A tooth extraction is performed for a wide variety of reasons. The most common reason is decay (caries) so deep into the tooth that it is impossible to save.

Other reasons for extraction of teeth:

• Severe gum disease (bone loss), which has ruined too much of the supporting bone around the tooth.
• In a case where a patient is scheduled to have Orthodontic treatment due to severe crowding (too many teeth for the space available) it is not uncommon that one or two perfectly healthy teeth have to be extracted in order to make enough space for the remaining teeth to be nicely aligned.
• Teeth which are in need of root canal treatment (Endodontic treatment), but where such treatment is impossible to perform.
• Fractured teeth are often doomed for extraction, especially where the fracture line runs along the axis of the tooth. If the fractured tooth has had a root canal treatment, the fracture might go unnoticed until bacteria have accumulated in the fracture area in such numbers that an abscess appears.
• Insufficient space especially for the lower wisdom teeth (impacted third molars). Although many dentists remove asymptomatic impacted third molars, other dentists today recommend against this routine procedure unless there is evidence of disease in the impacted tooth itself, the surrounding bone, or in the molar in front of the wisdom tooth.

Surgical extractions involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line or because they have not erupted fully. This is often the case with wisdom teeth in the lower jaw. Surgical extractions normally require an incision, which means that the soft tissue around the tooth which is to be surgically removed has to be raised. Typically, a small amount of bone has to be removed around the impacted wisdom tooth. Should the wisdom tooth lay more or less horizontally, the crown portion of the tooth might have to be removed as one piece or be split into a number of pieces – to be able to access and remove the remaining part of the tooth. Most often a surgical extraction is done under local anesthetic or local anesthetic in combination with conscious sedation.

What to expect after surgery

After the tooth has been removed, you may need stitches/sutures. Some stitches dissolve over time, and some have to be removed normally after a week to ten days. You will also be asked to gently bite down on cotton gauze placed over the wound to help stop bleeding.

You could also be asked to gently bite down on cotton gauze placed in the surgical area if there is any bleeding.

In most cases, the recovery period after an uncomplicated tooth extraction lasts only a few days up to five to six days. The most important issue after an extraction is to preserve the formed blood clot.

Once a tooth has been extracted, a blood clot normally forms in the socket, usually within an hour. It is not uncommon that slight bleeding can be noticed up to 24 hours after the extraction. The wound over the dental socket takes about a week to heal. Thereafter, the socket will gradually fill in with gum tissue and bone over a period of about one to two months. Before bone has fully filled out the extraction site (alveol), it can at least take another six months.

The following will help to speed up the recovery:

• Should there be pain, you take painkillers as prescribed by your dentist.
• Wait until the following day before you start rinsing your mouth gently with salt water several times a day to keep the surgical area clean.
• Make your own salt water by mixing a tablespoon of salt in a glass of warm water. The alternative is to rinse 3-4 times a day with an antiseptic mouth wash.
• Relax after surgery. Physical activity within the first two days after surgery may cause bleeding.
• If you happen to be a smoker, try to avoid smoking – at least for the first few days.
• Eat soup and soft food for a couple of days in order to reduce the muscle activity in the chewing muscles, thereby reducing the risk for dislocating the blood clot.