When you were
six years old, losing a tooth was a rite of passage, perhaps achieved by excessive tooth jiggling,
biting into an apple, or tying a string around the tooth and giving it a tug. As an adult, tooth
loss is hardly cause for celebration, yet having a tooth pulled is sometimes necessary to create a more healthy
Reasons for Pulling Teeth
Although permanent teeth were meant to last a lifetime, there are a number of reasons why a
extraction may be needed. The most common is a tooth that is badly damaged, from trauma or decay,
and cannot be repaired. Other reasons include:
- A crowded mouth due to lack of space from all the permanent teeth. Sometimes teeth are pulled to prepare
the mouth for orthodontics. The goal of orthodontics is to properly align the teeth, which may not be possible if your teeth are too big for your
mouth. Likewise, if a tooth cannot break through the gum (erupt) because there is not room in the mouth
for it, the dentist may recommend pulling it.
- A dental infection. If tooth decay or damage extends to the pulp -- the center of the tooth containing nerves
and blood vessels -- bacteria in the mouth can enter the pulp, leading to an infection. If the infection is so
severe that antibiotics cannot resolve it, an extraction may be needed to prevent the spread of infection to other
- The risk of infection is greater with a systemic condition. If your immune system is compromised due to
receiving chemotherapy or having an organ transplant, you may be at a greater risk of developing a systemic
infection from a particular tooth and may be reason to pull a tooth.
- Periodontal (gum) disease . In periodontal disease, patients develop an infection of the tissues and bones that surround and support
the teeth. This results in loosening of the teeth and may be necessary to the pull the tooth or teeth.
What to Expect With Tooth Extraction
Before extracting the tooth, Dr. Dillon will give you an injection to anesthetize (numb) the area
where the tooth will be removed. If you are having more than one tooth pulled or a tooth is impacted,
he may use a stronger longer lasting anesthetic. This will prevent pain throughout your body and make you sleep
through the procedure.
If the tooth is impacted, Dr. Dillon will cut away gum and bone tissue that cover the tooth and then,
using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments
that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces.
Once the tooth has been pulled, a blood clot usually forms in the socket. Dr. Dillon will pack a gauze pad
into the socket and have you bite down on it to help stop the bleeding. In some cases, he will place a few self-dissolving
stitches to close the edges of the gums over the extraction site.
Sometimes, the blood clot in the socket breaks loose, exposing the socket -- a painful condition
called dry socket. If this happens, Dr. Dillon will likely place a sedative dressing over the socket
for a few days to protect it as a new clot forms.
What We Need to Know About You Before You Have a Tooth Pulled
Although having a tooth pulled is usually very safe, the procedure can allow harmful bacteria into
the bloodstream. Gum tissue is also at risk of infection. If you have a condition that puts you at high
risk for developing a severe infection, you may need to take antibiotics before and after the extraction.
Before having a tooth pulled, let us know your complete medical history, the medications and
supplements you take, and if you have one of the following:
- damaged or man-made heart valves
- congenital heart defect
- impaired immune system
- liver disease (cirrhosis)
- artificial joint, such as total hip replacement
- history of bacterial endocarditis
After Your Tooth is Extracted
Following a tooth extraction, Dr. Dillon will send you home to recover. Recovery from a tooth extraction typically
takes a few days. The following can help minimize discomfort, reduce the risk of infection, and speed recovery.
- Take the anti-inflammatory and paid medication as prescribed by Dr. Dillon.
- Bite firmly but gently on the gauze pad placed by Dr. Dillon to reduce bleeding and allow a clot to
form in the tooth socket. Change gauze pads before they become soaked with blood. Otherwise, leave the pad
in place for three to four hours after the extraction.
- Apply an ice bag to the affected area immediately after the procedure to keep down swelling.
- Apply ice for 10 minute intervals 30 minutes at a time.
- Relax for at least 24 hours after the extraction. Limit activity during the next day or two.
- Avoid rinsing or spitting forcefully for 24 hours after the extraction to avoid dislodging the clot that
forms in the socket.
- After 24 hours, rinse with your mouth with a solution made of 1/2 teaspoon salt and 8 ounces of
- Do not drink from a straw for the first 24 hours.
- Do not smoke, which can inhibit healing.
- Eat soft foods, such as soup, pudding, yogurt, or applesauce the day after the extraction. Gradually
add solid foods to your diet as the extraction site heals.
- When lying down, prop your head with pillows. Lying flat may prolong bleeding.
- Continue to brush and floss your teeth, and brush your tongue, but be sure to avoid the extraction site.
Doing so will help prevent infection.