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I need a tooth removed – Now what?

When it comes to dental procedures, tooth extraction — or having teeth “pulled” — is among patients’ most dreaded thoughts. Also referred to as extractions, tooth removal involves removing a tooth from its socket in the jaw bone. Before your dentist considers extraction, every effort will be made to try to repair and restore your tooth. However, sometimes it’s necessary.

Reasons for Extraction

  • Severe Tooth Damage/Trauma: Some teeth have such extensive decay and damage (broken or cracked) that repair is not possible. For example, teeth affected by advanced gum (periodontal) disease may need to be pulled.
  • Malpositioned/Nonfunctioning Teeth: To avoid possible complications that may result in an eventual, negative impact on oral health, your dentist may recommend removing teeth that are malaligned and/or essentially useless (teeth that have no opposing teeth to bite against).
  • Orthodontic Treatment: Orthodontic treatment, such as braces, may require the removal of teeth to make needed space for improved teeth alignment.
  • Radiation: Head and neck radiation therapy may require the extraction of teeth in the field of radiation in order to help avoid possible complications, such as infection.
  • Chemotherapy: Chemotherapy weakens the immune system, increasing the risk of tooth infections, heightening the risk of extraction.
  • Organ Transplant: Medications prescribed after organ transplantation can increase the likelihood of tooth infection. As such, some teeth require removal prior to an organ transplant.

The Two Types of Extraction

  • Simple Extractions: These are performed on teeth that are visible in the mouth. General dentists commonly do simple extractions, and most are usually done under a local anesthetic, with or without anti-anxiety medications or sedation.
  • Surgical Extractions: These involve teeth that cannot easily be seen or reached in the mouth, either because they have broken off at the gum line or they have not fully erupted. Performed by dentists or oral surgeons, surgical extractions require some type of surgical procedure, such as bone removal, removing and/or lifting and folding back all or part of the gum tissue to expose the tooth, or breaking the tooth into pieces (called tooth sectioning). Surgical extractions can be done with local anesthesia and/or conscious sedation. Patients with special medical conditions and young children may receive general anesthesia.