Why would a dentist recommend that you have your tooth extracted?
It had better be a really good reason, right? None of us like losing body parts, so our entire training is based on trying to help people fix and save their teeth for as long as possible. However, there is a point past which, regardless of how much money or surgery you go through, we are just not going to be able to get a good long-term result from that effort. We never want to set you up to fail. So the point that we recommend extractions is when we've crossed that line of not being able to achieve a good long-term result.
Will a dentist provide anesthesia during the extraction process?
Local anesthetics will always be provided to numb the tooth and the tissues surrounding the tooth. Many people are apprehensive about having a body part removed, so different levels of sedation are also highly recommended if your health and budget allow. There are tiered levels of sedation, ranging from simple options like laughing gas (nitrous oxide) for light to moderate apprehension to deeper sedation options such as pill form sedation or even full anesthesia, where you're completely knocked out. However, for deeper levels of anesthesia, we usually prefer you to be with an oral surgeon so that any health-related complications can be managed effectively.
What should you expect during the extraction process?
First and foremost, you should be very numb, which is obviously very important. Secondly, we will use different instruments and techniques to expand the bone around the roots of your teeth until it opens up enough that your body will let go of the tooth. Typically, this involves applying pressure directly to the tooth from different angles and maintaining that pressure, allowing the bone to expand in various directions. So, beyond being very numb, you should also expect to feel some pressure, which is a normal part of the extraction process. Sometimes, we may need to cut the tooth into pieces to extract each root individually, and occasionally, we may need to remove a small amount of bone. However, since you should be very numb, you should only feel some vibration, similar to the sensation of getting a filling.
Is periodontal disease halted by a tooth extraction?
While extracting a tooth can significantly reduce periodontal disease in the tissues directly surrounding that tooth, it does nothing for the surrounding tissues on the other teeth. Periodontal disease is best treated by deep cleanings and maintaining excellent home care. Extractions are not our first choice for a periodontally involved tooth, as proper treatment can often save the tooth. We would consider removing a periodontally involved tooth if the periodontal disease is so advanced that all of the bone has been lost, leaving the tooth hanging by soft tissue, or if the tooth has lost enough bone that it is moving significantly and causing traumatic bone loss in its region and to adjacent teeth, thereby putting them at risk.