Dental extraction
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Exodontia, or dental extraction is a process by which a tooth is removed or uprooted from the gums. There are several reasons for tooth extraction, and among the most common is the incidence of tooth decay. When tooth decay has progressed to a certain extent such that it has completely eroded the structure of the tooth, a dental extraction is necessary, especially if the tooth cannot be restored by other dental means.

Dental extraction is also performed when a person experiences painful problems with their wisdom teeth, in cases of impacted teeth, or when a patient needs to have some permanent teeth removed to provide space for a number of orthodontic treatments, such as braces.

In the past, before antibiotics were discovered, infections of the teeth were most commonly associated with a number of heath conditions. Teeth were extracted to as a means to cure the accompanying disease or ailment. Tooth extraction was also used as a form of coercion to encourage law offenders to admit their guilt.


There were various instruments used for tooth removal over the centuries. Guy de Chauliac invented the dental pelican in the 14th century. This device was used throughout the late 18th century for tooth extraction. An instrument known as the dental key, which in turn was superseded by the use of forceps in the 20th century, replaced it. At present, due to the type of dental problems a person has, there is a wide array of dental instruments for each kind of dental situation.

A person’s teeth may be extracted for a variety of reasons. One of this is tooth damage that results from either decay or breakage. When tooth decay occurs, it signals the presence of dental carries or infection. Dental carries is the most common reason for a majority of tooth extractions in the present day.

Tooth extraction may also be necessary when a person’s mouth contains extra teeth that block new teeth that are set to appear. To prevent unsightly overlapping of teeth in the mouth, several tooth extractions may be required. A person who has gum disease that affects the teeth may also require a tooth extraction or two to prevent the disease from spreading towards the various supporting bone structures and tissues of the gums. For installation of braces, orthodontists may also recommend tooth extraction.


Other causes of tooth extraction involve removing teeth that are in the way of a line of fracture, such as occurs after a trauma or accident. Removal of fractured teeth is another reason, as well as extraction of teeth that are in the way of radiation as during radiation therapy to the head and neck areas. In some cases, people who have impacted third molars need to have them removed to make way for their wisdom teeth.
Dental extraction
Image: Dental Extraction

There are two categories of tooth extraction: simple and surgical. Simple extractions are usually done on teeth that are fully visible within the mouth. The dentist will inject a local anesthetic and make use of dental instruments to lift, grasp, and extricate the tooth from the gums. The tooth is lifted with the use of an instrument known as an elevator, and a pair of forceps is used to grasp the portion of the tooth that is visible, and rock it until the periodontal ligament is successfully detached and the alveolar bone is widened enough to loosen the tooth. This requires slow and steady pressure to enable the dentist to lift the tooth from the surrounding bone and gums.

The second type of extraction is surgical in nature. This method is used when there is teeth under the gum line that need to be removed, either because they are impacted or they haven’t erupted fully. A surgical extraction will require an incision to be made on the gums to uncover the hidden tooth. In some cases, some of the overlapping or overlying bone tissue will need to be removed with the use of a drill called an osteotome. To facilitate the removal of a particularly troublesome tooth, the dentist may break the actual tooth down into smaller parts for easier extraction.


Tooth extraction does have accompanying complications that require a variety of treatments. When infection sets in after an extraction, the dentist usually prescribes a round of antibiotics to treat it. Generally, a dentist will prescribe antibiotics after every extraction to prevent any incidence of infection.

Some dental extraction wounds experience prolonged bleeding long after the extraction. While small amounts of blood may appear with a person’s saliva for up to 72 hours following a tooth extraction, a greater amount of bleeding may occur and the dentist usually takes steps to prevent this type of bleeding.

Swelling is another complication that occurs after surgical extraction of the tooth. When the periosteum, a surgical flap covering the bone is lifted and the bone is subject to minor trauma during the extraction, such as when drilling is required, mild to moderate swelling is expected.

In some cases, a person’s sinus is exposed during extraction of the upper premolars or upper molars. The maxillary sinus is located above the roots of these teeth and the bony floor of the sinus as well as the Sniderian membrane that surrounds it may inadvertently be perforated or removed when an extracted molar is found within it. When this happens, the dentist may allow it to heal naturally, or close it surgically, depending on the size of the perforation or exposure. In both cases, the dentist will apply a dental gel foam to encourage clotting and to serve as a framework for the healing tissue to come together and close up the wound.

Other complications include nerve injury, as when a nerve is in very close proximity to the site of the surgery; displacement of tooth fragments into the maxillary sinus, as well as alveolar osteitis, a painful inflammatory condition that follows lower wisdom tooth extraction

After a tooth extraction, the resulting hole in the jawbone will take anytime from a couple of weeks up to a few months to heal. During the healing process, the hole will smoothen out with bone and gum tissue. Some bleeding may occur during this time which may be abated by packing a piece of gauze into the empty tooth socket and applying pressure by biting down on it for half an hour.

Patients need to avoid rinsing the wound for a period of 24 hours after extraction, as well as refraining from taking hot beverages or smoking. Any pain, swelling or inflammation may be remedied with painkillers like ibuprofen, or a round of antibiotics to prevent infection. After a couple of weeks, the pain and discomfort of the extraction site will have abated or disappeared.
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