Tooth extractions in Pearisburg

When does a tooth need to be pulled?

We look for a way to keep a tooth first, whether that is a filling, a crown or a root canal. If another office has told you a tooth has to go and you are not sure, a second opinion is a reasonable thing to ask for.

A tooth usually has to come out when:

• Decay has gone too deep to rebuild what is left.
• A crack or fracture runs down into the root.
• Advanced gum disease has taken so much bone that the tooth is loose.
• An infection cannot be cleared by treating the inside of the tooth.

What happens during a tooth extraction?

We start with an X-ray to see the roots and the bone around them. Tell us about every medicine you take, especially blood thinners and bone-strengthening medicines, because they change how an extraction is planned.

The area is numbed with a local anesthetic, and we check it is numb before starting. The tooth is loosened gently in its socket with steady pressure and then lifted out. You will feel pushing and pressure. A sharp feeling means you need more anesthetic, so tell us and we will stop. Sometimes a stitch helps the gum close over the socket.

If you are nervous, nitrous oxide and oral sedation are both available. If the X-ray shows a tooth that an oral surgeon would handle better, such as one with roots close to a nerve, we will refer you and tell you why.

What to do after a tooth extraction

The blood clot that forms in the socket is the start of healing, and most aftercare is about protecting it:

• Bite firmly on the gauze we give you, and leave it in place rather than checking it every few minutes.
• No straws, no smoking and no forceful spitting for the first few days. Suction can pull the clot out.
• Eat soft food and chew on the other side. Skip hot drinks until the numbness has worn off.
• From the day after, rinse gently with warm salt water, especially after meals.
• Brush your other teeth as normal, and go gently near the socket.

Signs of a dry socket, and when to call

Some oozing for the rest of the day is normal. If it starts bleeding again, fold clean gauze over the socket and bite firmly for twenty minutes without checking. If it is still bleeding heavily after that, call. Bleeding that will not stop after firm pressure, or swelling that makes it hard to swallow or breathe, needs an emergency room.

Occasionally the clot comes loose or breaks down before the socket has healed, leaving the bone underneath exposed. That is a dry socket, and smoking makes it more likely. It is treatable, so call rather than toughing it out if, a few days after the extraction, you notice:

• Pain that gets worse instead of better, often spreading toward the ear.
• A bad taste or smell from the socket.
• A socket that looks empty, where you would expect to see a dark clot.

What about wisdom teeth?

Wisdom teeth are their own question. Some come in straight and cause no trouble at all. Others come in tilted, stay partly under the gum, or trap food and set up an infection around them. If yours hurt, wisdom tooth pain explains what that can mean.

We examine them, take an X-ray to see how they sit, and explain what we find. Depending on that, we either treat the problem here or refer you to an oral surgeon, and you will know which, and why, before anything is booked.

Should you replace a tooth after it is pulled?

Not every gap needs filling: a missing wisdom tooth, for one, leaves nothing that needs replacing. For most other teeth the gap has consequences. The teeth beside it tip into the space, the opposing tooth drifts toward it, and the bone where the root was begins to shrink.

The options are a dental implant, a bridge or a partial or full denture, and each has its own trade-off in cost, comfort and what it asks of the teeth nearby. Talk it through before the extraction rather than after, because the bone starts changing once the tooth is gone.

Questions patients ask