General Dentistry

Wisdom Teeth Extractions

What is an extraction?

An extraction is a dental term for the removal of teeth or a single tooth. You might go in to get one tooth extracted or several teeth extracted, depending on the condition of your teeth.

Why do I need to extract my tooth?

There are several reasons why your tooth might need to be extracted, but usually the main reason is to help you be free of pain. Extracting a tooth that is causing you pain is quick, permanent, and inexpensive. There are other ways to relieve yourself from the pain, but other options might be more expensive or not right for you. Other reasons for extracting a tooth may include:

• Your dentist at Karing Dental Center might tell you that your tooth is not repairable or not possible to repair due to your situation, so an extraction would be the best treatment for you. Usually this happens if your tooth is badly decayed below the gum line or if the tooth has lost a lot of bone due to periodontal disease.
• Sometimes removal of teeth is a matter of health; wisdom teeth, teeth related to a cyst or a tumor, teeth that might affect a person’s health if left in place, or crowded front teeth all need to be removed.
• Teeth that are broken, cracked, or extremely decayed need to be extracted.


• Some people need treatment of the nerve space inside of the tooth, and if they can’t have a root canal treatment, extraction is their next option.
• Some teeth are positioned incorrectly in the mouth, which causes pain by rubbing against the cheek or making a person bite the tooth every time they chew. These teeth need to be extracted as well to lessen the pain.
• Some teeth need to be extracted because they are nonfunctional and serve no purpose, but can be problematic in the long run. Wisdom teeth are an example of this since they are so far back and hard to clean, which means they are more likely to decay and cause periodontal disease.
• Tooth extractions may be necessary for someone who needs orthodontic treatment such as braces. This may be done to help the orthodontist align the teeth better.

Types of Extractions?

One type of extraction is done when there are impacted teeth. When a tooth stays below the gum line and it never fully develops, it is said that the tooth is impacted. Impacted teeth generally cause health problems so they are removed to prevent future problems. To extract an impacted tooth, the dentist at Karing Dental will follow a surgical procedure. Once the tissue flap of your gum is raised so the dentist can remove the tooth, the tooth is considered to be a “tissue impaction” because the crown can be grasped and removed with dental forceps. However, there can be situations where the crown is so far below that it can’t be grasped that easily. If the tooth is lying on its side below the surface, this can make the extraction even more difficult. If this is the case, we have to remove the surrounding bone and then cut down the tooth into pieces so each one can be extracted. Teeth that have to be removed in this manner are considered to be “bony impactions” and are classified even further as vertical, horizontal, or angular.

Wisdom teeth are known as the third molars and erupt around the age of 17 or 18, which is when people are supposed to be entering “adulthood.” This is how these molars got their name. As we get older, our faces, more specifically our jaws, get shorter, and the number of our teeth stays the same. Most people don’t have room in their mouth for wisdom teeth so they have to get them removed. However, some people’s wisdom teeth never surface; they remain impacted all their lives without causing any pain.

You might think that a tooth that is underneath the gums will never be exposed to germs and become infected. This is not true. In reality, the enamel on the crown of the wisdom tooth touches the enamel on the crown of the second molar tooth, which is surfaced and right in front of the wisdom tooth. Therefore, germs can enter underneath the gums where both the wisdom tooth and second molar tooth meet, so there is still a chance of infection. Unfortunately, a wisdom tooth that hasn’t surfaced can’t be brushed. If the body is in normal state, your body’s immune system can fight off the germs surrounding your wisdom tooth. If your body encounters illness or emotional stress, the germs can overpower your body’s immune system and cause an infection around your wisdom tooth. This infection is called pericoronitis, which means, “an infection around the crown of an unerupted tooth.” Your dentist at Karing Dental can temporarily take care of the infection by cleaning around the tooth, but since pericoronitis returns the best thing to do is to have the tooth extracted.

What should I do after an extraction?

After you have an extraction, there are several steps that you should follow to start the healing process. It’s very important that you discuss these instructions with your dentist to see if they are right for you. Here is what you should do (for the most part):
• Know that once the numbness wears off, you won’t feel so great. You should go home and relax. Do NOT exercise for at least 12 to 24 hours.


• When you leave the Karing Dental office, you should have a piece of gauze in your mouth. Bite on the gauze gently for at least two hours to apply pressure on the socket to keep the bleeding under control, but do NOT chew on it! Make sure that the socket is completely covered. You don’t need to change the gauze unless it’s soaked with blood. If you kept the socket covered for at least two hours, the blood should have clotted over the socket. It keeps the socket from bleeding any further. When you fall asleep, you might wake up with a little blood on your pillow, but this is normal.


• You should not spit for 24 hours. Spitting causes you to suck, which will make you start bleeding again or dry out the socket. You can use a tissue to wipe away any blood or saliva from your tongue, but do NOT spit.


• The extraction procedure can cause swelling. To reduce the swelling on your face, you should place ice on the swollen area for ten minutes and then remove it for twenty minutes. Repeat this cycle up to the first 24 hours.


• If you are a smoker, do NOT smoke for at least 48 hours! If you do smoke before 48 hours, the chemicals from the smoke will dissolve the clot, causing a dry socket. Also, continual smoking irritates the bone and the dry socket, which will lead to pain. You don’t want this happening to you!


• You should wait to eat anything solid until the anesthesia wears off. Once you can feel your mouth again, you can eat whatever you want. You should avoid alcoholic drinks for at least 24 hours as well as hot liquids because they can dissolve the blood clot that has formed over the socket.


• If your dentist has prescribed you a medication, you should take it on schedule until the course is done! The medications are to help you feel less pain and help speed up the recovery process, so don’t ignore it! Also, if you are given a narcotic such as codeine, Vicodin or Percocet, don’t drive or operate anything for your safety.


• On the day of the extraction, you should avoid brushing your teeth near the extraction area. The next day you can clean your teeth with gentle brushing. It’s important that you don’t rinse vigorously because it could remove the blood clot. Also, don’t rinse with a mouthwash.


• After 48 hours, if the pain is still there, or you start bleeding again, you should call your dentist.

At Karing Dental Center, you dentist may add, take out, or revise the instructions above to meet your dental needs. Remember, it’s important that you follow the aftercare instructions given to you by your dentist.

What are some complications after an extraction?

There are some complications involved after having an extraction. Some of these include:

• Bleeding: As long as you follow the first couple of steps above, you should have no problems with too much bleeding. The only people who should worry about excessive bleeding are people who are taking blood thinner medications such as Coumadin or Heparin for cardiovascular problems, or people who have blood disorders. These people should talk to their doctor before having an extraction done.


• Infection: After an extraction, infections are a common problem that occurs in some people, especially with those people who have poor oral hygiene. People who have swollen faces, tender teeth from even light pressure, swollen gums or tongue, or excessive bleeding are usually already infected. They need to take antibiotics to help get rid of the infection. People can have an infection after the extraction even if they didn’t have one before the procedure. If you are experiencing any signs of infection after two days, you should see your dentist as soon as possible! You should always take any medication prescribed by your dentist on time and until it has finished or the infection can return.


• Dry Sockets: A dry socket is probably the most painful and common complication that occurs in people after an extraction. It’s when the blood clot becomes separated from the socket walls, or dissolves away, leaving the bone exposed to saliva and food. They are usually frequent in the lower teeth than they are in the upper teeth after an extraction. The most common way of getting a dry socket is if you were to smoke before 48 hours or constantly grind and apply pressure to your teeth. Usually, if you leave it alone, the dry sockets will eventually heal. Antibiotics and pain medications are not helpful in healing dry sockets, but you can go back to your dentist and have him or her “pack” the socket for you.


• Broken Jaws: Naturally, everyone is different from one another, and some people have fragile jaws than others. A dentist can look at an X-ray and tell whether or not a patient will be likely to have a fractured jaw.


• Sinus Perforation: The roots of the upper back teeth are very close to maxillary sinus. There is a thin wall of bone that separates the root and the sinus, but sometimes a piece of the bone can break off and be removed along with the tooth. As a result, there is a connection between the mouth and the sinus! If the perforation is small, you might only experience a nosebleed. To prevent infection and decongestant, your dentist might prescribe you an antibiotic.


• Sequestrii: This is when broken bone pieces come out several weeks after an extraction, which are mistaken as pieces of tooth. Sequestrii are usually unavoidable and unnoticeable after an extraction. After a dry socket has occurred, bony fragments that aren’t healed properly become dead tissue because they loose their blood supply. Then, the body starts to eject these fragments from the healing socket, which is process called “sequestration.” This can be painful, but once the dentist removes the sequestrum, the pain will go away.


• Retained Roots: Sometimes, dentists leave broken pieces of a tooth, or root tips, are left in the bone. Generally, the retained root tips will heal in place and not cause a problem in the long run, even after healing. Removing the root tips is sometimes worse than just leaving them alone because it involves a lot of drilling, prying, and time. It’s usually better to leave it alone because it doesn’t cause any complications after the healing process is done.