Dental extractions are performed for a variety of reasons, including tooth decay, injury, and orthodontic treatment. Surgical tooth extractions are relatively common dental surgical procedures in most dental offices, including our offices in Concord and Lexington, MA.
The difficulty of the procedure varies depending on the case and the patient. However, anesthesia is used to numb the area and prevent pain during the procedure.
Types of Tooth Extractions
There are two forms of extraction: simple and surgical extractions. Simple extractions are performed on teeth that can be seen in the mouth. They are removed due to decay or injury and are usually performed under a local anesthetic.
During this procedure, the doctor will grasp the tooth with forceps and loosen it by moving the forceps back and forth. The loosened tooth will then easily come out.
Surgical extractions are performed on teeth that have broken off at the gum line or that have not yet come in (ie: wisdom teeth). To remove the tooth, the doctor will have to cut and pull back the gums, which allows access to the area.
This is necessary so that they can see the tooth that needs to be removed. Surgical extractions are usually done with local anesthesia, but general anesthesia or nitrous oxide is sometimes preferred.
Reasons for Surgical Tooth Extraction
The most common reason for the removal of a tooth is severe decay or breakage of a tooth. However, teeth may also be removed because of:
- Severe tooth decay or infection
- Extra teeth that are blocking other teeth from growing in
- Severe gum disease
- To make room for orthodontic treatment
- The tooth can not be restored endodontically
- Fractured teeth
- To make room for a dental prosthesis (i.e.: bridge or denture)
- Cosmetic reasons
Regardless of why a tooth must be pulled, extraction is usually reserved only for cases in which no other treatment option will cure the infection or problem.
What Are Wisdom Teeth?
The wisdom teeth, or third molars, usually appear in adults between the ages of 17 and 25 and are the final set of molars that most people get. While most will eventually have their wisdom teeth removed, not everyone needs to do so. Most dental professionals will recommend having your wisdom teeth removed if you experience any of the following scenarios:
- Your wisdom teeth do not fit in your mouth – Most people have 28 teeth before wisdom teeth erupt. Many do not have enough room in their jaw for 32 teeth and this may cause teeth to become impacted. Impacted means the wisdom teeth cannot fully erupt or they may become misaligned. Removing the wisdom teeth can prevent impaction and overcrowding in your jaw.
- You experience chronic pain in your gums around your wisdom teeth – Pain in your gums can be an indication of infection. Infections are common around partially erupted wisdom teeth because food and bacteria get trapped in these areas. Having your wisdom teeth removed can prevent further infection.
- Your wisdom teeth do not come in straight – Often, wisdom teeth will not grow in straight and can cause your teeth to shift and move over time. To prevent your teeth from moving, removing your wisdom teeth is often recommended.
- Your wisdom teeth are causing tooth decay to adjacent teeth – Wisdom teeth can be difficult to keep clean because of their location in the mouth. Flossing and brushing can be challenging and without good oral care, gum disease and tooth decay can develop. Removing your wisdom teeth can prevent tooth decay issues in surrounding teeth as well as the wisdom teeth.
What Happens During Wisdom Tooth Surgery?
Before the surgery date, your doctor will discuss the procedure with you and let you know what to expect before, during, and after the extraction. On the day of your extraction, we will give you a local anesthetic to numb the area. We may also give you a general anesthetic or nitrous oxide, especially if all of your wisdom teeth are removed at once.
To remove the wisdom teeth, your doctor will open the gum tissue over the tooth and remove any bone that is over the tooth. The whole tooth is then either extracted or cut into smaller pieces to make it easier to remove. After the tooth is removed, you may need stitches.
Several factors will affect how easy it is to remove wisdom teeth. If the tooth has fully erupted, it is a similar procedure to a typical tooth extraction. However, if the tooth is fully impacted or if the teeth have not erupted through the gums, the surgery may be more complicated.
Wisdom Tooth FAQs
Read answers to frequently asked questions about wisdom teeth:
Will all of my wisdom teeth be removed?
Because each patient’s needs are unique, discussing your options with your doctor is important. During your consultation, your doctor will discuss how many wisdom teeth need to be removed to prevent future dental issues. The doctor may remove all wisdom teeth at once or remove a few potentially problematic teeth.
How long does the procedure take?
The duration of your procedure depends on how many wisdom teeth are being removed. Usually, the procedure lasts 1 to 2 hours.
How long until I am completely healed after surgery?
Complete healing doesn’t fully occur for a few weeks to a few months after extraction. Usually, after about two weeks, your mouth will be reasonably comfortable.
Are there any potential post-surgery complications?
There are two potential complications that may occur post-surgery. Dry socket is a common complication that occurs when a blood clot has failed to form in the extracted tooth socket or when a clot has been dislodged.
Dry sockets usually occur 3-4 days after the extraction and are accompanied by pain and a foul mouth odor. Dry sockets are easily treated by placing a medication in the socket.
Paresthesia is a less common complication that occurs when nerves in the jawbone are bruised or damaged during the extraction process. This may result in numbness (paresthesia) of the tongue, lip, or chin that can last days, weeks or be permanent.
Will I have to miss work or school?
Most patients usually miss at least 1-2 days of work or school after their wisdom teeth are extracted. Your doctor may prescribe painkillers that will make it difficult to focus as they may make you dizzy or sleepy. Patients are asked to keep ice on the outside of their face for at least 24 hours to prevent inflammation or swelling.
Your doctor will also usually recommend relaxing as physical activity, even as minor as walking, may increase bleeding. However, after a few days of recovery, most patients can return to their day-to-day activities with little to no problem.
My dentist does wisdom tooth extraction. Should I still see an oral surgeon to have my wisdom teeth removed?
Oral and maxillofacial surgeons (OMSs) are the only dental specialists recognized by the American Dental Association who are surgically trained in a hospital-based residency program for a minimum of four years.
OMS’s train alongside medical residents in internal medicine, general surgery and anesthesiology, and spend time in otolaryngology, plastic surgery, emergency medicine and other specialty areas.
Their training focuses almost exclusively on the hard (i.e., bone) and soft (i.e., skin, muscle) tissue of the face, mouth, and jaws. Their knowledge and surgical expertise uniquely qualifies them to diagnose and treat the functional and esthetic conditions in this anatomical area.
What is the best age to have wisdom teeth removed?
Because each patient is unique, the ideal age to remove wisdom teeth may vary. Most doctors will recommend having them removed before they are fully developed to prevent crowding after eruption. Younger patients also tend to heal faster and with fewer complications than older patients.
What if I chose not to have my wisdom teeth removed now?
Even if you choose to wait to have your wisdom teeth removed, it is important to monitor them continuously. Your mouth is constantly changing over time, and it is possible to develop problems later in life.
As with many other health conditions, as people age, they are at a greater risk for health problems, and that risk includes potential problems with their wisdom teeth.
Restore Your Oral Health
Call our Lexington office at 781.384.5892 or our Concord office at 978.391.6081. You can also schedule a dental appointment with us online.