Our team at Carolina’s Dental Choice knows that the word “extraction” can cause anxiety and even fear in some people. Many of us have had this procedure done, sometimes multiple times, and the reason a tooth needs to be extracted varies from patient to patient.

What Is Dental Extraction?

A dental extraction (also called exondontia or informally, tooth pulling) is the removal of teeth from the socket (dental alveolus) in the alveolar bone. Extractions are performed for a wide range of reasons, but most commonly because a tooth is unrestorable due to decay, periodontal disease, or dental trauma.

Tooth decay is the softening of your tooth enamel and refers to the damage of the structure of the tooth caused by acids that are created when plaque bacteria break down sugar in your mouth.

Periodontal diseases are infections of the structures around the teeth, which include the gums, periodontal ligament, and alveolar bone.

Traumatic dental injuries most often occur as a result of an accident or sports injury. The majority of these injuries are minor, such as chipped teeth. Occasionally though, a tooth will dislodge or even get knocked out completely.

Extraction Procedure

Typically, when undergoing a tooth extraction procedure, your dentist will numb the area with a local anesthetic before the procedure.

Common forms of local anesthesia are Novocaine and more popularly, Lidocaine, which is injected after the dentist numbs the area with an external numbing agent. Here are all the common forms of anesthesia:

• Local Anesthesia—this is when medication is injected into the mouth to numb the area to be treated and block the nerves that transmit pain. This type of anesthesia is commonly used during fillings, treating gum disease, or preparing teeth for crowns.
• Sedation—this method is usually administered by inhaling nitrous oxide, also known as laughing gas. It can also be administered orally in the form of a pill taken prior to the dental procedure. This form of anesthesia is commonly combined with a local anesthetic to help relieve anxiety and reduce pain.
• General Anesthesia—this is the strongest form of anesthesia available for dental procedures and involves intravenous medications that produce a temporary loss of consciousness. General anesthesia is usually only used during oral surgery procedures.

You may have also heard of I.V. sedation and wondered if it were for you. Intravenous (I.V.) sedation has become more common and works well for those with fear of the dentist and dental procedures. It is also ideal for patients whose fear of dentistry has led to a large amounts of dental work needing to be completed.  I.V. Sedation is also used for outpatient procedures, like colonoscopies. Referred to as “twilight sleep,” you will wake with little or no memory of the procedure. Anesthesia is given via the I.V. and recovery requires someone take you to/from the procedure.

If the extraction involves an impacted tooth, the tooth may be broken into pieces before it is removed. An impacted tooth is a tooth that, for some reason, has been blocked from breaking through the gum. Sometimes a tooth may be only partially impacted, meaning it has started to break through.

Your dentist will perform x-rays and thorough examinations before this stage and will explain the procedure and any other possible options. Often, with impacted teeth, there are no symptoms and only an x-ray will discover it.

Another reason teeth are extracted, especially in youth and young adults, is to make room in the mouth before planning to straighten remaining teeth. Teeth may also be extracted if they are so poorly positioned that they cannot possibly be straightened. A less common reason to extract a tooth is as a cheaper alternative to filling or placing a crown on a decayed tooth.

If you or your child has a condition where a tooth extraction might be called for, please call Carolina’s Dental Choice at (704) 289-9519 to schedule an appointment.

The number of Americans missing at least one tooth is more than 120 million, so it’s not at all unusual to be missing one or more teeth for a variety of reasons, including those listed above.

What’s the deal with Wisdom Teeth?

One of the most common procedures is the removal of the “wisdom teeth.” What is this procedure and why do these teeth often need to be removed and what are the benefits? According to www.mayoclinic.org:

Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth — the four permanent adult teeth located at the back corners of your mouth on the top and bottom.

If a wisdom tooth doesn’t have room to grow (impacted wisdom tooth), resulting in pain, infection, or other dental problems, you’ll likely need to have it pulled. Wisdom tooth extraction may be done by a dentist or an oral surgeon.

For many, the first use of dental anesthesia is during extraction of wisdom teeth (the four hindmost molars that come in during young adulthood), which can cause issues including moving other teeth around.

To prevent potential future problems, some dentists and oral surgeons recommend wisdom tooth extraction even if impacted teeth aren’t currently causing problems.

Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.

Many people develop impacted wisdom teeth — teeth that don’t have enough room to erupt into the mouth or develop normally. Impacted wisdom teeth may erupt only partially or not at all.

An impacted wisdom tooth may:

• Grow at an angle toward the next tooth (second molar)
• Grow at an angle toward the back of the mouth
• Grow at a right angle to the other teeth, as if the wisdom tooth is “lying down” within the jawbone
• Grow straight up or down like other teeth but stay trapped within the jawbone

Problems with impacted wisdom teeth. You’ll likely need your impacted wisdom tooth pulled if it results in problems such as:

• Pain
• Trapping food and debris behind the wisdom tooth
• Infection or gum disease (periodontal disease)
• Tooth decay in a partially erupted wisdom tooth
• Damage to a nearby tooth or surrounding bone
• Development of a fluid-filled sac (cyst)

Preventing future dental problems. Dental specialists disagree about the value of extracting impacted wisdom teeth that aren’t causing problems (asymptomatic), because it is difficult to predict future problems with impacted wisdom teeth. However, here’s the rationale for preventive extraction:

• Symptom-free wisdom teeth could still harbor disease.
• If there isn’t enough space for the tooth to erupt, it’s often hard to get to it and clean it properly.
• Serious complications with wisdom teeth happen less often in younger adults.
• Older adults may experience difficulty with surgery and complications after surgery.

What to expect after a Dental Extraction

Immediately after an extraction, be sure to follow your dentist’s instructions. You may receive a prescription for a mild pain killer or antibiotic, but in most cases, over-the-counter medications will manage pain. Do not eat solid foods or smoke for 48 hours. Stick with soft foods like yogurt, soups, mashed potatoes, and smoothies (avoided fruit seeds). The soft tissue takes about 3-4 weeks to heal.

Keep an eye out for any signs of acute bleeding, pain, or swelling. This could indicate an infection.

Beware of Dry Socket

Dry socket (alveolar osteitis) is a painful dental condition that sometimes happens after you have a permanent adult tooth extracted. Dry socket is when the blood clot at the site of the tooth extraction fails to develop, or it dislodges or dissolves before the wound has healed.

Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot also provides the foundation for the growth of new bone and for the development of soft tissue over the clot.

Exposure of the underlying bone and nerves results in intense pain, not only in the socket but also along the nerves radiating to the side of your face. The socket becomes inflamed and may fill with food debris, adding to the pain. If you develop dry socket, the pain usually begins one to three days after your tooth is removed.

Dry socket is the most common complication following tooth extractions, such as the removal of third molars (wisdom teeth). Over-the-counter medications alone won’t be enough to treat dry socket pain. Your dentist or oral surgeon can offer treatments to relieve your pain.

Signs and symptoms of dry socket may include:

• Severe pain within a few days after a tooth extraction
• Partial or total loss of the blood clot at the tooth extraction site, which you may notice as an empty-looking (dry) socket
• Visible bone in the socket
• Pain that radiates from the socket to your ear, eye, temple, or neck on the same side of your face as the extraction
• Bad breath
• Unpleasant taste in your mouth

When to see a doctor. A certain degree of pain and discomfort is normal after a tooth extraction. However, you should be able to manage normal pain with the pain reliever prescribed by your dentist or oral surgeon, and the pain should lessen with time.

If you develop new or worsening pain in the days after your tooth extraction, contact your dentist or oral surgeon immediately.

Expected Costs

The cost of a dental extraction can vary depending on your dentist’s fees and the scope of work. In some instances, extractions (such as wisdom teeth that are impacted) may need to be handled by a dental surgeon under anesthesia.

According to Member Benefits, who tracks the cost of dental work throughout the country, the cost of dental extraction (per tooth) can range from $75-$300 for a non-surgical extraction, and upwards of $650 for a single surgical extraction.  Additional costs could include x-rays and exam fees.

If you have dental insurance, it will take a bite (no pun intended) out of your bill. Depending on your policy, it may cover up to 50% of the cost. At Carolina’s Dental Choice, we work with a variety of Dental Insurers, as well as, Medicaid. Our staff will help you understand the costs involved and file the insurance paperwork for you. If you don’t have insurance, we offer an In-House Dental Savings Plan that allows patients to receive treatment at a discounted price.

Carolina’s Dental Choice also welcomes new patients. Whether you have just moved to the Monroe/Charlotte area, are transferring your care from another practice, need to establish care with a dentist, or find yourself suddenly in need of dental service, we look forward to partnering with you for the benefit of your oral health.

As we’ve explored, the reasons for a dental extraction are varied. There is no need to be in pain or discomfort, or even embarrassment, if you feel you need help with dental issues. Our staff is ready to help you find solutions for your dental needs.