While it is nearly always better to retain your teeth instead of extracting them, sometimes extraction is the best treatment option. Here are some reasons for extraction:
- If tooth is badly decayed or damaged
- Infection due to periodontal disease
- To prevent complications from badly diseased teeth
- To improve appearance
- To remove teeth with no function
- If there are cracks in a tooth root
Removal of a tooth or teeth is only done after careful consideration and discussion. Your dentist will aim to achieve the best long term outcome while giving you the most satisfactory function and appearance possible. The method of extraction varies depending on the type of tooth and its roots, and its position in the jaw. It can be easy or difficult. Difficult extractions are usually due to:
- Extensive decay in the tooth
- Adjacent teeth have crowns or fillings
- Affecting neighbouring teeth
- An impacted tooth (ankylosis)
- A nerve lying near the tooth
- Large and curved roots that penetrate the jaw bone deeply
Possible complications of extraction
Pain may occur once the anaesthetic wears off. Your dentist will advise you and prescribe painkillers.
Bleeding may occur although is uncommon. It can normally be stopped by applying pressure with a gauze pack over the wound.
A dry socket may occur if the blood clot that normally forms in the socket is washed away or dissolves. Without it, proper healing and relief from pain become slow and difficult. To prevent a dry socket, do not rinse your mouth or spit during the first 24 hours after your surgery. Do not brush your teeth around the area. Do not smoke for two weeks. After the first day, rinse your mouth gently with warm salt water.
An infection may occur in the gum or bone. Contact your dentist at once if you develop a fever, or bleed or feel increasing pain.
A sinus may be opened when an upper tooth is removed because it is close to the sinuses. This will usually heal quickly.
Numbness in the teeth, gums, cheeks, lips, chin, and tongue may occur due to an injured nerve. This will usually disappear over a few weeks as the nerve recovers. In some people, this may take 6 to 18 months. In rare cases, the nerve may not completely heal and the numbness may be permanent. Chronic pain is also possible.
The tooth or fillings next to the extracted tooth may be chipped or loosened during. This is rare.
Your jaw bone may thin due to an extracted tooth. To prevent thinning, your dentist may recommend implants or dentures so you can exert pressure on your jaw bone with daily chewing.
When wisdom teeth don’t have enough space to come through, they become impacted and may need to be removed if causing problems. Removal of wisdom teeth is a very common procedure. If your wisdom teeth are likely to be complicated to remove, your dentist may refer you to an oral and maxillofacial surgeon.
If your wisdom teeth need to be removed, your dentist will examine your teeth and discuss a diagnosis with you. If the area around the wisdom teeth has been infected, your dentist may decide to treat this first before the surgery. If he sees that the tooth may “settle down” and stop causing problems, he may observe it first before deciding on removing it.
Removal of wisdom teeth
Your dentist will make an incision to open your gums to remove the wisdom tooth. A small portion of the bone may have to be removed. The tooth may have to be divided into segments so it can be removed easily and safely. The incision in your gums may have to be closed with stitches.
After the surgery, you will need to rest for a while before going home. Have someone drive you home and arrange this well in advance. At home, you must rest and not engage in any physical activity. Take several days off work or school, do not drink alcoholic drinks while taking antibiotics or painkillers, eat soft foods, and drink lots of water.
Possible complications of wisdom tooth surgery
- Numbness or altered sensation
- Nerve damage causing pain
- Dry socket
- Difficulty in opening mouth
- Lip sores – while tooth is being removed, stretching of the lip by surgical instruments may cause bruises or small sores. They usually heal without any problems and are uncommon.
- Damage to nearby tooth or fillings
- Vomiting – some people may vomit from the effects of a general anaesthetic.
- Sinus problems
- Weak jaw – this is temporary.