When is a tooth extraction necessary?

Many teeth that seem beyond help can be saved with a filling, a crown, or a root canal. A root canal, for example, removes infection from inside the tooth so the tooth itself can stay. Read more in Do I need a root canal?

An extraction is usually recommended only when saving the tooth is not possible or would not last.

• Severe decay. The damage is too extensive to repair.
• A deep crack. The crack runs below the gumline or through the root.
• Advanced gum disease. The tooth has lost too much support and has become loose.
• Infection that will not clear. Other treatment has not resolved it.
• Crowding. There is not enough room for the teeth to line up properly.
• Impacted wisdom teeth. They are stuck under the gum or growing at an angle.

The area is numbed before anything begins, and Dr. Balani talks with you about pain management and sets a plan around your comfort level. Sedation is available if you feel anxious. Afterward, you bite on gauze for a short time to help the area start healing.

The first few days matter most. To help the area heal:

• Keep the gauze in place. Bite down on it as directed to control bleeding.
• Protect the clot. Avoid straws, smoking, and spitting forcefully for the first few days.
• Eat soft foods. Chew on the other side until the area feels better.
• Rinse with care. After the first day, rinse with warm salt water as directed.
• Manage soreness. Over-the-counter pain relief, taken as the label directs, usually helps.

Once the area heals, a missing tooth can be replaced with an implant, a bridge, or a denture. If you are considering an implant, a bone graft is sometimes placed at the same visit as the extraction to preserve the area. See Options for replacing missing teeth.