A Look at the Difference between Simple and Surgical Tooth Extraction Methods
You want to keep your teeth for a lifetime, but some circumstances may prompt your dentist to recommend a tooth removal for the good of your dental health.
Tooth extraction may not seem complicated, but it should only be performed by a professional.
So here’s a guide to tooth extractions and whether you should see a dentist or an oral surgeon for the procedure.
When Is A Tooth Extraction Needed?
A tooth extraction procedure is needed when there is damage to a tooth that is beyond repair caused by decay or trauma (e.g., a hit to the face during sports or an accident). An extraction may also be needed if there is risk of decay or damage to a tooth.
Here are some additional reasons a dentist or oral surgeon may carry out a tooth extraction.
The Mouth is Crowded
A mouth is considered crowded when there are too many teeth or the teeth are too large for the patient’s mouth.
Your dentist might need to pull a tooth if there is no room for other teeth – like wisdom teeth – to erupt or break through the gum. And if a wisdom tooth is impacted, it will need to be extracted as well.
Crowded teeth also tend to be misaligned. So if you want an orthodontic procedure to align your teeth, tooth extraction will likely be necessary.
The Tooth is Infected
If left untreated, tooth decay can reach the pulp of a tooth—the tissue at the center of a tooth that contains nerves and blood vessels.
When bacteria from the mouth enters the pulp, the pulp can become infected. Often, this infection can be treated with antibiotics and root canal therapy. But in cases when the infection is too severe to treat, tooth extraction is necessary to prevent the spread of infection.
There Is Risk of Infection
Dentists might extract a tooth if there is a risk of infection and the patient has a compromised immune system (e.g., they are going through chemotherapy or are having an organ transplant).
The Patient Has Periodontal Disease
Periodontal (gum) disease is an infection of the bones and tissues that support teeth. Over time, gum disease can lead to loosening of the teeth due to a loss of bone and gum tissue.
Dentists may opt to extract loose teeth and replace them so patients can eat properly and avoid discomfort.
Dentist or Oral Surgeon?
There are two different types of tooth extraction methods—simple and surgical extractions.
Dentists perform simple extractions—when the tooth can be seen in the mouth. Whereas, oral surgeons often perform surgical extractions when the tooth has broken off at the gum line or has not even erupted through the gum yet.
However, dentists can also perform surgical extractions if they have had the proper training.
How Do They Differ?
Oral surgeons are trained in dental surgery—the procedures that require making an incision in the gum and working with the jawbone. So while a dentist may remove a visible tooth, an oral surgeon will cut into the gum to remove a tooth below the gum or place a dental implant into the jawbone.
Your dentist might refer you to an oral surgeon if the tooth extraction or other dental procedures require surgery.
At the start of a tooth extraction procedure, your dentist or oral surgeon will inject a local anesthetic to numb the treatment area. In some cases, a sedative may also be used to relax the patient or put them to sleep.
For simple dentistry procedures, your dentist will loosen your tooth with an instrument called an elevator, and then use forceps to remove the tooth.
For tooth extraction surgery to remove an impacted tooth, such as a wisdom tooth, the oral surgeon will cut the gum and bone tissue covering the tooth and use forceps to pull the tooth out by gently rocking it back and forth. If the tooth is too difficult to pull, it will need to be removed in pieces.
After the extraction, a blood clot will form in the empty tooth socket. You will have to bite down on gauze to help stop the bleeding, and your dentist may insert a few self-dissolving stitches to close the edges of the gum over the extraction site.
It will take several days to recover from tooth extraction, and one to two weeks to heal, so plan to take some time off from work or school so you can relax and recover.
To help speed healing, reduce discomfort, and avoid complications such as infection, be sure to follow these aftercare tips:
- Bite firmly on the gauze pad placed by your dentist to help reduce bleeding and allow for a blood clot to form.
- Change the gauze pads three to four hours after the extraction or before they become soaked with blood.
- Apply an ice bag to the side of your face that is closest to the extraction area for 10 minutes at a time to help reduce swelling.
- Take any medication (painkillers, antibiotics) as prescribed.
- Relax for 24 hours after the extraction, and limit your activity for the next couple of days.
- Do not sleep flat as this can prolong bleeding. Instead, sleep with your head propped up on pillows.
- Do not smoke during recovery as this can slow down healing and dislodge the blood clot.
- Do not drink from a straw for the first 24 hours following the extraction.
- Do not rinse or spit forcefully for 24 hours following the procedure. Otherwise, you will risk dislodging the blood clot.
- After 24 hours, you can rinse your mouth with warm saltwater—1/2 teaspoon of salt mixed with 8 ounces of warm water.
- For the first day or two, only eat soft foods, like soup, yogurt, applesauce, and pudding. And gradually introduce solid foods back into your diet as your extraction area heals.
- Brush and floss your teeth as usual, but avoid the extraction site.
Sometimes, especially if a patient doesn’t follow the aftercare instructions, there is a risk of infection or a dry socket—when the blood clot breaks loose from the extraction site and exposes the bone in the socket.
A dry socket is extremely painful and will need immediate attention from your dentist. To treat a dry socket, your dentist will place a sedative dressing over the socket to relieve the pain and protect it for a few days while a new blood clot forms.
The gum tissue may also be at risk of infection following the extraction, and the procedure can allow bacteria to enter the bloodstream.
So if you are at risk of developing an infection, you may need to take antibiotics both before and after treatment. And you will need to tell your dentist if you have any of the following medical conditions:
- Congenital heart defect
- Damaged or artificial heart valves
- Impaired immune system
- Liver disease (cirrhosis)
- Artificial joints, such as a hip replacement
- History of bacterial endocarditis
When to Call A Professional
Pain, bleeding, and swelling are normal for the 24 hours after treatment. But if you notice the pain or bleeding becomes severe, especially after 24 hours, or you experience any of the following, call your dentist right away:
- Nausea or vomiting
- Signs of infection, which includes fever and chills, redness, swelling, and excessive discharge from the treatment area
- Cough, chest pain, or shortness of breath
If you think you need a tooth extraction, consult with your dentist. Depending on the complexity of the treatment, you may need to see an oral surgeon for the procedure.
Tooth extraction is a necessary treatment for a number of dental issues to help improve a patient’s oral health, comfort, and quality of life. And with the right aftercare, it can heal quickly so you can get back to your regular day-to-day activities sooner than later.