honey patel

i am a dentist with bachelor's degree. i will be soon pursuing masters in health care management.

All you need to know about tooth extraction

23 September 2021

If you are afraid of getting your tooth pulled, this blog is all you need to read. In this article, you can expect to read the reasons why teeth have to be extracted, indications of extraction, costs, precautions as well as post-extraction care tips.

Tooth extraction is the procedure of getting one’s tooth/teeth removed from the oral cavity. It has to be performed due to multiple reasons.

Reasons for tooth extraction:

There can be several factors that may lead to the removal of teeth.

  • Severe tooth decay

When the tooth is cavitated to an extent that it causes pain, food accumulation, or is weakened, it is imperative to get it removed to avoid any further nuisance. Also, there are options to replace it with a prosthetic.

  • Periodontal problems(periodontitis, bone loss due to other reasons)

Since severe gum problems make the tooth/teeth lost due to bone loss and recession, it is best to remove it in order to proceed with periodontal surgery further. Also, such teeth pose a risk of spread of infection.

  • Loosening of tooth

Loosening can be due to multiple reasons- Pathological or Physiological

  • Severe accidental trauma to the tooth

Traumatic blows can act as a trigger for root and pulp infection. If left untreated, the tooth can become non-vital after a while and may act as a focus of infection. There may be unbearable pain as well.

  • pulpal pathologies (pulpitis)

Deep caries can cause pulp inflammation, which advances from reversible to irreversible in a matter of time if not treated by removing the carious parts. In such cases, RCT is done. But if the infection cannot be treated by root canal therapy, it has to be

  • Malaligned teeth due to crowding

When there is not enough space for realigning teeth through orthodontic treatment, few teeth are removed (mostly premolars) so as to make some allowance for other teeth to get aligned.

  • Impacted wisdom tooth

In the case where there is not enough space for the 3rd molar to erupt, it causes severe pain, nerve impingement, caries in the 2nd molar and many other consequences. Most individuals need such type of surgery due to evolutionary lack of space in the oral cavity to accommodate the 3rd molar. Disimpaction needs a surgical intervention.

What will you come across on the day of the appointment for dental extraction?

When you visit your dentist, they will take an x-ray of your tooth to determine the difficulty level of the extraction. Other than that, x-rays will help them to locate surrounding landmarks, tooth root size, an extension of caries(if any) and so on.

Once done with x-rays, the dentist will ask you for your relevant medical history, allergies(if any), drug history, drug allergies, the food you ate that day, if you have taken your medications and other things. It is done to avoid any medical emergency and be prepared for one, just in case.

After noting down your history, the dentist will prepare you for anaesthesia. Anaesthetic will help your mouth to numb down so that the procedure can be carried out painlessly and without any discomfort.

After injecting anesthetic, you will be made to wait for a few minutes to let its effect kick in. The dentist will ensure that you do not feel any pain. He will then initiate reflecting gums around that particular tooth to avoid tearing them. After reflection, he will luxate the tooth with an instrument to loosen its grip within the tooth socket. This has to be done with pressure so the patient might feel a little high pressure over the jaw. However, there is no pain.

Once the tooth is extracted, a gauze with disinfectant is packed into the socket to accelerate blood clot formation along with reducing chances of infection.

Surgical extraction/disimpaction

If the tooth seems hard to be extracted non-surgically,i.e., if the tooth has a long root, ankylosis, impaction or other factors that can hamper exodontia, it has to be removed surgically. In surgical intervention, incisions are to be made on gums and surrounding bone has to be cut so as to facilitate tooth removal. If need arises, the tooth is cut or sectioned into halves for ease of removal.

Post-extraction care

There are few things to be taken care of after the surgery to ensure smooth and painless recovery.

  • Packed cotton rolls must not be removed before half an hour.

  • After removing cotton, one must apply something cold over it(eating plain ice cream does the job)

  • Take the prescribed medications religiously

  • Remember that swelling of cheeks is normal, Apply cold packs twice a day to reduce swelling

  • Do not chew from the side where tooth is extracted

  • Do not consume anything hot or hard for a week. It can disrupt the blood clot formation

  • Do not smoke, chew tobacco or consume alcohol. It will only lead to delayed painful healing or a condition called ‘Dry socket’

  • Do not do anything that will create negative pressure in the oral cavity. For example, vigorous gargling, and using straw.

  • Gargle softly with prescribed chlorhexidine mouthwash to clean your mouth

Tooth extraction expenses

The cost of the surgery depends on the difficulty level of it. If the tooth can be easily pulled out without any post-operative trauma, the charges in India will be around 500-1000 rupees. If there is a need to canary out disimpaction, the charges will be around 1500-3000 and some clinics charging up to 5000/-

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