoramic X-ray. This X-ray takes a picture of all of your teeth
at once. It can show several things that help to guide an
extraction:
The relationship of your wisdom teeth to your other teeth
The upper teeth's relationship to your sinuses
The lower teeth's relationship to a nerve in the jawbone that
gives feeling to your lower jaw, lower teeth, lower lip and chin.
This nerve is called the inferior alveolar nerve.
Any infections, tumors or bone disease that may be present
Some health care professionals prescribe antibiotics to be taken
before and after surgery. This practice varies by the dentist or
oral surgeon. Antibiotics are more likely to be given if:
You have infection at the time of surgery
You have a weakened immune system
You will have a long surgery
You have specific medical condition(s)
If you're going to have conscious sedation or deeper anesthesia,
wear clothing that has short sleeves or sleeves that can be rolled
up easily. This allows easy access for an intravenous (IV) line to
be placed in a vein.
You will be told not to eat or drink anything for six or eight
hours before the procedure. You also should make sure you have
someone available to drive you home after the surgery.
How It's Done There are two types of extractions:
A simple extraction is performed on a tooth that can be seen in
the mouth. General dentists commonly do simple extractions. Most
of these can be done using just an injection (a local anesthetic),
with or without anti-anxiety drugs. In a simple extraction, the
dentist will grasp the tooth with forceps and loosen it by moving
the forceps back and forth. Then the tooth will be pulled out.
Sometimes the dentist will use a dental "elevator" to help loosen
the tooth. This is an instrument that fits between the tooth and
the gum.
A surgical extraction involves teeth that cannot be seen easily in
the mouth. They may have broken off at the gum line or they may
not have come in yet. To see and remove the tooth, the dentist or
oral surgeon must cut and pull back the gums. Pulling back the gum
"flap" provides access to remove bone and/or a piece of the tooth.
Surgical extractions commonly are done by oral surgeons. They are
done with injections (local anesthesia), and you can also have
conscious sedation. Patients with special medical conditions and
young children may be given general anesthesia. In a surgical
extraction, the dentist will need to make a cut (incision) in your
gum to reach the tooth. In some cases, the tooth will need to be
cut into pieces to be removed.
If you are having teeth extracted and are receiving conscious
sedation, you may be given steroids in your IV line to help reduce
swelling after the procedure.
If you need all four wisdom teeth removed, they are usually taken
out at the same time. The top teeth are usually easier to remove
than the lower ones.
Here are the types of wisdom teeth, in order from easiest to
remove to most complex to remove:
Erupted (already in the mouth)
Soft-tissue impacted (just under the gum)
Partial-bony impacted (partially stuck in the jaw)
Full-bony impacted (completely stuck in the jaw)
Also, if your wisdom teeth are tilted sideways, they can be harder
to remove than if they are vertical.
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