Tooth Extractions – When Are They Required?

April 11, 2024
Posted by:
Dr Sonam Bhatia

We look at when an extraction is needed and how it’s carried out.

All of us will lose some teeth during our lifetime, even if these are largely our ‘baby teeth’ which fall out naturally. Even in our adult years, the need to have a tooth extracted is a real possibility if we are unlucky enough to have an accident that damages a tooth beyond repair, or if we neglect our teeth, causing them to decay.

Although extraction is a widely used procedure, there is more to it than a tooth simply being ‘yanked’ out of the socket. Care still needs to be taken and we will look at the procedure in a little more detail later on in this blog. First of all though, let us take a look at the possible reasons for needing to have a tooth extracted.

Tooth decay

One of the most common reasons for extracting a tooth at Purley Dental Care is where it has suffered significant decay. While we will always do what we can to save a natural tooth, perhaps through a filling or the addition of a crown, this may not always be possible and the tooth may need to be extracted. Our patients have the options of a number of tooth replacement treatments if this should happen, including dentures, bridges and dental implants.

Broken Tooth

A broken tooth almost always means that the less well protected inner part of the tooth is exposed. When this happens, tooth decay is unlikely to be far behind. As with tooth decay, we will always restore a broken tooth wherever possible but an extraction is a possibility depending on the severity of the damage.

Overcrowding

This tends to occur in the late pre teens to teenage years and can cause problems such as crooked teeth. Not only does this often cause embarrassment and sometimes social awkwardness which can have an effect throughout their life, but can also make cleaning teeth more difficult, leading to more problems later on. By removing appropriate teeth, this problem can often be resolved.

Fitting a denture or bridge

While bridges and dentures can often be fitted without the need for a tooth extraction, it may be necessary where a number of teeth are missing bar one or two lone teeth in the middle. Removing these means that a single row of replacement teeth can be used in either a denture or a bridge.

Gum disease

Gum disease can be uncomfortable and unpleasant but, if not treated in time, can also cause teeth to become loose and fall out. This is caused by damage to the surrounding bone which is affected by later stage gum disease (periodontitis). Although treatment at this stage can sometimes be carried out, it isn’t always successful and extracting the tooth may be the only option available.

How is a tooth extracted?

Everyone has seen the cartoons with the ‘bad old dentist’ yanking the tooth out with a pair of pliers while the patient screams in pain. Thankfully, this is not the case and, in reality, you should feel little or no discomfort during the whole procedure. This is largely due to the powerful local anaesthetics that are available these days.

Initially, the local anaesthetic will be injected into the gum and allowed to take effect before the procedure begins. Where possible, the tooth will be extracted in one piece, but in some instances, it may be necessary to divide the tooth into sections for ease of removal. Generally though, the dentist will take hold of the tooth with a special implement and gently rock the tooth from side to side and back and forth to gradually loosen it from its socket. When sufficiently loose, the tooth can then be extracted. This can lead to some grinding sensation as the tooth is manoeuvred but no pain should be felt during this.

Where a tooth has broken off at the gum line, this method may not be possible and a different one may be needed. In some cases, a dental specialist may be needed to ensure that there are no nerves in the area where the procedure is to take place.

In order to remove a tooth where the crown is no longer visible to hold, a special implement called a ‘dental elevator’ is used. This is a simple tool that is inserted between the tooth root and the gum, following a local anaesthetic of course, and is then gently twisted to elevate the root from the socket. As with a standard tooth extraction, no pain should be felt.

Whichever method is used, the dentist will apply clean gauze to the bleeding area to stem the flow and form a blood clot. It is this clot that starts the healing process and should not be removed. You need to take care for a short while afterwards and advice, including cleaning advice, will be provided for you to take home and help you take care of the affected area.

Extracting baby teeth

It is worth discussing here how children’s first teeth should be extracted. Often they will simply fall out themselves but this isn’t always the case and sometimes they need a little help. We do encourage parents not to attempt to do this themselves, at least not without contacting us first. If you attempt to do so and it goes wrong, your child could be in pain and it may even damage the area and affect the way that their adult teeth erupt.

Under no circumstances should you use a ‘violent’ method especially, whether this be attaching a string to the tooth and the door before slamming it, or any other similar method. You should seek the advice of one of our children’s dentists before taking any action. We will be able to advise you how best to proceed. That may be at home or you may need to bring your child into our dental practice to have the tooth removed.

The removal of a tooth should always be carried out by a professional. If you have a toothache or are aware of any dental problems that you might have, please make an appointment to see us as soon as possible. You can do this by using the contact form on our website or by calling Purley Dental Care on 020 8660 2928.

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