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. In this case, the tooth needs to be extracted. A very loose tooth also will require extraction if it can't be saved, even with bone replacement surgery (bone graft).
Here are other reasons:
- Some people have extra teeth that block other teeth from coming in.
- Sometimes baby teeth don't fall out in time to allow the permanent teeth to come in.
- People getting braces may need teeth extracted to create room for the teeth that are being moved into place.
- 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. They need to be removed if they are decayed, cause pain or have a cyst or infection. These teeth often get stuck in the jaw (impacted) and do not come in. This can irritate the gum, causing pain and swelling. In this case, the tooth may be removed.
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. In a simple extraction, the dentist loosens the tooth with an instrument called an elevator. Then the dentist uses an instrument called a forceps to remove the tooth.
- A surgical extraction is a more complex procedure. It is used if a tooth may have broken off at the gum line or has not come into the mouth yet or to remove a wisdom tooth. The dentist will make a small incision (cut) into your gum. Sometimes it's necessary to remove some of the bone around the tooth or to cut the tooth in half in order to extract it. After the tooth is removed, you may need stitches. Some stitches dissolve over time and some have to be removed after a few days. Your dentist will tell you whether your stitches need to be removed. A folded cotton gauze pad placed over the wound will help stop the bleeding.
Your dentist or oral surgeon will take an X-ray of the area to help plan the best way to remove the tooth. Be sure to provide your full medical and dental history and a list of all medicines you take. This should include both prescription and over-the-counter drugs, vitamins and supplements.
If you are having 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
During a tooth extraction, you can expect to feel pressure, but no pain. If you feel any pain or pinching, tell your dentist.