While it’s generally best to try to preserve a tooth and avoid extraction, there are some situations where having a tooth pulled is the best option for maintaining optimal oral health. Teeth that are badly broken or have extensive decay may need to be extracted to prevent infection or the spread of decay to other teeth. Teeth that are impacted (“stuck” under neighboring teeth) or crowding or pushing against other teeth also may need to be pulled. Wisdom teeth almost always need to be extracted to prevent future oral health problems.
That depends on why the tooth is being pulled, where it’s located and other factors. Some extractions are simple and can be performed by simply grasping the tooth with special “grippers” and gently pulling. Other extractions require incisions into the gum to access the entire tooth, including the root portion, and more complex extractions may require the removal of some of the surrounding bone. Tooth extractions can be performed using IV sedation to prevent discomfort and anxiety.
Many wisdom teeth come in sideways or become impacted when erupting, and they must be pulled to prevent more serious oral health issues from occurring. Even if a wisdom tooth comes in straight, extraction generally is still recommended to prevent future problems that can occur when these hard-to-clean teeth become harbors for harmful bacteria.
Sedation used during extractions can cause drowsiness, so patients should arrange to have someone drive them home after the appointment. Plan to spend the rest of the day napping, and drink plenty of fluids, but nothing too hot or too cold to avoid causing sensitivity. Don’t use a straw which can dislodge the protective clot that forms and initiate bleeding. For the first couple of days, it’s a good idea to stick to soft foods and avoid foods that are hard or crunchy. Swelling typically resolves within a few days and discomfort can be managed with mild pain relievers.