What Is Tooth Extraction?
Tooth extraction refers to the methods used to remove teeth from their sockets. There are two kinds of extraction — non-surgical extraction, also known as simple extraction, and surgical extraction.
- A non-surgical or simple extraction involves loosening the tooth with a lifter, then gently removing the tooth from the gums with forceps. A simple extraction is most commonly used for teeth that have fully erupted or are completely visible above the gumline.
- A surgical extraction involves making small incisions in the gums to expose every part of the tooth, so it can be completely removed. This extraction is required when a tooth is impacted.
A tooth becomes impacted when there’s a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone, or another tooth. A tooth may be partially impacted, meaning a portion of it has broken through the gum. Or a tooth can be totally impacted when it is unable to break through the gum at all. While your regular teeth can become impacted, wisdom teeth are especially susceptible.
What Are Wisdom Teeth?
Wisdom teeth, also referred to as third molars, usually erupt between the age of 17 to 25. Wisdom teeth used to erupt in order to compensate for the excessive wear and forward drifting of teeth due to the rough diet of early humans. Modern diets are soft and refined and excessive wear of teeth is not observed. As a result, there is often no room for wisdom teeth to fully erupt and they become impacted.
Potential Problems of Avoiding Tooth Extraction
Failure to remove problematic teeth, especially wisdom teeth in a timely manner can result in numerous problems. Notable potential issues include the following:
Inflammation and Irritation – Partially impacted teeth cause the overlying gum tissue to become inflamed and irritated.
Decay – In the case of an impacted tooth, food may become lodged in the area which will eventually lead to decay of both the wisdom tooth and the tooth next to it. This will necessitate root canal treatment on the adjacent tooth. If the tooth is erupted, but badly decayed, failing to remove it could also spread decay to other adjacent teeth.
Infection – Infection of the tooth or the area around the tooth can spread to the muscles that help to open and close the mouth. This can lead to the restricted opening of the mouth, stiffness, and illnesses such as gum disease.
Misalignment – The pressure from an erupting wisdom tooth may move other teeth and disrupt their alignment. Sometimes the wisdom teeth make their way through the gum tissue but due to lack of space may erupt more buccally (towards your cheek) or lingually (towards your tongue). This causes cheek biting, food lodgment, and subsequent decay and infection. This can also occur in non-wisdom teeth.
Cysts – When a tooth is totally impacted, especially a wisdom tooth, the developmental sac that surrounds the tooth may become filled with fluid and enlarge to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone, and nerves. In some cases, if a cyst isn’t treated, a tumor may develop and a more serious surgical procedure may be required to remove it.
The Tooth Extraction Process
Before having any of your teeth extracted, you’ll undergo a consultation with Dr. Nishime. During your consultation, he’ll gather necessary information by examining and taking X-rays and impressions of your mouth, reviewing your medical history, and asking you about your smile goals.
Once you and Dr. Nishime have both decided that extraction is the right option, we’ll schedule your next appointment. Most tooth extractions are performed in the oral and maxillofacial surgery office under local and general anesthesia and sedation. Your oral and maxillofacial surgeon will discuss the options which may be best for you.
To prepare the surgical site, your mouth will be thoroughly cleaned. Then, you’ll have an anesthetic applied alongside your sedation option of choice. Your oral and maxillofacial surgeon will make sure both your anesthetic and your sedative are working properly before proceeding.
For a non-surgical extraction of a fully erupted tooth, the tooth will be loosened. Then, it will be gently removed with a dental elevator, also called a lifter or luxator. Then, the tooth will be gently removed from the socket with forceps.
For a surgical extraction, an incision is made in your gums adjacent to the probable location of the tooth to be removed. The gum tissue overlying the impacted tooth is pulled back to expose the tooth. Removal of some bone around the tooth may be necessary to free the tooth and aid in a non-traumatic extraction. Resorbable sutures and gauze may be placed to aid in healing.
Frequently Asked Questions
Wisdom teeth are easier to remove when the patient is younger since their roots are not completely formed, the surrounding bone is softer, and there is less chance of damaging nearby nerves or other structures. Removal of wisdom teeth at a later age becomes more complicated as the roots have fully developed, sometimes involving the nerve, and the jawbone is denser. Early removal will help ensure optimal and less complicated healing.
For some patients, the wisdom teeth may erupt normally and will be properly aligned in the arch. In such instances, the wisdom teeth can be retained with proper at-home care.
Common rules to follow after a tooth extraction include the following:
- Rinse gently with warm salt water or antimicrobial mouthwash after meals
- Avoid exercise and strenuous activity for at least two days
- Take medications as directed
- Apply a cold compress to reduce swelling and discomfort
- Replace any gauze as needed, usually every 30 to 45 minutes during active bleeding
- Avoid foods that are hard, brittle, chewy, crunchy, or spicy for at least one week
- Avoid alcohol, tobacco, caffeine, carbonation, and hot drinks for at least one week
- Stay hydrated
- Avoid vigorous rinsing, spitting, and sucking on straws for the first 72 hours
- Be gentle around the removal site when cleaning your teeth
- Attend follow-up exams and bi-annual dental exams as needed
Your oral and maxillofacial surgeon will give you more specific instructions for postoperative aftercare based on your unique oral health needs.
The exact cost of your procedure will depend on a number of factors including how many teeth need to be removed, whether you require simple or surgical extraction, and your insurance. We encourage you to call your provider beforehand to ask them which costs they can cover. Rest assured that Dr. Nishime and his team will work with you to find ways to help you afford your procedure.
Don’t Let Problem Teeth Ruin Your Smile, Choose Extraction
Extraction doesn’t just protect your oral health, it can also help prepare your mouth for beneficial restorations like implants and orthodontic treatments like Invisalign®. Regardless of which teeth need to be extracted or why, Dr. Nishime can help your smile be healthy again. To learn more about tooth extraction, or to schedule a consultation with Dr. Nishime at Advanced Restorative Dentistry of Honolulu, call us at (808) 732-0291. You can also request an appointment by submitting a completed contact form found at the bottom of the page.