Sometimes, to maintain overall oral health, we must say goodbye to some teeth. Tooth extraction is one of the professional and controlled procedures in dentistry aimed at preventing the spread of infection, relieving pain, or preparing for other treatments.
At Dr. Bonyanian’s Clinic, this procedure is performed with complete adherence to hygienic principles, effective anesthesia, and minimal discomfort for the patient.
What is Tooth Extraction?
Tooth extraction is one of the common and routine treatments in dentistry that is recommended to patients in specific circumstances and when other treatment methods are ineffective. For example, when the extent of decay or fracture is so large that tooth extraction is the only remaining option.
Sometimes, extracting a tooth is the best solution for maintaining the health of the remaining teeth and gums. Because if the tooth remains in place, more severe and serious dangers will threaten the condition of your mouth and teeth.
For example, when tooth decay has reached its maximum extent and cannot be treated even with root canal therapy, the tooth must be extracted, and alternative methods like dental implants should be used. This is because the presence of this tooth in the mouth can also damage adjacent teeth.
What is the Reason for Tooth Extraction?
Sometimes, problems with a damaged tooth can be resolved with root canal treatment. However, in some cases, the trauma or decay is severe, and the tooth is no longer restorable. Other reasons that lead to dental extraction include the following:
1. Infection
In situations where a tooth is infected and damaged, there are two ways to solve this problem. If the infection is at the superficial levels of the tooth and has not involved the tooth pulp, using antibiotics and root canal treatment will resolve the issue.
However, if the damage has led to high levels of infection in the tooth and antibiotics are not effective, the dentist will be forced to extract the tooth. Otherwise, the infection will spread to adjacent teeth.
In such circumstances, preventing the spread of infection is more important than preserving the tooth. Because if, due to a compromised immune system (such as chemotherapy or organ transplant), the risk of a specific tooth infection spreading increases, there is sufficient reason for tooth extraction.
2. Periodontal Disease
One of the oral and dental diseases is periodontal disease. This disease is a type of bacterial infection that, by the accumulation of bacteria from plaque and tartar, causes infection of the gums, bone, and other tissues surrounding the teeth. Bleeding and swollen gums are among the main symptoms of this disease.
If periodontal disease has caused infection in the tissues and bones surrounding the tooth, you may need to have the tooth extracted. Because if gum disease is not treated in time, tooth decay can threaten the health of other teeth.
3. Crowded Teeth and Orthodontic Treatment
Sometimes, for orthodontic treatment, due to crowded teeth, some teeth being too large, or lack of sufficient space for other teeth, the dentist is forced to extract some permanent teeth. This creates more space for other teeth and provides conditions for the teeth to align and sit next to each other.
4. Tooth Injury or Trauma
If a tooth breaks at or near the gum line, there might not be enough visible tooth structure left, and options like crowning the tooth are no longer possible. In such cases, removing the tooth is necessary.
5. Baby Teeth That Don’t Fall Out on Time
Baby teeth generally fall out between the ages of 6 and 12. However, certain specific conditions can cause delays or prevent baby teeth from falling out on time.
One of the most common problems observed when permanent teeth erupt alongside baby teeth is the eruption of a permanent tooth behind the baby tooth. This situation puts a lot of pressure on the teeth.
To resolve this issue, the dentist must extract the baby tooth. Therefore, if you observe that a baby tooth has not fallen out, be sure to consult a pediatric dentist or an orthodontist. Because delayed falling of baby teeth can negatively affect the child’s well-being.
6. Impacted and Partially Impacted Teeth
If, after the completion of the growth period, a tooth has not yet erupted from the gum or only a small part of it has emerged, it is called impacted or partially impacted. This is most often the case with canine and wisdom teeth. If it causes problems for the individual, the dentist will surgically remove these teeth.
7. Incorrect Positioning
Some teeth (that have grown in an improper position) can damage the soft tissues of the oral cavity, gums, or tongue. Therefore, the doctor will recommend the extraction of that tooth.
Preparing for Tooth Extraction
Before tooth extraction at the dental clinic, you can take the following steps to prepare:
- Prepare a list of questions to ask your dentist to fully understand the stages of tooth extraction.
- If you have any medical conditions or are taking any medications, be sure to inform your dentist.
- If you are taking blood-thinning medications or have drug allergies, inform your dentist.
- Sometimes, due to infection, antibiotics may be prescribed. Be sure to take them seriously.
- On the day of your appointment for tooth extraction, be sure to bring an X-ray of the tooth so the dentist can choose the best method for extraction.
- Stop smoking at least one day before the surgery. Smoking can lead to dry socket and prevent the alveolar bone from being covered.
- If undergoing surgery with general anesthesia, refrain from eating food 12 hours before the surgery to prevent nausea after anesthesia.
- Usually, if the dentist uses local anesthesia, fasting will not be necessary.
- It is better to wear comfortable and loose clothing for surgery or tooth extraction.
Tooth Extraction Methods
Many patients visiting Dr. Bonyanian’s dental clinic are mistaken about tooth extraction methods. They imagine that tooth extraction is done solely through an anesthetic injection and pulling out the tooth.
However, tooth extraction has different types and methods. Knowing what will happen after you arrive at the dentist for tooth extraction will alleviate many of your concerns and worries. Below, we will mention some of these methods.
Simple Extraction
One of the most common methods of tooth removal is simple extraction. Simple extraction is what most people think of when they consider treatment: that is, removing a decayed or damaged tooth from its socket.
Simple extraction is usually performed for severely decayed teeth or damaged roots. In this method, the dentist numbs the gum area with a local anesthetic injection, reducing the patient’s pain.
Contrary to popular belief, in this method, the tooth is not pulled directly from the socket; rather, by applying pressure to the depth of the gum, the root pressure pushes it out from inside the jaw. This is the simplest extraction method and usually happens relatively quickly.
Partial Extraction
The partial extraction method is specifically for teeth whose roots remain completely healthy and undamaged within the person’s jawbone. This method is relatively new and has positive and lasting effects on the health of the tooth and jawbone.
Removing teeth and their roots weakens the jaw. Therefore, partial tooth extraction without damaging the jawbone causes the separation of the broken and decayed tooth. Partial extraction is an excellent option for those who decide to remove their teeth and replace them with dental implants.
Surgical Extraction
This method is used for tooth removal when partial or simple extraction is not feasible. Surgical removal of the tooth along with its root is necessary if it is decayed or damaged below the gum line. Depending on the number of teeth to be extracted and the severity of decay, the dentist may decide on general anesthesia.
Simple and partial extractions are the least invasive types of extraction and usually require the least amount of anesthetic. However, if the damage is out of sight or has spread to surrounding teeth and gums, extraction can seem a bit daunting.
But again, dental health is a priority, and with the administration of anesthetic drugs, dental procedures are performed almost painlessly.
Tooth Extraction Using Laser
One of the methods recently used for tooth extraction is laser. This method is performed in two stages and in the dentist’s office.
- In the first stage, laser is used to separate the tissue around the tooth and loosen it in the bone. After separating the tooth from its tissue, the tooth is easily removed from the socket using dental forceps.
- The second stage is performed after tooth extraction. In this way, with the help of laser, any remaining bacteria and microbes in the tooth are destroyed, and it is also used to close bleeding sites, stimulate jawbone growth, and surrounding tissues.
The most important advantages of the laser method include painless tooth extraction, stimulation of healthy tissue growth, preservation of jawbone tissue and structure, faster healing of the extraction site, reduced risk of bacterial infection, shorter recovery period after tooth extraction, and lower risk for patients at risk.
You may find articles on “Remaining Root in the Gum,” “Gum Bleeding,” and “Home Treatment for Tooth Infection” useful and practical.
Stages of Tooth Extraction
According to a reputable article titled “Oral Surgery, Extraction of Teeth,” the stages of tooth extraction usually vary depending on the type of tooth and its position.
For example, extracting a wisdom tooth is completely different from extracting a decayed and damaged tooth and may require surgery. However, this method generally has several main stages, which we explain below.
| Stage | Description |
|---|---|
| 1. Initial Examination and Evaluation | Assessing the condition of the tooth and surrounding tissue with a clinical examination and, if necessary, radiography. |
| 2. Reviewing Patient’s Medical History | Inquiring about underlying diseases, medications taken, and conditions such as pregnancy or diabetes. |
| 3. Local Anesthesia | Injecting anesthetic medication into the area around the tooth to prevent pain. |
| 4. Loosening the Tooth | Using special instruments to gently separate the tooth from its supporting tissues. |
| 5. Extracting the Tooth | Completely removing the tooth with precision and minimal damage to surrounding tissues. |
| 6. Controlling Bleeding and Suturing | Using sterile gauze and, if necessary, sutures to stop bleeding. |
| 7. Post-Extraction Recommendations | Providing guidance on diet, medication, painkillers, avoiding vigorous rinsing, or smoking. |
Wisdom Tooth Extraction
Wisdom teeth are the last teeth to erupt in the jaw. These teeth are located at the back of the upper and lower jaw and are also known as third molars.
If a wisdom tooth is healthy, has erupted correctly and in the right direction, and its contact with opposing and adjacent teeth is without problems, there will be no need for its extraction. Not only does it not cause any complications, but it also plays a very useful role as an auxiliary tooth in the mouth.
However, if this tooth is impacted, gets stuck in the jaw, causes a dental cyst, infection, and pain in the jawbone, and due to lack of sufficient space for eruption, it puts pressure on other teeth, then wisdom tooth extraction should be performed.
The process of wisdom tooth extraction is the most difficult type of tooth extraction. This is because access to this tooth is very difficult for the dentist, and the patient may experience pain and discomfort for a long time after the tooth is extracted.
Condition of Mouth and Teeth After Extraction
- Dentists recommend using liquid and soft foods in the first week after extraction and avoiding irritating foods.
- Recovery after tooth extraction may take some time, and the most important healing process occurs in the first three days.
- After the anesthetic wears off, you may feel pain and discomfort again, for which dentists recommend taking certain medications.
- The extraction site will also bleed for a few hours (about 4 hours), and sterile gauze should remain on it until the bleeding stops.
Complications of Tooth Extraction
Tooth extraction, or dental extraction, is always accompanied by problems such as pain, inflammation, bruising, bleeding, and infection, all of which resolve over time and with the use of anti-inflammatory and pain-relieving drugs.
However, some of these problems are a bit more troublesome and endanger the health of the remaining teeth. For example, after tooth extraction, the likelihood of remaining teeth shifting increases, leading to misaligned teeth and changes in bite.
Below, you will become more familiar with such issues:
- Dry Socket: When a tooth is extracted, a blood clot naturally forms in the area where the tooth was previously present. Sometimes this blood clot disappears prematurely, which can lead to dry socket.
- Bone Death (Osteonecrosis): Individuals with a history of radiation therapy to the head and neck area are at risk of developing a condition called osteoradionecrosis after tooth extraction. This condition results from bone death in the extracted tooth area due to damage to blood vessels.
- Mouth Sores: If you do not follow your dentist’s recommendation to avoid eating for a few hours after surgery, due to numbness in the mouth, you might unconsciously bite your tongue or the corner of your mouth, causing a sore.
- Numbness of Lip and Chin: If you do not consult a specialist for lower tooth extractions (especially wisdom teeth), the inferior alveolar nerve may be damaged, leading to numbness of the lip and chin for a few days to a few months. In rare cases, this numbness may be permanent.
- Bone Fracture: In rare cases, fracture of the jawbone may occur during tooth extraction.
Tooth Extraction During Pregnancy
Tooth extraction during pregnancy is considerable from several aspects. First, to assess the condition of the tooth, imaging of the mouth and teeth with X-rays is required. If you are in the first trimester of pregnancy, your obstetrician may suggest you postpone this procedure, as radiation can be harmful to the developing baby.
On the other hand, if the tooth is severely infected, the need for tooth extraction will be very serious. This is because there is a risk of infection spreading to other teeth and even other organs.
Dr. Bonyanian’s recommendation to pregnant women who face dental problems and are forced to have an extraction is to undergo this procedure during the second trimester of pregnancy (from three to six months). He explains to pregnant women that:
During this period, your baby’s main organs have formed, and sitting in the dental chair and receiving anesthesia will not be harmful. However, before proceeding with your dental treatment and extraction, be sure to consult with your obstetrician and gynecologist and pay extra attention to their recommendations.
Extraction of a Broken Tooth
In some cases, a tooth may break due to excessive decay, trauma, or nerve weakness. In such situations, if the dentist is able to preserve the tooth structure, they will treat it and restore it to its natural form with the help of dental laminate, dental crown, or dental composite.
However, in situations where the extent of fracture and damage is too great, the dentist will be forced to extract the tooth. Extraction of a broken tooth will not differ much in process from a regular tooth extraction.
Role of a Specialist in Tooth Extraction
Usually, the most suitable and best specialist for tooth extraction is a dental surgeon. In situations where the tooth is in a normal condition (not impacted or partially impacted) or there is no need to remove the tooth root after extraction, a general dentist can also extract your tooth.
However, if the condition of the tooth you intend to extract is special, impacted or partially impacted, the tooth root is damaged, or even if the tooth in question is a wisdom tooth, you should consult an oral surgeon or even a maxillofacial surgeon.
Your general dentist may even suggest that you use the services of a specialist in this field. Because sometimes, the tooth extraction process will be very complicated, and you will need the high skill of a doctor.
Dental surgeons focus more broadly on corrective and therapeutic methods for patients’ mouths and jaws. They also often collaborate with other surgeons and orthodontists.
What Instruments Does a Dentist Use for Tooth Extraction?
Usually, the tray required for tooth extraction includes the following instruments:
- Cotton rolls
- Topical anesthetic agent
- Anesthetic needle
- Syringe
- Mirror
- Explorer (Probe)
- Gauze dressing
- Surgical curette
- Forceps
Infection of an Extracted Tooth
If your extracted tooth becomes infected at the extraction site, it is best to see your dentist immediately. A tooth infection can enter the bloodstream and consequently all organs of the body, leaving a negative impact. Therefore, prompt treatment is essential.
Symptoms of Infection After Tooth Extraction
Infection of an extracted tooth may be accompanied by various signs and symptoms. However, some of the most indicative signs of tooth infection include the following:
- Pain
- Swelling
- Bleeding
- Fever
- Bad breath
Treatment of an Infected Extracted Tooth
If you consult a dentist after observing symptoms of an infected extracted tooth, the dentist will prescribe antibiotics for you. However, in situations where visiting a dentist is not possible, you can use the following measures to prevent the worsening of the infection, treat the tooth infection, and reduce pain until then:
- Rinsing the mouth with lukewarm water and salt.
- Using a cold compress on the cheek.
- Using an oral antiseptic.
Bleeding After Tooth Extraction
Bleeding from the tooth socket after extraction is a completely normal occurrence. This bleeding may continue for up to 24 hours after the tooth extraction (though not as intensely as the first hour).
However, if you experience severe and prolonged bleeding, it is best to consult your dentist to investigate the cause of this problem. Until you visit the dentist, apply pressure to the bleeding site of the extracted tooth with sterile gauze. This will help stop the bleeding.
Reasons for Bleeding Not Stopping After Tooth Extraction
- Failure of blood to clot at the extracted tooth site.
- Bleeding and clotting disorders.
- High severity of infection at the site.
- Weak immune system.
How to Care for an Extracted Tooth Site?
- After tooth extraction, you can gradually resume your normal activities within 24 hours.
- Avoid spitting and vigorous rinsing of the mouth for the first 24 hours.
- Immediately after tooth extraction, apply an ice pack to the area. Apply ice for 10 minutes and then remove for 10 minutes. This will prevent swelling.
- To prevent infection, after 24 hours, rinse your mouth with a saltwater solution or saline.
- Brush and floss your teeth as usual.
- Be careful not to reopen the incision and cause bleeding.
- In the first few days, it is better to consume soft foods such as soup, yogurt, mashed potatoes, jelly, etc.
- You can follow your regular diet, but avoid eating hard foods.
- The recovery period is usually a few days but can sometimes last up to two weeks.
- If you experience any unusual symptoms, contact your doctor immediately.
Cost of Tooth Extraction
The price of tooth extraction will fall into two categories:
- Cost of surgical tooth extraction
- Cost of non-surgical tooth extraction
If tooth extraction requires surgery, you will naturally have to pay a higher cost. Also, the more difficult the surgical process and complications, the higher the cost of tooth extraction will be.
In addition to the above, the skill and expertise of the dentist will also significantly affect the fee for tooth extraction. Naturally, the fee for a specialist dental surgeon will be higher than that of a general dentist, although this will also make the surgery easier for you.
Best Painkiller for Extracted Tooth Pain
The dentist who extracts your tooth will also provide you with solutions to reduce pain in the mouth and the empty socket of the extracted tooth. If you experience severe pain after tooth extraction, you can take painkiller pills every 8 hours.
The most common painkillers for reducing extracted tooth pain include the following:
- Ibuprofen
- Acetaminophen (plain or with codeine)
- Naproxen
- Mefenamic acid
- Gelofen
- Diclofenac
If your pain is within the normal range of tooth extraction complications and is a mild pain, you can also use home remedies for toothache, which we have discussed in detail in a separate article.
Tooth Extraction with Laser
Dentistry, like other fields of medicine, has undergone amazing changes with the help of technological advancements. One of these changes is the presence of laser in performing dental procedures.
Laser consists of a very narrow and focused beam of light that causes tissue separation upon contact. This tool is used for cutting soft and hard tissues, which greatly facilitates the treatment process.
Final Summary
Tooth extraction is a complex process that many of us may need at some point in our lives. In situations where we are inevitably faced with extracting one or more of our teeth, it is best to observe all safety and care aspects to get through this process smoothly and as easily as possible.
Dr. Bonyanian’s Dental Clinic, with a specialized and experienced staff, provides all services related to tooth extraction and dental surgery to dear clients.
Dr. Nazi Bonyanian
Dental Surgeon (DDS) — Medical Council Number: 138662
Graduate of Isfahan University of Medical Sciences with over 15 years of experience in implants, laminates, and oral and dental surgery.
Address: No. 22, Unit 7, West Alley 6, Bokharest Street, Argentina Sq., Tehran, Iran
Phone: +98-21-88539720 | WhatsApp: +98-912-514-2202
Email: info@drbonyanian.com
Working Hours: Sat–Wed 09:00–20:00 | Thu 09:00–14:00 | Friday Closed
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