Tooth Extractions

Tooth Extractions


dental-examReasons for Pulling Teeth

Although permanent teeth were meant to last a lifetime, there are a number of reasons why tooth extraction may be needed. A very common reason involves a tooth that is too badly damaged, from trauma or decay, to be repaired. Other reasons include:

  • A crowded mouth
    Sometimes dentists pull teeth to prepare the mouth for orthodontia. The goal of orthodontia 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, your dentist may recommend pulling it.
  • 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 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.

When an extraction is necessary

When a tooth is severely decayed and cannot be saved, extracting it can be the best choice for relieving pain and preventing the spread of infection.

tooth-decay1Most decayed teeth can be saved

Most decayed teeth can be treated successfully with a filling or crown. But for these treatments to work, there must be enough healthy tooth structure above the jawbone to support the restoration.

For example, a crown is often used to cover, protect, and restore a tooth that’s been damaged by decay. The crown attaches to the part of the tooth that’s above the bone, so an adequate amount of tooth structure must remain to hold the crown securely.

Some teeth cannot be saved

If too much of your tooth has been severely damaged by decay, there isn’t enough healthy tooth structure left to hold a restoration. In this case, we may have no choice but to remove what remains of the tooth.

Diagnosis and treatment

To determine if an extraction is right for your situation, we’ll perform a thorough exam, which typically includes x-rays.

If the tooth cannot be saved, it’s important to extract it as soon as possible to prevent infection in the tooth and jawbone. With modern dental techniques, the procedure should be a comfortable one for you. In many cases, we also recommend replacing an extracted tooth to preserve the jawbone and stabilize your bite, so we’ll talk with you about your replacement options.

Will I need to have x-rays taken?

In order to diagnose and treat any problems involving the teeth or jaw, X-rays are necessary.

After surgery, will I need someone to drive me home?

If you received sedation, you will need someone to drive you home. Patients who receive local anesthesia can drive home themselves.

What are the possible side effects after a tooth extraction?

You may have some discomfort and swelling for a few days afterwards, and your jaw may feel a little stiff. If you need pain relief, try over-the-counter painkillers such as paracetamol or ibuprofen. Always read the accompanying consumer medicines information leaflet and ask your pharmacist for advice.

Some slight bleeding is normal in the first couple of days after having a tooth removed. Rinse the excess out of your mouth and then bite down on a clean pad of material such as a handkerchief. If the bleeding doesn’t stop within 15 to 30 minutes, contact your dentist for advice.

Single Tooth Extraction Procedure

Post-Op Instructions for an Extraction

Homecare:  Tooth Extractions

Follow these instructions carefully to ensure the successful healing of your tooth extraction.

During the first 24 hours

It is important that a blood clot forms on the extraction site to stop  bleeding, reduce pain, and speed  healing. To protect the clot and avoid  the pain of dry socket:

  • Bite on a gauze pad firmly for  30-60 minutes. Blood and saliva mix in the mouth and make it look like there is more bleeding than there really is. Some oozing is normal; however, after 1 hour, repeat with a clean  gauze pad if oozing is profuse.  The site could ooze for as long  as 24 hours.
  • Don’t spit, and don’t suck on candies or through a straw.
  • Don’t rinse your mouth, and don’t brush or floss next to the site.
    Don’t smoke or use tobacco.
  • Avoid tobacco for at least 72 hours because it slows healing.
  • Don’t sneeze or cough, so have sinus or allergy medication on hand if necessary.
  • Limit yourself to calm activities and elevate your head with pillows when you lie down to reduce bleeding.
  • Don’t drink hot, carbonated, or alcoholic drinks, and avoid hot or spicy foods.


To control discomfort, take pain medication before the anesthetic has worn off or as recommended.
™To keep swelling to a minimum, use an ice bag over the area, 20 minutes on and 20 minutes off .

When the numbness has worn off completely, drink lots of fluids and eat only soft nutritious foods, chewing on the opposite side.

After the first 24 hours

Begin to eat normally as soon as it’s comfortable.

Resume brushing and flossing, but clean gently around the site for
about a week.

If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.

Reduce soreness or swelling by applying moist heat. Swelling usually starts to go down after 48 hours.

Further reduce swelling by rinsing your mouth very gently with warm salt water. Use about one teaspoon of salt per glass of warm water.

Rinse two to three times a day for the week following the extraction.


When to call us

  • It is normal to experience some discomfort for several days after a tooth extraction, but call us right away if you have:
    Heavy or increased bleeding
  • Pain or swelling that increases or continues beyond two or three days
  • A bad taste or odor in your mouth
  • A reaction to the medication


pediatric dentistry pasadena