Exodontia: What You Need To Know About Tooth Extraction

What is exodontia? The procedure is formally defined as the removal of teeth from the socket of the jawbone. Your dentist will consider all methods for keeping the tooth and restoring its health before recommending extraction. However, in some cases, pulling the tooth is essential for oral health. These cases might include:

• Damaged or decayed tooth. Injury or trauma can fracture or damage a tooth beyond repair. Tooth decay can also progress so much that it can no longer be treated with a dental filling, crown, or root canal.
• Crowded mouth or impacted teeth. Preparation for orthodontic work — such as braces and retainers — often requires pulling one or more teeth. Wisdom teeth are often removed because the mouth is already crowded, or the teeth are impacted or infected.
• Infection or risk of infection. Severe periodontal disease — the infection of the gums, tissues, and bones that support the teeth — can cause the tooth to loosen significantly, requiring extraction. For those with compromised immune systems — such as chemotherapy patients — the risk of infection in a tooth provides enough reason to pull it.

Two types of tooth extraction exist. The first — a simple extraction — involves removing a tooth that is visible in the mouth. A general dentist typically performs these simple procedures. On the other hand, surgical tooth extraction requires an oral surgeon and involves removing a tooth that is not visible because it has not erupted or has broken off. The process for exodontia typically looks like this:

• Anesthesia. Most extractions require only local anesthesia. Some dental professionals might also provide anti-anxiety medication or use conscious sedation to make you more comfortable. However, some surgical extractions will require general anesthesia, which puts you completely to sleep.
• Extraction. The dental professional will grip the tooth with forceps or another instrument and gently rock it from side to side until it loosens from the socket. You may feel a slight tug, but you shouldn't experience any pain. An impacted tooth will require the surgeon to cut away the gum and bone tissue covering the tooth before loosening it from the jawbone. Sometimes, stubborn teeth must be removed in pieces.
• Repair. After removal, a blood clot forms in the socket. The dental professional might place a few self-dissolving stitches to help close the gap, and you will bite into soft cotton gauze to help stop the bleeding.
• Recovery. It will take 2 - 7 days to recover, depending on the type of extraction. Your dental professional will provide directions to maximize the healing process and maintain your oral health, so follow their instructions closely. Use painkillers as prescribed and gently apply ice to the affected area to help with pain and swelling. Avoid strenuous activity, drinking from a straw, smoking, forceful rinsing and spitting, and solid foods until the extraction site heals.

You should expect a little pain or soreness after your procedure, and it may take a few hours for the site to stop bleeding. However, keep an eye out for these complications:

• Dry socket. This common — but avoidable — complication occurs when the blood clot that covers the empty socket is removed. Activities like smoking or sucking on a straw can dislodge the blood clot, exposing the bone and nerves and causing extreme pain. Follow your dentist's instructions to avoid dry sockets.
• Infection. Your mouth houses a lot of bacteria, so any wounds are susceptible to infection. Your dentist might prescribe an antibiotic as a preventative measure. Do your best to keep the site clean and care for other areas of your mouth. If you start to notice pain or pus at the extraction site, contact your dentist immediately.
• Fractures. Sometimes hard-to-pull teeth break during the extraction, but it's not a big deal because the tooth was coming out anyway. Problems occur when a piece of the tooth gets left behind, causing infections or cysts later. Other times too much pressure can fracture the neighboring teeth or jawbone. This usually happens if your jawbone is already weak from age or periodontal disease. Your dentist can let you know if your jawbone is at risk before the procedure.
• Nerve damage. During the procedure, you could also receive damage to the trigeminal nerve, which helps you chew. Though uncommon, this nerve damage leads to symptoms like numbness, tingling, or pain in the lips, chin, gums, teeth, and tongue. Damage usually resolves when the nerve heals after a few weeks or months. Your dental professional will take the necessary precautions to avoid potential nerve damage.

Unless you have a major toothache that needs relief, you likely feel unexcited about your upcoming tooth extraction. However, this routine procedure is pretty common, and your dentist would only recommend exodontia if necessary for your oral health. Listen to your dental professional, and follow their instructions to avoid any complications and enjoy a smooth recovery from your tooth extraction.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider.