Tooth Removal

Reasons for Pulling Teeth
Although permanent teeth were meant to last a lifetime, there are a number of reasons why tooth extraction may be needed. A very common reason involves a tooth that is too badly damaged, from trauma or decay, to be repaired. Other reasons include:

A crowded mouth. Sometimes dentists pull teeth to prepare the mouth for orthodontia. The goal of orthodontia is to properly align the teeth, which may not be possible if your teeth are too big for your mouth. Likewise, if a tooth cannot break through the gum (erupt) because there is not enough room in the mouth for it, your dentist may recommend pulling it.

Infection. If tooth decay or damage extends to the pulp -- the center of the tooth containing nerves and blood vessels -- bacteria in the mouth can enter the pulp, leading to infection. Often this can be corrected with root canal therapy (RCT), but if the infection is so severe that antibiotics or RCT do not cure it, extraction may be needed to prevent the spread of infection.

Risk of infection. If your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant) even the risk of infection in a particular tooth may be reason enough to pull the tooth.
Periodontal (Gum) Disease. If periodontal disease -- an infection of the tissues and bones that surround and support the teeth -- have caused loosening of the teeth, it may be necessary to the pull the tooth or teeth
After the tooth is removed, you may need stitches. You can gently bite down on a cotton gauze pad placed over the wound to help stop the bleeding. The removed tooth can be replaced with an implant, a denture, or a bridge. A bridge is a replacement for one or more (but not all) of the teeth and may be permanent or removable.

After You've Had a Tooth Pulled
Following an extraction, your dentist will send you home to recover. Recovery typically takes a few days. The following can help minimize discomfort, reduce the risk of infection, and speed recovery.

After the tooth is removed, you may need stitches. Some stitches dissolve over time, and some have to be removed after a few days. Your dentist will tell you whether your stitches need to be removed.

When to Call the Dentist
It is normal to feel some pain after the anesthesia wears off. For 24 hours after having a tooth pulled, you should also expect some swelling and residual bleeding. However, if either bleeding or pain is still severe more than four hours after your tooth is pulled, you should call your dentist. You should also call your dentist if you experience any of the following:

The initial healing period usually takes about one to two weeks. New bone and gum tissue will grow into the gap. Long-term, however, having a tooth (or teeth) missing can cause the remaining teeth to shift, affecting your bite and making it difficult to chew. For that reason, your dentist may advise replacing the missing tooth or teeth with an implant, fixed bridge, or denture.