in Pittsford NY
What is Tooth Extraction?
Tooth extraction is the removal of a diseased or decaying tooth. Removing a tooth is often the last resort for many dentists. In most cases, a dentist can save a decayed or dysfunctional tooth. DeStefano Dentistry recommends that patients get a full examination before assuming their circumstances call for tooth extraction. After all, our focus is to always save and maintain a healthy and full set of teeth. But there are certain circumstances where tooth extractions are necessary to avoid future oral health problems.
Candidates for a Tooth Extraction
If a patient experiences one of the following conditions Dr. DeStefano may need to perform a tooth extraction.
- Wisdom teeth
- Decayed teeth
- Broken teeth
- Loose teeth
- Preparation for Braces
When is it necessary to get a tooth extraction?
Dr. DeStefano does everything possible to save a tooth, but there are instances where the tooth cannot be saved. A root canal is a usual treatment used to save a tooth where the infection has invaded the tooth interior, but it cannot always save the tooth.
The usual line between extraction and not is a matter of degree. For instance, a tooth with a crack can usually be saved with a crown. But a tooth with a deep crack may be too compromised, as it won’t provide the underlying base needed to place the crown. The same is true with a chip. A small chip can be covered with bonding, a porcelain veneer, or a crown. But a large chip may expose too much of the tooth interior to be able to be saved.
What happens before my tooth extraction?
Unlike your grandma, who may have tried to pull one of your baby teeth by attaching a string to a door or other old school methods, we want you to be comfortable. To do so, we thoroughly numb the area around the tooth to be extracted with local anesthesia. If the extraction looks more difficult, we may opt for general anesthesia, so that you sleep through the procedure. This isn’t usually necessary, however. Of course, wisdom teeth are usually removed with the patient under general anesthesia, due to issues such as impaction.
Tooth Extraction Procedure
Though the process is often simple, it is still important to seek a dentist with proper training in the safe removal of teeth. As Pittsford’s Top-Rated Local® dentist, Dr. DeStefano uses gentle precision and expertise to remove teeth when it is necessary and safe for his patients. First, x-rays will be done to evaluate the tooth. Next, the patient will be under local or general anesthesia to minimize pain and discomfort. In addition to removing the tooth, Dr. DeStefano may use a dental bridge, dental implant, or denture to replace the missing tooth.
The first type of extraction process is a simple extraction. Dr. DeStefano will choose a simple extraction when the tooth is visible in the mouth and will use forceps to remove the tooth. The procedure requires no surgical techniques and is typically the cheaper removal option.
The second extraction process is surgical extraction. This extraction is performed on teeth that have a broken gum line or if they have not descended into the mouth. For example, wisdom teeth removal. The procedure is more complex so an oral surgeon and anesthesia may be necessary.
Tooth Extraction Patient Testimonial
“Amazing staff! Super friendly! Very Professional! They make you feel very comfortable! Highly recommended!”
“Another great checkup today with Dr. DeStefano and his staff. The atmosphere is always relaxed, friendly, and professional. My hygienist, Stephanie, is top-notch, and I know I am in good hands. Highly recommend this office.”
Tooth extraction versus a root canal
Dr. DeStefano can often use a root canal to save a tooth that would otherwise need extraction. As a bonus for our Pittsford patients, Dr. DeStefano has the training and expertise to perform his own root canals, saving our patients the expense and hassle of using a separate endodontist.
When the infection has penetrated the tooth enamel layer and the dentin beneath, it then enters the pulp of the tooth. This is where the blood vessels and nerves are. Once this has happened, a root canal is the only way to save the tooth from extraction. Dr. DeStefano makes a small hole in the top of the tooth, thoroughly cleans out all the soft tissue in the tooth, disinfects the interior, fills it with a substance called gutta-percha, and closes the hole with a small filling. The tooth is then usually crowned to provide strength for chewing and biting. This natural tooth often can last the rest of the patient’s life.
But if the infection has created an abscess in the gums and the infection has now affected the connective tissues that hold the tooth in place in the jawbone, even a root canal is unlikely to be able to save the tooth. The tooth is likely becoming loose in its socket. This is the problem with late-stage gum disease, and it is why some people eventually end up losing all of their natural teeth and need dentures.
As mentioned above, root canals also cannot do anything to save a tooth with extensive damage, such as a deep crack, overly large chip, or large amounts of decay.
Tooth Extraction Recovery
After tooth extraction, patients may experience a certain amount of pain. They can relieve the pain by applying ice to the external area, rinsing with warm salt water, or anti-inflammatory medicine. Antibiotics can be prescribed to the patient in order to fight infection. Patients may not be able to eat certain foods and hot liquids for up to 24 hours after the extraction. If stitches are placed, a follow-up appointment is necessary to remove stitches. Patients typically take a week or two to recover.
Your initial healing and recovery period usually takes about one to two weeks. Gradually, new bone and the gum tissue will grow into the gap. Your gums will heal and you won’t have any pain. But now you have a gap in your teeth (unless the tooth was extracted to address crowding). While not a problem by itself, a gap in your teeth can cause problems with your other teeth. The teeth on each side of the missing tooth tend to slide over into the gap because they no longer have any pressure on them from each side. This can start various problems with your alignment, bite, and other issues. That’s why Dr. DeStefano recommends replacing your missing tooth with a dental implant or a fixed bridge.
What can I do to help my extraction heal faster?
The obvious things you can do to help with healing are to control your bleeding, to keep the blood clot in place in the tooth socket, to take pain medication as prescribed, and to reduce swelling with ice. When lying down or sleeping keep your head slightly elevated.
These are other things you can do to help to heal:
- Eat a diet of soft, healthy foods, and snacks.
- Drink plenty of liquids.
- Brush your teeth, but without toothpaste. Rinsing toothpaste from your mouth can dislodge the blood clot. Avoid the extraction site.
- Keep the extraction site clean.
- Lightly rinse with a saltwater solution.
And don’t do these things:
- Don’t drink with a straw. Sucking on a straw may dislodge the blood clot.
- No hot liquids. Hot liquids can increase your sales.
- Limit your alcohol. This can slow your healing if you drink in excess.
- No smoking. Smoking can break down the blood clot.
How long after having a tooth extracted before I can eat normally?
There is not a set timeline for eating normal foods after an extraction. For the first 24 hours, you’ll only eat soft foods such as yogurt and liquids. You can’t eat anything hot or spicy for at least 3 days. Generally, you’ll want to eat soft foods for 3-5 days. These are things such as macaroni and cheese, mashed potatoes, oatmeal, applesauce, yogurt, and pasta. Let hot foods cool.
You can eat some foods that require chewing, but you need to stay completely on the opposite side away from the extraction location. It’s a better idea to stay with soft foods.
After 3 to 5 days, depending on the person, you can get back to your normal diet. This is completely up to you. Until the gums have fully healed, you should avoid any sharp foods, such as pretzels or chips.
Dental Prosthetics after a tooth extraction
Now that the heavily decayed or damaged tooth has been removed, your danger of infection is gone. But now you have a gap in your teeth that can cause alignment problems, is aesthetically unappealing, and may affect what you eat (depending on the location).
While you can choose not to replace the extracted tooth, Dr. DeStefano wouldn’t advise that, for reasons described above. He recommends replacing an extracted tooth with either a dental implant, a fixed bridge, or if you had a few teeth pulled, a partial denture. All of these tooth replacements keep your other teeth in place, so they don’t migrate and affect your overall bite. Plus, replacing the extracted tooth allows you to eat normal foods, and it prevents possible whistling sounds when speaking. And your smile is complete once again.
Treating postoperative bleeding After Tooth Extraction
Once your tooth has been extracted, the cut in the gums tends to bleed more than a cut on the skin. This is because the area cannot dry out and form a scab. To stem the blood flow, Dr. DeStefano will have you bite down on a piece of gauze in the extraction site for 20 to 30 minutes. This usually allows a clot to form. You may have a continuing small amount of bleeding for the next 24 hours, but it should taper off. It’s important to leave the blood clot alone to avoid developing a dry socket.
How To maintain Your oral health after a tooth extraction
One key to a fast recovery is to take it easy for at least 24 hours. This keeps blood pressure on the facial area down. You’ll need to avoid rinsing or spitting forcefully for 24 hours after the extraction to not dislodge the blood clot that has formed in the socket. Do not use a straw for the first 24 hours.
After 24 hours, you can rinse your mouth with a solution made of ½ teaspoon salt in 8 ounces of warm water. Don’t get carried away with aggressive swishing.
You can’t smoke during your recovery, and you should eat soft foods to not disturb the extraction site. You should prop your head up when lying down. You continue to brush and floss your teeth, and brush your tongue, but simply avoid the extraction site. Even limited brushing will help keep your mouth clean and minimize the possibility of infection.
How painful is getting a tooth extracted?
You won’t feel anything during the extraction, thanks to the local or general anesthesia used by Dr. DeStefano. The pain that follows after your anesthesia wears off varies depending on the type of tooth and the location, on whether the tooth was impacted (wisdom teeth), and other factors.
Generally, you’ll have some pain for the first day or two, but this should be easily manageable with over-the-counter pain medication. You’ll have some swelling and possible slight bleeding. This is all normal. Anything more extreme merits a call to Dr. DeStefano.
Wisdom teeth are the exception. Because most wisdom teeth are impacted, meaning they are coming in sideways and are blocked by your molars, this involves more work to get the teeth out. They often need to be broken and removed in pieces. Sometimes they have wrapped around the roots of the normal molars. Removing wisdom teeth will usually create a good deal of pain for the next two to three days after the procedure.
Risks of a tooth extraction
The main risk with tooth extraction is what is known as “dry socket.” This occurs when a blood clot doesn’t form in the hole or the blood clot breaks off or breaks down too early. This happens in about 3-4 percent of all extractions, although the occurrence is higher after difficult extractions, particularly with impacted wisdom teeth.
- Dry socket is a problem because, without the blood clot, the underlying bone is exposed to air and food. This is usually very painful, and it will likely create a bad odor and a bad taste in your mouth.
- Beyond dry socket, there is also a risk of infection after extraction. This is rare in patients with healthy immune systems. There are slight risks of damage to other adjacent teeth, a fractured jaw caused by pressure during extraction (usually only possible with patients with osteoporosis), and a hole in the sinus when an upper back molar is extracted.
Generally, the main risk/complication after extraction is soreness in the jaw muscles and jaw joints. This is due to your anesthetic injections and having your mouth open for a long period of time.
Are tooth extractions covered by dental insurance?
Yes, tooth extractions are covered by dental insurance.