Dentistry in Rochester, MN that restores confidence!

Should I Be Scared of Getting a Tooth Pulled?

You find yourself in a situation that you never thought you would…. the dentist telling you that you need to have your tooth pulled. You may have a few emotions running through your head like anger, sadness, disappointment, frustration, and fear.

But fear does not need to be one of them! I can assure you that you do not need to fear getting a tooth pulled.

This blog will discuss reasons for needing a tooth pulled, the process of removal, possible replacement options, and what to do when you find yourself in need of tooth removal.

What Leads to a Tooth Needing to Be Pulled?

When you hear someone say a tooth needs to be pulled, it is a bit of a misnomer. Dentists don’t really PULL teeth, but rather gently rock them back and forth to loosen and remove them….

Now getting back, there are many reasons that your dentist may recommend that your tooth needs to be removed. Some of the reasons include: extra teeth, limited space, periodontal disease, and inability to restore the tooth back to function.

Did you know that some individuals are born with extra teeth? This condition is known as hyperdontia or supernumerary teeth. Famous singer Freddy Mercury was known for his signature look of having extra teeth on his upper arch. Other extra teeth may be found at the midline known as mesiodens or behind the wisdom teeth known as distodens. There are also conditions that can lead to extra teeth. One of the more common conditions is cryo cranial dysplasia. These extra teeth may lead to spacing issues or difficulty cleaning leading to indication for removal.

Some individuals may have smaller arches than their teeth can fit leading to the need for removal for orthodontic reasons. Though modern dentistry now challenges this due to airway concerns, there still may be indication in more extreme cases of crowding. If the teeth can’t fit, then they can’t fit!

Periodontal disease may also lead to tooth loss. Periodontal disease occurs when gum and bone inflammation leads to bone loss around the teeth. Once enough bone has been lost, the teeth may become loose, painful, and no longer able to properly function. Unfortunately, once the bone is gone, it is gone. There is no getting it back to original health. This may lead to a reason for a dentist to recommend removal.

The inability to restore a tooth mainly comes from either a large cavity, fractured tooth, or fractured root. If the cavity gets large enough, your dentist may not be able to replace the lost tooth structure with a filling or crown. Trauma leading to fractured roots may also cause the tooth to need to come out or a cracked tooth fracturing below the gumline. Vertical root fractures are also a condition that cannot be restored in modern dentistry. Any of the above conditions may indicate immediate removal.

What is the Process for Tooth Removal?

The dentist will place topical anesthetic in the area that local anesthetic will be placed. Next the dentist will use a tiny needle to administer local anesthetic to numb the area. The anesthetic may take a few minutes to fully take effect – in most cases it takes longer for anesthetic to set in than to take the tooth out! When it comes to the anesthetic, it will prevent the pain cell receptors from sending signals to your brain, but it will not affect the pressure sensor nerve cells from sending signals to your brain. This means that you will feel pressure during the removal but not pain.

The first step for tooth removal is gently releasing the gum tissue around the tooth. This is also a great way to know that you are numb. Next the dentist will use an instrument to slowly rock the tooth back and forth to loosen it (think about trying to remove a post out of the ground). Once the tooth is loose, it can easily be removed with specially designed forceps by rocking it back and forth. In some cases, it may be easier to cut the tooth into multiple sections to properly remove it (divide and conquer!). The area is then gently rinsed with saline. Bleeding is controlled by pressure and damp gauze and typically stops after 30 minutes.

Mild discomfort may peak on the second or third day after the tooth has been removed. Speak to your dentist regarding proper over the counter pain relief for your situation. A warm saltwater rinse can be used in the initial week to help with cleaning the area. It is important to continue to brush your teeth while taking care not to disrupt the blood clot. The cleaner you keep your mouth, the faster things will heal. Avoid alcohol and tobacco use during the healing area as well as any spitting or sucking. The gum tissue typically heals over in about 2-3 weeks with the bone filling in over the next 3-4 months.

What are My Options for Tooth Replacement?

While a tooth can never truly be replaced, there are placement options for where the tooth used to be. Placement options are slit up into fixed and removable options:

Fixed options include implant and fixed partial dentures (dental bridge). There are a few things to consider when choosing between an implant or dental bridge. A dental bridge requires preparation of the tooth in front and back of the missing tooth. It can be a great case when both teeth need crowns as well as placement of a tooth that is missing. Otherwise, it can turn a single tooth problem into a three-tooth problem. The other fixed option is a dental implant. Dental implants require enough space as well as bone for placement. Proper evaluation and planning are needed for an implant as well as longer process of dental crown placement.

There are a few different removable options. This can include either a complete denture or partial denture to fill the space that the tooth or teeth are missing. These typically are taken out at night to allow the mouth a break. Implants can be used to help hold the denture in place. The downside to this option is that no matter how good it fits, it will always move slightly as well as get food caught underneath.

Do I Have to See an Oral Surgeon for My Tooth to Be Pulled?

ABSOLUTELY NOT! At Med City Dental, Dr. Scott A. Funke is well versed in tooth extractions and removal. He has taken numerous courses as well as taken hundreds if not thousands of teeth out. He is skilled in getting the teeth removed efficiently and effectively. He also volunteers his time to help remove teeth for those in need at the local Good Samaritan Dental Clinic that are otherwise unable to afford the care. Dr. Funke uses advanced technology to view wisdom teeth and complex anatomy with the CBCT. This allows him to treat more complex cases right in his office. He is also able to administer oral sedatives prior to appointments if needed. It is not necessary to be put to sleep for tooth extractions, but patients that desire this will need to be referred to a specialist with proper monitoring.