Dental Care

Tooth Extraction - What To Expect

Is a tooth extraction painful? There's no question that many dental patients fear root canal procedures, believing them to be extremely painful and something to be avoided whenever possible. 

In reality, however, an extraction of a tooth can actually be more physically traumatic than the dreaded root canal because an entire tooth is being removed from its socket in the surrounding alveolar bone.

Most extractions are performed because a tooth has broken off or been damaged beyond repair by tooth decay. 

In some cases, dental patients have extra (supernumerary) teeth that must be removed to make way for other teeth to come in. 

Still other patients are getting braces and one or more teeth must first be extracted to make room for the teeth that are being repositioned. 

And, wisdom teeth (the third molars) are often extracted for one or more reasons, either before or after erupting from the gums.

Although there is a system of proposed rates, the cost you will have to pay can be variable, depending on the needs and care of your specific case.

Types of Extractions

Two main types of tooth extractions are performed by dentists and oral surgeons. 

The first type consists of procedures called "simple extractions."  Often performed by general dentists, this type of tooth extraction is only performed on teeth that are visible above the gum line. 

The second, more complicated type of tooth extraction consists of procedures called "surgical extractions."  Performed by oral surgeons, a surgical extraction is required when the tooth can only be removed after the gums have been cut and pulled back to allow access to the tooth. 

This article will focus on simple tooth extractions.

Most simple extractions can be performed following the injection of a simple local anesthetic.  If having your tooth pulled is making you nervous, your dentist can also give you some anti-anxiety medication.

The Procedure of Extraction

Once the procedure begins, you'll almost certainly feel a lot of pressure.  The root of your tooth is firmly encased in a socket within the alveolar bone, held firmly in place by a periodontal ligament. 

To be able to extract the tooth, your dentist will need to widen and enlarge the socket as well as loosen and eventually break the connection between the tooth and its ligament.

The bone in the jaw is somewhat compressible, and this characteristic plays an important role during simple tooth extractions.  When a dentist forces the tooth against one of the sides of its socket by applying firm pressure, the bone in that region will slightly compress and the tooth's socket will slightly expand. 

By repeatedly applying controlled pressure to the tooth from different directions, the entire socket will grow larger and the ligament holding the tooth firmly in place will loosen. 

Eventually, the pressure detaches the ligament and creates enough space in the socket to allow the tooth to come out.

Dentists have an assortment of instruments available to manipulate and apply the necessary pressure to the tooth being extracted.  For example, tools known as "extraction forceps" are specialized pliers, and dental "elevators" are levers that fit between the tooth and the gum.  Both instruments are frequently used during the extraction process.

Using the extraction forceps, your dentist will grasp the tooth and then loosen it by slowly rocking it back and forth, simultaneously applying firm, steady pressure and rotating the tooth as much as possible. 

In some cases your dentist will also use an elevator to help lift and loosen your tooth.  These manipulations combine to expand the socket of the tooth in all directions and break the attachment between the tooth and the periodontal ligament, ultimately allowing the tooth to be pulled out with the forceps.

Once the procedure is over, dental patients typically don't experience much extraction pain

If you do have some discomfort, however, you could take Tylenol®, Advil®, Motrin® or some other over-the-counter pain reliever. On the other hand, you might not need any pain medication at all.

Don´t forget that the tooth care you give yourself afterwards is paramount for a swift healing process.


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