Emergency tooth extractions in Pearisburg

When does a tooth need to come out urgently?

Keeping a tooth usually serves you better than replacing it. If there is a realistic way to save yours, we will say so, even when taking it out would be quicker and cheaper on the day. An urgent extraction tends to come down to one of three things:

• A severe infection in a tooth that cannot be saved with a root canal.
• A tooth broken beyond repair, such as one split down into the root, or with too little left above the gum to rebuild.
• Pain that cannot be relieved any other way.

What happens at the appointment

Tell whoever answers the phone what has happened and they will get you seen. When you arrive, we look at the tooth and take an X-ray, to see the roots and the bone around them. Then we explain what we will do, what you will feel and what it will cost, and how the tooth could be replaced, so the decision is made with that in view.

The area is numbed with local anesthetic, and we check that it is fully numb before starting. You will feel pressure as the tooth is loosened, but it should not be sharp. If it is, raise your hand and we stop.

If you are anxious, say so when you call. Nitrous oxide or oral sedation can help. Oral sedation takes a little planning, because someone has to drive you home afterward.

When the infection is severe

Sometimes an infection has to be brought under control before the tooth comes out. Badly infected tissue can be hard to numb, and swelling can make the tooth hard to reach. The first step may then be draining it, with antibiotics when the dentist judges they are needed, and the extraction follows once things have settled. Our page on a dental abscess explains the signs.

Swelling that is closing an eye or spreading down the neck, or difficulty breathing or swallowing, is a reason to go to the emergency room rather than to us. Those need a hospital first. Call us afterward and we will take care of the tooth.

Caring for the socket afterward

For the first few days, the aim is to let a blood clot form in the socket and to leave it alone. That clot is how the socket heals.

• Bite firmly on clean gauze for twenty minutes without checking it. If it is still bleeding heavily after that, call.
• On the first day, do not spit, rinse hard or drink through a straw, and put off smoking for as long as you can. Each of these can pull the clot loose.
• Eat soft food and chew on the other side.
• From the next day, rinse gently with warm salt water after meals to keep the socket clean.
• Take an over-the-counter pain reliever as the label directs, and hold a cold pack against your cheek to limit swelling.
• Call if swelling is growing rather than going down after a few days, or if you develop a fever.

Signs of a dry socket

Sometimes the clot comes out or breaks down too early, leaving the bone in the socket exposed. This is called a dry socket. It is more likely after a difficult extraction and in people who smoke.

It is painful but treatable, so call us: the socket can be cleaned out and a soothing dressing placed in it. Ordinary healing gets a little better each day. A dry socket looks and feels different:

• Pain that gets worse a few days after the extraction, instead of better.
• Pain that spreads toward the ear on that side.
• A socket that looks empty, sometimes with bone showing.
• A bad taste or smell from the socket.

Replacing the tooth later

There is no need to decide on the day. Once the socket has healed, there are three main ways to fill the gap: a dental implant, which replaces the root as well as the tooth; a bridge, anchored to the teeth on either side; or a partial denture, which lifts out.

Leaving the gap is a choice too, but make it knowingly. Over time the teeth beside it tend to tip toward the space and the tooth opposite can drift into it, which changes how your teeth meet. We will lay out the trade-offs of each option for your mouth, cost included, and the decision is yours.

Questions patients ask