Tooth extraction is when a tooth is removed from it’s place in the gum & bone of your jaw. Compared to many dental procedures, tooth extraction can sound scary, especially when it’s referred to as “oral surgery”. However, we believe that understanding the reasons that an extraction is necessary will ease your mind if you’ve been told you need a tooth removed.

Damage from Decay or Trauma

Dentists will alway try a conservative approach first when trying to repair a tooth that is damaged. However, if the damage is too severe for the usual  solutions such as a crown or a filling, the dentist may decide to remove the tooth completely. Teeth sometimes shift into the place where the removed tooth used to be, which can cause problems with your bite. For this reason (& your own comfort) we may recommend putting a bridge, partial denture or dental implant in the space where the missing tooth was.

Orthodontics

Tooth extraction can also be a part of orthodontic (or braces) treatment. When teeth are too large for the mouth & are causing problems, teeth may need to removed in order for orthodontic treatment to be completed. The most common reason for tooth extraction in braces treatment is the alleviate crowding, though there are other conditions that may warrant the removal of teeth (such as overbite). Usually teeth are removed symmetrically, so the same 2 teeth in each jaw are removed in order to keep the bite balanced, so a total of 4 teeth would be removed. While tooth extraction for the sake of braces may seem like an extreme choice, but in some cases it is an alternative to more serious surgery to re-align the jaw.

Wisdom Teeth Removal

Wisdom teeth are an extra set of adult molars that usually come in when patients are in their late teens or early 20s. Not everyone’s wisdom teeth cause problems, but it is common for them to be impacted, meaning they’ve come in at a funny angle or have failed to come in at all, & trapped under the gum pressing against other teeth. In some cases, wisdom teeth can become infected or cause abscesses, pain or swelling. Wisdom teeth removal is usually recommended on wisdom teeth that are impacted or have otherwise started to cause problems.

Timely Development in Kids

Sometimes a dentist will recommend tooth extraction of baby teeth (also known as primary teeth or “milk” teeth) that have not been lost in a timely fashion. For example, if your dentist sees that your child still has a baby tooth that most children their age would have lost years ago they may recommend extracting it. The reason for such extractions is usually to ensure that permanent adult teeth come in (or erupt) in the right position.

It’s also important that you understand that dentists never take the extraction of a tooth lightly. Our first choice is always conservative treatment (i.e. “conserving” as many teeth in your mouth as possible), but sometimes health or developmental considerations make keeping a tooth inadvisable. No matter the reason, if we’ve recommended tooth extraction as part of your treatment, we will go over the details of what to expect both during & after the procedure, & what the resulting benefit to your health will be.

Wisdom teeth are the name for your third permanent molars, which typically appear from age 17-25. It is thought the name “wisdom teeth” comes from the fact that they appear long after all your other permanent teeth, when you a much older & wiser. Most people have four wisdom teeth, one in each quadrant of the mouth (upper left, upper right, lower left, lower right). If your dentist has been doing updated x-rays of your mouth every year, they might be able to see where your wisdom teeth are going to come in, but there’s no guarantee on how wisdom teeth will behave.

In some cases, wisdom teeth come in (or erupt, as we dentists say) normally & function just like your other molars. In many other cases, however, wisdom teeth are impacted. Impacted means the teeth are stuck in the bone under your gums. Either there isn’t enough room for them to come in all the way, or they’re coming in at such a strange angle that it’s impossible for them to emerge from your gums.

Not all impacted wisdom teeth will cause problems, but wisdom teeth removal is still recommended for many patients, even when they are not experiencing any negative symptoms. The reason for this is wisdom teeth removal is much easier & less complicated the younger the tooth is. Younger wisdom teeth have less developed roots & are less likely to be near nerves. Also, younger people tend to heal better, so having wisdom teeth removed in the late teens or early twenties often provides for better results. As the wisdom teeth get older & get integrated into the bone of your jaw, they become harder to remove.

Some patients start experiencing pain & swelling soon after their wisdom teeth appear. In other cases, the wisdom teeth can come in only partially, creating an optimal place for bacteria & infection to grow between the partially exposed gum & other teeth. This infection is called pericornitis. In these situations, emergency wisdom teeth removal is usually recommended to relieve pain & prevent further complications. If you are in your late teens or twenties & are experiencing a toothache or jaw pain, visit the dentist to see if it could be related to your wisdom teeth.

Wisdom teeth removal is performed either by your dentist or an oral surgeon. Some dental clinics have an oral surgeon on staff, but others may require you to get a referral to a separate oral surgeon’s office. If your dentist doesn’t perform oral surgeries, they usually have a trusted local oral surgeon that they work with who they will refer you to.

Removing wisdom teeth is a fairly straightforward procedure. If your wisdom tooth has emerged from the gum normally (erupted), it will be “pulled” like any other tooth. If it is impacted, the dentist or oral surgeon may have to make an incision in the gum to access the tooth in the bone. The complexity of removing an impacted is particular to each patient’s situation. You dentist or oral surgeon will also help determine the level of sedation needed to keep you comfortable.

After wisdom teeth removal surgery, most patients experience some pain & swelling for several days. Your dentist or oral surgeon will give you post-operative instructions, like taking Tylenol or using ice packs, to help you heal & stay comfortable. You may also get a prescription for a stronger painkiller if necessary. You will also get recommendations on the types of soft foods you can eat until you’ve healed enough to chew again.

Did you know that not everyone develops wisdom teeth? In fact, the incidence of wisdom teeth in those with Tasmanian Aboriginal ancestry is practically zero. By contrast, nearly 100% of indigenous Mexicans have wisdom teeth.