Our dentists make every effort to help patients keep their teeth healthy and free of decay. At-home brushing and flossing, routine professional cleanings, fillings, root canal procedures, bonding, gum disease prevention, and a number of other services we offer are designed to maintain dental health. In some cases, though, teeth simply can’t be saved, and this brings about the need for an extraction.

Reasons for Needing an Extraction

Perhaps the most common reason for extraction, or pulling of a tooth, is decay. Often, too much of the tooth has been affected to be filled successfully, so we’ll need to pull it to stop the pain and prevent cavities from spreading to surrounding teeth. Some of the other issues we typically see include:

  • Infection: When an infection is too severe to be remedied by antibiotics or a root canal procedure, we may have to pull the tooth to eliminate the infection as well as any pain it may be causing.
  • Periodontal disease: If advanced stages of gum disease have caused a patient’s teeth to loosen, they may need to be extracted to pave the way for future treatments and reduce the risks of serious infections.
  • Trauma: Falling by the pool, being hit with baseballs, and vehicle accidents are only a few of the common causes we see when dealing with broken teeth. Facial trauma can happen to anyone, and though we’re often able to repair cracks or chips, this isn’t always the case.
  • Overcrowding: Some people, essentially, have too many teeth to fit in their mouths properly, so we may have to extract one to make room for another. We also perform extractions before fitting a patient with braces, if need be, to allow his or her teeth to move and align as they should.
  • Increased Risk of Infection: Patients with weakened immune systems or who are more susceptible to the impacts of an infection may need to have a tooth extracted. These may be teeth we would attempt to save under ordinary circumstances but, for some patients, eliminating even the slightest chance of developing an infection would be more beneficial in the long run.

In some instances, we may need to prescribe a round of antibiotics before extracting a tooth to eliminate any existing bacterial infections. If we pull a tooth before treating infections like these, bacteria could enter the bloodstream, leading to more widespread health issues. This is the reason behind many of the questions we have you answer on your pre-care forms, so it’s crucial to answer them truthfully and thoroughly.

What Happens During an Extraction?

We’ll need to numb your tooth and its surrounding tissues before we begin the procedure. First of all, we’ll dab anesthetic gel on your gums near the tooth to be pulled. This needs to sit for about five minutes before the next step. It won’t completely numb your gums, but it will keep you from feeling the injection quite as much as you would otherwise.

Next comes the anesthetic injection. We’ll insert the needle into your gum tissue, working it slowly from the injection site to the tooth we’ll be extracting. As we move the needle, we’ll be injecting tiny amounts of anesthetic along the way, finally delivering most of the dose at the tooth itself. You’ll feel the complete numbing effects after about ten minutes.

Once the area where we’ll be working is numb, we’ll begin the extraction process. We have to move the tooth back and forth to widen its socket enough for the tooth to be released. You shouldn’t feel any pain while we’re working, but you’ll probably feel a lot of pressure. If you do begin to feel actual pain, please stop us so we can administer more anesthetic.

Other Possibilities

In some situations, a simple extraction isn’t possible. If wiggling the tooth to widen its socket doesn’t work, or in the event the root is curved, we may have to section the tooth, which means we’ll cut it into smaller sections and remove those one by one. If the tooth is broken off at the gum line or is impacted within your gum tissue, we may have to perform a surgical extraction. The procedure will be much the same as conventional pulling, but we’ll need to make small incisions in your gums to remove the tooth. We’ll close the incisions with dissolving stitches after the tooth is extracted.

After-Care Instructions

After your extraction, we’ll place a gauze pad in the space left behind to slow any bleeding and protect the tooth’s socket while a blood clot forms. You may need to change the gauze a few times before the bleeding stops, and we recommend keeping gauze in place for at least three hours after your procedure. We’ll give you a prescription for pain medication to be taken as needed.

At the Washington Center for Cosmetic Dentistry, we strongly caution against drinking from a straw for at least 24 hours, as this could dislodge the clot and lead to bleeding as well as infections. Smoking and drinking alcohol tend to have similar effects. Ice packs can be used to reduce swelling. Though we recommend keeping up with your normal at-home dental hygiene practices, you should take extra care to avoid brushing the extraction site for the first few days following the procedure.

After 24 hours, you may begin using a rinse made of eight ounces warm water and 1/8 teaspoon of salt. You should avoid strenuous activity for a couple days. These are general rules, and we may give you more specific instructions to follow.