Dental Extractions

There are many reasons why it may be necessary to remove an adult tooth, but all of them share the same basic underlying premise—if leaving the tooth in place will do more harm than good, it should be removed.

Situations where that may be the case include:

• Tooth infection
• Badly decayed tooth
• A tooth that is too badly damaged by trauma to repair
• Preparing for orthodontic realignment of the teeth
• People who are undergoing chemotherapy or preparing for an organ transplant

In some cases, whether or not to remove a tooth is a judgement call by the dentist based on many factors including the age and health of the patient.

There are two types of tooth removal procedures—a simple extractions, which we do at Blackstone Family Dentistry, and a surgical extraction, which is performed by an oral surgeon.

A simple tooth extraction is used in situations where the tooth is visible. In this procedure, a dentist will use a local anesthetic to numb the area around the tooth so you won’t feel any pain during the procedure, only pressure. She will then use an instrument called an elevator along with forceps to remove the tooth.

A surgical extraction is necessary when the tooth is impacted (not visible). This is a more complicated procedure requiring the administration of general anesthetic, and thus for this procedure we will refer you to an oral surgeon.

The recovery period from a tooth extraction is usually not more than a few days. During that time, there are a few things you can do to help make sure the recovery is complete and happens as quickly as possible. Those may include:

• Applying an ice pack to your cheek for 10 minutes at a time in the hours immediately after the procedure to reduce swelling.
• Keep the gauze pad that the dentist places over the affected area on for at least 3-4 hours, and bite down to keep pressure on it and reduce bleeding.
• Don’t smoke, use a straw, or rinse your mouth out for 24 hours after the procedure.
• Avoid brushing or flossing the area of the extraction during the recovery.
• After 24 hours, you can use warm salt water to rinse out your mouth.
• Eat soft foods the day after the procedure and reintroduce other foods in the days following as the recovery progresses.

If at any time you experience symptoms of an infection during the recovery from a tooth extraction, such as fever, pain, or pus or drainage coming from the site of the extraction, contact our office immediately.

While tooth extractions are very common, it is technically a surgical procedure and as with any type of surgery there are risks. Those risks include:

• Bleeding lasting longer than 12 hours
• Infection causing severe fever and chills
• Nausea or vomiting
• Chest pain or shortness of breath
• Swelling around the site of the extraction
• Dry socket

The last risk on the list, dry socket, is also referred to as alveolar osteitis. It only happens to about 2-5% of people who get a tooth pulled, mostly in cases where the patient smokes, has poor oral hygiene, or has had a more complicated oral surgery like wisdom tooth extraction.

What happens in a case of dry socket is that the blood clot that forms at the site of the extraction gets dislodged, and the bone and nerve are exposed to air, food, fluid, and anything else in the mouth. This can be very painful and also cause an infection.

Dry socket is treated by applying a medicated dressing to the area to promote healing. The dressing will need to be changed every few days by a dentist until the area is fully healed. During that time the dentist may prescribe painkillers to help reduce discomfort.

Here are some of the questions we most frequently get asked about dental extractions, along with the answers.

How much does a dental extraction cost and will my insurance cover it?

A simple tooth extraction costs anywhere from $75—200 per tooth, depending on the type of anesthetic needed. Your dental insurance may cover a portion of that expense. Surgical extractions, which we do not perform at Blackstone Family Dentistry, can be much more expensive, up to several thousand dollars.

How long does the procedure take?

The simple tooth extractions we perform at our office usually take less than an hour. The actual extraction of the tooth usually takes less than 15 minutes; the rest of the time is used for apply local anesthetic and allowing it to take effect, and for cleaning up the extraction site after the procedure is over and instructing the patient on the recovery process.