Infection. If tooth decay or damage extends to the pulp -- the centre of the tooth containing nerves and blood vessels -- bacteria in the mouth can enter the pulp, leading to infection. Often this can be corrected with root canal therapy (RCT), but if the infection is so severe that antibiotics or RCT do not cure it, extraction may be needed to prevent the spread of infection.
Risk of infection. If your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant), even the risk of infection in a particular tooth may be reason enough to pull the tooth.
Periodontal (Gum) Disease. If periodontal disease -- an infection of the tissues and bones that surround and support the teeth -- have caused loosening of the teeth, it may be necessary to the pull the tooth or teeth.
Once the tooth has been pulled, a blood clot usually forms in the socket. The dentist will pack a gauze pad into the socket and have you bite down on it to help stop the bleeding. Sometimes the dentist will place a few stitches -- usually self-dissolving -- to close the gum edges over the extraction site.
Sometimes, the blood clot in the socket breaks loose, exposing the bone in the socket. This is a painful condition called dry socket. If this happens, your dentist will likely place a sedative dressing over the socket for a few days to protect it as a new clot forms.
There is no reason these days that any dental procedure, tooth extractions included, should be painful. The local anaesthetics that we have now, especially the new ones like Articaine, which has been released in the last few years, are more powerful than before. The anaesthetic lasts longer, so there is absolutely no need to anyone to suffer in pain at the dentist.
In addition to the modern pain relief we also add in all the TLC (tender loving care), take our time to do things gently, use numbing creams and help patients relax with mod-cons like DVD’s, music and neck cushions.
What to Tell Your Dentist 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 your dentist 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 a hip replacement
- History of bacterial endocarditis