There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth and jaw at risk of decay, so your doctor may recommend removal and replacement with a bridge or implant. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
When it is determined that a tooth needs to be removed, your dentist may extract the tooth during a regular checkup or may schedule another visit for this procedure. The root of each tooth is encased within your jawbone in a “tooth socket,” and your tooth is held in that socket by a ligament. In order to extract a tooth, your dentist must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share with your doctor any concerns or preferences for sedation.
Once a tooth has been removed, neighboring teeth may shift, causing problems with chewing or with your jaw joint function. To avoid these complications, your dentist may recommend that you replace the extracted tooth.
The removal of wisdom teeth has become so commonplace that it is almost a rite of passage for young adults. Wisdom teeth are a type of molar that is found in the very back of your mouth. There are four wisdom teeth: upper left, upper right, lower left, and lower right. These teeth usually appear in late teens or early twenties but may become impacted (fail to erupt) due to lack of room in the jaw or angle of entry. The most common type of impacted wisdom tooth is “mesial”, meaning that the tooth is angled forward toward the front of your mouth.
When a tooth is impacted, it may need to be removed. If it is not removed, you may develop gum tenderness, swelling, or even severe pain. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease.
Each patient’s situation is unique, and your dentist will take x-rays and discuss your particular needs with you. If your dentist recommends removal of your wisdom teeth, it is best to have them removed sooner than later. As a general rule, wisdom teeth are removed in the late teens or early twenties because there is a greater chance that the teeth’s roots have not fully formed and the bone surrounding the teeth is less dense. These two factors can make extraction easier.
In order to remove a wisdom tooth, your dentist first needs access to it. To make this process most comfortable, your dentist will numb the area with a local anesthetic. Your dentist can even use additional medication to safely sedate you during the extraction if you are feeling nervous about the procedure. Because the impacted tooth is frequently under the gums and still encased in your jaw bone, your dentist will need to remove a portion of the covering bone to extract the tooth. To minimize the amount of bone that must be removed, your dentist will often “section” your wisdom tooth so that each section can be removed through a small opening in the bone.
Once the teeth have been extracted, the healing process begins. Healing time varies depending on the degree of difficulty related to the extraction. Your dentist will share with you what to expect and provide instructions for an efficient healing.