Why do teeth need to be extracted?
The main reasons teeth are extracted is because they are either diseased to the point where there are no other options or orthodontic reasons. Diseases can be categorized into cavities, periodontal disease, and infection.
Extraction due to Cavities
Most teeth that have cavities do not need to be extracted. When cavities are small they can be taken care of by your general dentist with a simple filling. As the cavity gets larger, there may not be enough tooth structure to secure the filling and a crown will be recommended instead. If the cavity reaches the pulp of a tooth, a root canal will be required. The root canal process often weakens the structural integrity of the tooth so a crown is almost always needed after a root canal. The sooner a cavity is addressed, the smaller the restoration (filling or crown) will be.
Teeth need to be extracted when the cavity gets so large that a restoration will not support a tooth. Other times, the tooth has a cavity or crack below the gum line so that getting a good margin between the restoration and natural tooth structure is impossible. When the margin presents as either a gap or ledge, bacteria and plaque quickly collect and cause the restoration to fail.
Extraction due to Periodontal Disease
Periodontal disease is loss of the bone that support teeth. Most teeth that have periodontal disease can be saved with deep cleanings and dedicated oral hygiene. However if there is so much bone loss that your tooth moves significantly or creates an impossible hygiene problem, your tooth will probably need to be extracted.
Extraction due to Infection
Teeth become infected due to either large cavities or periodontal disease. Bacteria invade either the tooth or bone causing pain and swelling. If the infection is in the early stages, an antibiotic may be given calm the infection and allow for treatment on a later date. Treatment of an infected tooth is challenging because local anesthesia is not always effective in numbing the surgical site.
As an infection develops it can get larger and walled off so that antibiotics are no longer effective. Treatment may require draining the infection in addition to either extraction or root canal therapy. Failure to treat an infected tooth can lead to hospitalization and even death.
When an infected tooth is extracted, IV sedation should be considered. With IV sedation, strong pain medications can be provided to supplement the not so effective local anesthetic and provide a significantly more comfortable experience for our patients.
Extraction for Orthodontic Reasons
Orthodontist may require teeth to be extracted if they will interfere with the movement of your teeth or to make space for them movement of your teeth. Any extraction for orthodontic reasons will require a referral from your orthodontist.
How is a Tooth Extracted?
The first step required for any tooth extraction is making sure the tooth is numb for the procedure. All patients receive local anesthesia for this procedure regardless of if IV sedation is also being administered.
Once you are numb, the surrounding gum tissue is moved to better visualize the tooth. Bone is often removed to help create some space to start wiggling the tooth. The initial slow controlled movements help further separate the tooth from the bone. Sometime teeth have multiple roots. These teeth are often sectioned and removed one root at a time. Once the tooth is removed, the empty socket is debrided and washed. If PRF therapy is planned, the preformed clot is placed in the socket to facilitate healing.
What does it feel like to have a Tooth Extracted?
Once you are numb from the local anesthetic, patients should only feel pressure associated with the extraction. There should be no sharp pain (some infected teeth may not get numb). If you do feel sharp patient at any time during the surgery, you should let us know so we can provide additional local anesthesia.
If you have IV sedation with your surgery, you will likely only remember going to sleep and waking up from your procedure. Most patients do not get IV sedation for one or two teeth, but if you have a lot of anxiety regarding your procedure sedation may be an option to consider.
How long does it take to have a Tooth Extracted?
Most teeth take 10-20 minutes to be extracted. However some can take significantly longer. Every effort is made to preserve the bone surrounding your tooth as it will provide you with more options in the future. Factors that effect extraction difficulty include:
- tooth anatomy
- number of roots
- bone density
- root canal treatment
- teeth grinding/bruxism
- restorations on neighboring teeth
- patient age and medical conditions
What are options to replace an Extracted Tooth?
There are four options for the space following a tooth extraction.
- leave it as a space
- dental implant
- partial denture
While placement of a dental implants are a surgical procedure, we do not offer dental implants at South Austin Oral Surgery. We do offer bone grafting at the time of tooth extraction, however if you a strongly leaning towards a dental implant and do not need the tooth extracted in an urgent manner, you may consider receiving treatment with a provider who also places dental implants.