When the cavity becomes too big to the point where the tooth is unrestorable, the tooth needs to be extracted (or removed). Or, if the tooth has too much periodontal loss or moving too much the tooth is considered to be unrestorable and needs to be pulled.
Extractions can be classified into few categories
- Simple Extraction
- Surgical Extraction where it involves more advanced technique to pull the tooth out. Gingival tissue may need to be raised and bone needs to be sectioned to expose the tooth
- Root Tip Extraction where only roots are remained and need to be extracted
- Soft Tissue Impaction was either partially or completely, soft tissue is covering the tooth and the gingival tissue needs to be extracted
- Bony Impaction was either partially or completely, bone tissue is covering the tooth and the bone needs to be sectioned to pull the tooth out
Depending on the difficulty of the extraction and the tooth structure remaining, extractions can be categorized into above. Before the extraction, your medical condition will be carefully reviewed to see if you are suitable for the extraction procedure, such as blood pressure, diabetes condition, etc. You may be asked to bring a medical clearance if you have some medical condition or medication that may be complicating the procedure such as blood thinner (Coumadin, Plavix, etc). Also, if you have some medical condition, you may be asked to take prophylactic antibiotic known as pre-medication prior to the procedure to prevent possible serious medical complication. After the extraction, it is possible to get infection, swelling, and pain for a week or two. Proper medications will be prescribed by your dentist. Most importantly, if you are a smoker, it is important not to smoke for at least 2 weeks as you can develop a “dry socket”, which can be very painful. Detail post-op instruction will be given by your dentist. It is important to have good healthy nutrition to bring the immune system up and keep the oral hygiene clean to avoid major infection.