There are any number of reasons why it might become necessary to have a tooth pulled as an adult. For one thing, it can become badly decayed, or you may have suffered some recent physical trauma to the mouth, which damaged the tooth so that it must be pulled. In some cases, your dentist will recommend that one or more teeth be pulled, simply because the mouth is becoming too crowded.
When there are too many teeth simultaneously trying to burst through, it can quickly develop a crowded situation that causes misaligned teeth. This generally happens when the teeth are too big for the mouth, and they simply can’t all coexist together. There are also cases where a specific tooth is unable to break through the gum line because there’s no room for it, and in this case also, your dentist may recommend that it be pulled.
Whenever tooth decay or damage reaches down into the pulp of the tooth, that’s the center part which contains all the blood vessels and nerves, it’s possible for bacteria to enter the pulp as well, thus possibly creating infection. Sometimes this is treatable with root canal therapy, but if the infection cannot be cured by antibiotics, it may be necessary to pull the tooth, simply to stop the spread of infection.
What happens during tooth extraction
Oral surgeons and dentists are the professionals typically tasked with performing tooth extractions. Before the procedure begins, your dentist will administer a local anesthetic, so as to numb the area where the tooth is to be removed. This will negate any pain or discomfort you might feel, so that the tooth can be extracted in a pain-free manner. An impacted tooth will require that the dentist cut through any gum or bone tissue which might be covering the tooth, and then he/she will have to rock the tooth backward and forward to loosen it and extract it.
There are situations where a really difficult tooth has to be removed in fragments, rather than as an entire unit. However, once the tooth has indeed been pulled, it’s typical for a blood clot to form in the remaining socket. Your dentist will usually pack the socket with a gauze pad and have you bite down on it, so as to limit any bleeding.
In some cases, pincers will be used to close the gum edges around the site of the extraction. If the blood clot in the socket happens to break loose, that could expose the bone in the socket, which is an uncomfortable situation referred to as dry socket. If this should occur, it’s likely that your dentist will apply a sedative dress for a few days, to help protect the area while a new clot is forming.
Aftercare for tooth extraction
Once you’ve successfully had your tooth extracted, your dentist will allow you to go home, so that you can recover from the procedure. Recovery will generally require several days, and it will always proceed most smoothly if you observe the following recommendations:
- don’t drink from a straw for the first day following a tooth extraction
- don’t smoke tobacco, because it interferes with the healing process
- when reclining, make sure to keep your head propped up with pillows, because lying flat might promote more bleeding
- maintain your routine oral hygiene, making sure to avoid the extraction site
- if necessary, take painkillers as prescribed by your doctor
- avoid spitting forcefully or rinsing for the first day after extraction, so as to avoid disturbing the clot that will typically form in the socket
- bite down on the gauze pad put in place by your dentist, so as to reduce bleeding and promote the formation of a blood clot in the tooth socket
- make sure to change the gauze pads before they get completely saturated with blood. Otherwise it would be okay to leave the pad in place after the extraction for 3 to 4 hours
- it’s a good idea to minimize your activities for the first day after an extraction, and to avoid strenuous exercise for at least the first two days if necessary, hold an ice bag directly on the affected area to reduce any swelling. You should alternate between applying the ice pack for 10 minutes, and then removing it for 10 minutes.
- after the first day following extraction, rinse your mouth out with a solution consisting of 8 oz of warm water mixed with 1/2 tsp of salt
- try to stick to a diet which includes mostly soft foods, e.g. yogurt, applesauce, pudding, and soup, for several days after the extraction. It’s okay to gradually include more solid foods as your extraction site recovers.
When to contact your dentist
It’s perfectly normal to feel some level of pain in your mouth when the local anesthetic wears off. That first day after a tooth extraction, you can also anticipate some residual bleeding and some swelling as well. If either one of these persist for more than several hours after a tooth extraction, you should probably contact your dentist. It’s also good idea to get in touch with your dentist if you experience any signs of infection, fever, or chills.
When you undergo nausea or vomiting, that’s also a reason to contact your doctor. Look for any swelling or redness, as well as some kind of discharge from the tooth extraction site. If you begin experiencing chest pains, shortness of breath, or sudden coughing, these are also warning signs that should spur you to get in touch with your dentist promptly.
Most people recover from a tooth extraction over the course of one or two weeks. During this time, new gum and bone tissue will grow into the gap created by the extraction. However, over a period of time, when you have one or more missing teeth, it can cause the other teeth to shift toward that gap, and make it difficult to bite or chew your foods. That’s why you shouldn’t let too much time go by before you adopt some kind of tooth replacement strategy, for instance a denture, bridge, or a dental implant.