Surgical tooth extraction is much more common than it used to be, for a variety of reasons. If you need a tooth extracted, here’s what you need to know.

Do I need a surgical tooth extraction?

Surgical tooth extraction includes any type of surgical procedure that’s performed to fully remove a tooth. This may include cutting into the gum to access the tooth, or sectioning the tooth into more than one piece for easier removal.

Although it remains the most well-known type of extraction, surgical tooth extraction is not just for wisdom teeth. Dentists perform surgical tooth extractions for any of the following conditions.

Broken tooth

If your tooth breaks or cracks beyond repair, either due to decay, periodontal disease, or during a simple extraction, surgical tooth extraction may be necessary.

Surgical extraction is generally recommended to relieve crowding or to treat a tooth that is not capable of being saved with a dental restoration such as a dental crown.

Root tip extraction

Even simple extractions can end up surgically if the root tip breaks off. Your teeth have two main outer areas: the crown above the gumline and the roots below. Sometimes in simple extractions, a tooth’s root tip may break off.

While some dentists elect to leave the root tip, especially if it goes undiscovered until after the extraction site has healed, most others will opt to use oral surgery for extraction.

Wisdom teeth

Wisdom teeth extraction is probably the most well known type of surgical tooth extraction. Over ten million wisdom teeth are extracted annually.

Impacted or partially erupted wisdom teeth require surgical extraction.

After root canal

In some cases, teeth that have been treated with root canal continue to be a problem. Decay and infection can lead to abscess, which may be prevented by surgical tooth extraction.

Surgical extraction vs. simple extraction

Not all tooth extractions are surgical. There are some differences when talking about a surgical extraction vs simple extraction.

A simple tooth extraction occurs when the tooth being extracted is:

  • Not anchored into the bone
  • Clearly visible above the gumline
  • Positioned in such a way that your dentist can remove it with the help of dental forceps

A surgical extraction is a much more involved process. The tooth being extracted may only be partially erupted, or it may be firmly attached to the underlying bone structures in such a way that it would be challenging to simply “pull” it out.

Surgical extraction is used when there are complicating factors that mean the tooth needs more help than just pulling or twisting to be extracted.

What should I expect during a surgical tooth extraction procedure?

Your surgical extraction begins with an X-ray to determine the exact position of the tooth and to plan a course of action.

Once you and your dentist have decided on a clear path, your dentist will numb the surgical area with a local anesthetic. This may be a local anesthetic, general anesthetic, or, in rare cases, IV sedation. Sometimes your dentist will use a combination of nitrous oxide for relaxation and local injected anesthetic for pain. Each patient and their needs are different.

Many patients worry about feeling pain during the procedure. Your dentist will take special care to make sure you are not feeling any pain during the procedure. When you receive a numbing injection, you may feel a pinch or sting that soon subsides. You may also feel pressure and movement in the jaw, but there should be no pain during the procedure.

For a surgical extraction, your dentist will typically make an incision to access the tooth from the outside of the gum (instead of from above). This access can help to loosen the gum around the tooth’s roots. In some cases, your dentist may need to remove bone from the tooth socket to loosen the tooth. For stubborn teeth that hold fast, your dentist may remove the tooth in sections. Removing the first section makes the second section come out more easily.

Regardless of the approach, once the tooth is looser in its socket, your dentist will use dental forceps to grasp and gently pull the tooth out. Your dentist will then check to make sure the whole tooth is gone before cleaning and stitching the incision.

Surgical tooth extraction recovery time

Every patient is different, which means every recovery time is different. On average, expect to gradually resume normal activity levels after a week, with a fully healed extraction site in 30 days.

That said, the size of the surgical site changes the length of time it takes to heal. And just because the gums heal does not mean the bone is back to normal underneath. Bone resorption (where the open tooth socket seals up) takes anywhere from six to 12 months.

Surgical tooth extraction aftercare

After your extraction, take the rest of the day off to relax and let your body start to heal. The following aftercare tips can help speed healing:

  • Follow pain medication directions: Follow prescription medications as directed, using ibuprofen as directed for pain management after 48 hours
  • Apply pressure to the extraction site to stop bleeding
  • Rest on the day of the extraction: Avoid strenuous activity for 72 hours after your oral surgery
  • Protect the clot: Do not use straws, smoke, or otherwise apply any suction to allow a protective clot to form
  • Eat well: Choose soft but nutritious foods like yogurt, tofu, pasta, scrambled eggs, and soft fruit
  • Avoid certain foods: Spicy and salty foods can aggravate the wound, while crunchy and hard foods may dislodge the clot
  • Maintain good oral hygiene: Do not brush for 12 hours after the extraction, then brush gently, avoiding the extraction site

Always follow your dentist’s guidance regarding surgical tooth extraction aftercare. If you experience excessive bleeding, swelling, or pain, or feel feverish or unwell, check in with your dentist to make sure healing is progressing as it should.

If you are looking for a Phoenix area oral surgeon, AZ Dentist can help. We know surgical extraction can cause anxiety. We pride ourselves on patient comfort; give us a call to schedule a consultation today.