Hi, I'm Dr. Ramya Narayanan from Strong Roots Dental. I have my colleague Dr. Saloni Trivedi here with me today, so we are going to talk about tooth extractions today and answer some of the most commonly asked questions.
What are tooth extractions?
It is simply just to take the tooth out of the patient's mouth.
When is it recommended?
There can be a few scenarios. It could be decay deep to the bone, deep to the nerve, where the tooth cannot be saved in the patient's mouth anymore. It could be a severe infection in the bone, where again it's probably not safe to keep the tooth in the patient's mouth, or it could be for orthodontic purposes, meaning the patient needs the tooth to be removed so that the teeth can be aligned better. Or it could be a wisdom tooth extraction where the teeth are impacted, causing issues to the teeth in front. There could be several scenarios, but I've listed some of them.
Why would a dentist recommend a tooth extraction versus a root canal?
A root canal is one of the last resorts to save the tooth in the patient's mouth. If, for whatever reason, after a root canal, the tooth is probably not savable because there's an infection in the bone, and it's just not right for that tooth to be in the patient's mouth anymore, then yes, we would go ahead and recommend the tooth extraction.
Is tooth extraction necessary for braces?
It depends on what the orthodontist recommends. If the orthodontist recommends that it's necessary, yes, then we go ahead and extract it.
Is it always necessary to remove wisdom teeth?
It is not always necessary to remove them. Your general dentist would recommend the extraction of your wisdom teeth for a couple of reasons: it's impacted, and it's not completely in the bone, so it's impinging on the tooth in front of it. It can cause decay on the tooth in front because it's hard to keep that area clean. If something like that happens, the dentist generally recommends that you go ahead and take out your wisdom tooth. Or if the wisdom tooth itself catches decay, can it be filled? Yes, it can be filled, but would you necessarily do a root canal on a wisdom tooth? Probably not, so at that point, we go ahead and ask them to remove the wisdom tooth. Most of your chewing efficiency, anyway, goes on the other molars, so you're not missing much.
If I'm going to have a tooth extraction, when do I need a dentist versus an oral surgeon?
These days, most of the general dentists are equipped to be able to do wisdom teeth extractions, but it entirely depends on your general dentist when they decide to refer you to an oral surgeon.
Can tooth extraction cure periodontal disease?
Yes and no. Periodontal disease can be cured by actually seeing a periodontist and making sure that you get the deep cleaning you require and all of the procedures recommended by the periodontist to get back to health. So, dental extraction, to your point, can it cure periodontal disease? Yes, if all the teeth are taken out, but that's not always the goal. That is not the goal.
Is tooth extraction necessary before dental implant surgery?
Generally, yes, unless you're congenitally missing a tooth; then obviously, you don't need a tooth extraction because you've gone without that tooth.
What should I expect during a tooth extraction?
You will have had a consultation with your general dentist to decide why the tooth needs to go. Then, you will come back to see either the same general dentist or the oral surgeon, depending on what's decided between you and the dentist. You will go ahead and get yourself numb, and then the oral surgeon will take that tooth out and give you instructions on what needs to be done. You'll probably come back for a follow-up a week after to make sure the site is healing well.
Is bone graft necessary after tooth extraction?
It depends on which tooth, and also depends on the reasoning why the tooth has come out. Generally, one of the most common reasons for taking a tooth out would be some kind of infected tooth. When it's infected and the bone around that tooth has also been infected, yes, we generally recommend some kind of grafting. That way, you take the tooth out, clean the bone, clean the infection out, place some new bone, and let that bone heal and integrate with your existing bone.
How painful is a tooth extraction?
You will be numb, so the most painful part is to get numb, which is most likely just a pinch. During the procedure, you should not feel anything. Having said that, depending on the area where the tooth is being extracted, you might feel a little bit of pressure because you will have to keep your mouth open for some amount of time, but other than that, you should not have any pain.
What about afterwards? You might be a little sore for sure because it is a procedure that is being done. But your dentist would have given you prescription antibiotics and medications to be taken before the procedure, so that way there's some amount of medication in your system while the procedure is being done and to continue it after until finished.
How long does it normally take to heal from tooth extractions?
Again, it depends on the kind of extractions. It can be a completely impacted tooth or wisdom tooth versus a simple extraction. Generally, I would probably say within 24 to 48 hours, the soreness will remain, and then after that, you should be fine.
What helps tooth extraction heal faster?
Your dentist would be giving you instructions after the procedure, but definitely making sure that you follow those instructions to the tee is one of the best ways for it to heal at the fastest rate.
How can I minimize bleeding after a tooth extraction?
One of the instructions after tooth extraction is not to rinse, spit, or drink through a straw for 24 hours. The reason is that you do not want the blood clot that is formed over the extraction site to dislodge. If that dislodges, then one, you're going to have bleeding, and two, you will actually get into a situation where the underlying bone is exposed and that can cause secondary pain. So, to avoid all of these complications, like I said, you want to listen and adhere to the instructions given after the extraction.
How can I avoid a dry socket after tooth extraction?
Again, try not to rinse, spit, or drink through a straw because it will cause dislodgement of the blood clot. If that happens, there is going to be exposure of the underlying bone, which can cause a lot of pain. If you do have pain setting in 3 days after the extraction, please ensure to go back to the dentist.
Do I need to rest after a tooth extraction?
Yes, some amount of rest would be indicated after a procedure. Generally, once it's done, you take your medications, eat right, and just sleep well that day. The next day, you should be fine and back to normal.
When should I schedule an appointment for a tooth extraction?
As soon as your dentist asks you. When we ask you to schedule for an extraction or say that you need an extraction, obviously, there is a reason behind it, so I would not recommend waiting.
I hope we've been able to answer some of your questions on tooth extractions and the process, but, if any other questions come up, please do give us a call at Strong Roots Dental, and we'd be happy to help you. Thank you.