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Tooth Extractions

tooth extraction illustrationAlthough permanent teeth were meant to last a lifetime, there are a number of reasons why tooth extractions may be needed. A very common reason involves a tooth that is too badly damaged, from trauma or decay, to be repaired. Another very common reason is wisdom tooth extraction, which happens with most people as their mouths are to crowded and the wisdom teeth become impacted.

Reasons for Tooth Extractions and Wisdom Tooth Extraction

In addition to the reasons listed above, there are other reasons a tooth extraction may be required.

Your Mouth is Crowded

Sometimes dentists pull teeth to prepare the mouth for orthodontia. The goal for 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 no room in the mouth for it, your dentist may recommend pulling it. This is especially true, again, with wisdom teeth.

You Have a Severe Infection

If tooth decay or damage extends to the pulp – the center of the 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.

You Have 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 pull the tooth or teeth.

Dentists and oral surgeons (dentist with special training to perform surgery) perform tooth extractions. Before pulling the tooth, your dentist will give you an injection of a local anesthetic to numb the area where the tooth will be removed.

If the tooth is impacted, the the dentist will cut away gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces.

You’ve heard the saying, “It’s like pulling teeth”….sometimes they can be difficult, particularly for a wisdom tooth extraction.

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.

Following your extraction, it’s back home to recover. Recovery typically takes a few days. The following can help minimize discomfort, reduce the risk of infection and speed recovery.

  • Take painkillers as prescribed.
  • Bite firmly but gently on the gauze pad placed by your dentist to reduce bleeding and allow a clot to form in the tooth socket. Change gauze pads before they become soaked with blood. Otherwise, leave the pad in place for three to four hours after the extraction.
  • Apply an ice bag to the affected area immediately after the procedure to keep swelling down. Apply ice for 10 minutes at a time.
  • Relax for at least 24 hours after the extraction. Limit activity for the next day or two.
  • Avoid rinsing or spitting forcefully for 24 hours after the extraction to avoid dislodging the clot that forms in the socket.
  • After 24 hours, rinse your mouth with a solution made of 1/2 teaspoon salt and 8 ounces of warm water.
  • Do not drink from a straw for the first 24 hours.
  • Do not smoke, which can inhibit healing.
  • Eat soft foods, such as soup, pudding, yogurt, or applesauce the day after the extraction. Gradually add solid foods to your diet as the extraction site heals.
  • When lying down, prop your head with pillows. Lying flat may prolong bleeding.

Continue to brush and floss your teeth, and brush your tongue, but be sure to avoid the extraction site. Doing so will prevent infection.

Once your mouth is healed, and the infection gone, depending on the location of the extraction, you may wish to have the tooth replaced with a dental implant or a bridge.


Dr. Tony is always pleasant and in a great mood. He always makes me comfortable and at ease. Not an easy task for a dentist!! He’s just a joy to be around! Any work that done has been pain free and done right. You can just tell he’s great at what he does! The staff and hygienists are also very nice and helpful. Perhaps the best thing of all is you NEVER EVER wait a long time to be seen. They get you in and out in no time. Just the best!!”
Robin H.


Tooth Extractions Midland Park, Bergen County, Wyckoff, Waldwick NJ | (201) 447-5555