Treatment
Tooth Extractions in Mesa, AZ
You have been told a tooth needs to come out, and you would like to be sure that is really the case before it does.
Taking a tooth out is the last option, not the first one, and a great many teeth that feel beyond hope can be kept.
The treatment
When a tooth cannot be saved, and when it can
Taking a tooth out is the last option, not the first one. A tooth that hurts is not automatically a tooth that has to go, and a great many teeth that feel beyond hope can be kept.
An infected nerve, on its own, is usually a case forroot canal treatment rather than removal. A tooth that has cracked, worn down or been filled so often there is little left of it can often be covered and held together with acrown. Even a tooth that has broken at the gumline is worth looking at properly before anyone decides.
Removal genuinely becomes the sensible answer when:
- decay or a fracture has gone below the bone, so there is nothing solid left to build on
- advanced gum disease has taken away the bone that held the tooth, and it is already loose
- an infection keeps returning to the same tooth after it has already been treated
- a wisdom tooth is trapped against the tooth in front of it and damaging it
- the tooth could be saved, but only with a run of treatment you have decided you do not want (a legitimate reason, and yours to give)
A second opinion is a reasonable thing to want. An extraction cannot be reversed, so if you have been told a tooth has to come out and it does not sit right with you, get it looked at again. Ask what the alternatives are, ask what happens if you leave it, and ask to see the X-ray. You should get a clear answer to all three, here or anywhere else.
Wisdom teeth
Wisdom teeth arrive last, usually into a jaw that has no room left for them. Some come through straight, work perfectly well and never need touching. Others come through at an angle, only partly emerge, or stay buried against the tooth in front.
The problem is rarely the tooth itself. It is that a partly emerged wisdom tooth is almost impossible to clean, so the gum around it becomes inflamed and the tooth next door starts to decay where the brush cannot reach. That is what usually decides it. If a wisdom tooth is doing none of those things, it can be left where it is and kept an eye on.
Looking after the socket
A blood clot forms in the empty socket and does the protecting while the gum grows over it. Almost all of the aftercare exists to keep that clot where it is, and the first twenty-four hours are when it matters most.
- Bite gently on the gauze pad for as long as you are asked to.
- No smoking, no rinsing and no drinking through a straw on the first day: suction and swilling are what dislodge a clot.
- Soft food, and chew on the other side.
- Keep brushing the rest of your mouth normally, and go carefully around the socket itself.
- Some swelling and a little oozing on the first day is expected. Pain that gets worse after a few days rather than better is not, so call us.
You will get instructions specific to your extraction on the day. If anything about the healing worries you afterwards, phone the practice rather than waiting for the next appointment.
Planning for the space it leaves
This is the part that is easiest to put off and hardest to undo. When a tooth is removed, the bone that used to hold it slowly recedes, and the teeth around the gap drift towards it over the years. The longer a space is left, the more limited the options for filling it become.
So the conversation about what comes next belongs before the extraction, not months after it. Broadly:
- A dental implant replaces the root as well as the tooth, and leaves the neighbouring teeth untouched.
- A bridge spans the gap using the teeth either side, which can make sense when those teeth already need crowning anyway.
- Leaving the gap is sometimes perfectly reasonable. A back tooth you neither chew on nor see is not always worth replacing, and a wisdom tooth is never replaced.
You will get a straight opinion on which of those applies to your mouth, including when the honest answer is that nothing needs to go in the space at all.
Good to know
Carried out under local anaesthetic
Simple or surgical, depending on the tooth
The socket heals around a blood clot
Planned alongside whatever fills the space
What to expect
Four stages, spread over a few visits.
01
Examination
We check whether the tooth can be kept at all. You see the X-ray, hear the alternatives, and hear what happens if you wait.
02
The appointment
The tooth comes out under local anaesthetic, simple or surgical depending on the tooth. You feel firm pressure and movement rather than pain.
03
Healing at home
A clot forms in the socket and protects it while the gum grows over. You go home with aftercare instructions and a number to call.
04
Filling the space
The replacement is planned with you beforehand and fitted once the site has settled. Sometimes the honest answer is that nothing needs to go there.
Candidacy
Does this tooth have to come out?
Removal is the last option, not the first. Plenty of teeth people are told to lose can be kept, and asking for a second opinion is a reasonable thing to do.
Decay or a fracture has gone below the bone, with nothing solid left to build on.
Gum disease has taken away the bone that held the tooth, and it is already loose.
An infection keeps coming back to the same tooth after it has been treated.
A wisdom tooth is trapped against the tooth in front of it and damaging it.
The tooth could be saved, but only with a run of treatment you have decided against.
You have been told it has to go, and you would like a second view first.
“They are so friendly, professional and do not try to push treatments I don't need. I love them!”
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Common questions
Does having a tooth taken out hurt?
The extraction itself is done under local anaesthetic, so the area is numb and you should feel pressure and movement rather than pain. Afterwards there is usually soreness once the anaesthetic wears off, and that settles over the following days. If you are nervous about it, say so when you book rather than on the day. It changes how the appointment is paced, and it is a very ordinary thing to tell us.
Do my wisdom teeth have to come out?
Not automatically. A wisdom tooth that has come through in a usable position, that you can clean, and that is not causing problems can be left alone and watched. Removal is considered when the tooth is repeatedly infected, is decaying where a brush cannot reach, is damaging the tooth in front of it, or is trapped in a way that makes any of that likely. An X-ray and an examination are what answer it, not the fact that they are wisdom teeth.
How long does the socket take to heal?
The gum closes over first and the bone underneath fills in more slowly: weeks for the surface, months for the site to settle fully. How quickly that happens varies with the tooth, whether it was a surgical removal, whether you smoke, and your general health. You will be given aftercare instructions for the first few days, which is the part that matters most.
What is dry socket, and how do I avoid it?
A blood clot forms in the socket after the tooth comes out, and it protects the bone underneath while the gum heals. Dry socket is what happens when that clot is lost too early, and it is painful. The pain typically arrives a few days after the extraction rather than straight away. Smoking, rinsing hard and drinking through a straw in the first day or two all make it more likely, which is why the aftercare instructions ask you to avoid them. If it happens, call the practice; it is treatable and it is not something to wait out.
I take a blood thinner. Does that rule out an extraction?
Usually not, but it does change how the appointment is planned, so we need to know about it beforehand. Tell us every medication you take, including over-the-counter ones, when you book. Never stop or alter a prescribed medicine on your own to prepare for dental treatment. If anything needs adjusting, that is a conversation between us and the doctor who prescribed it.
Should I get a second opinion before agreeing to have a tooth out?
Yes, if you want one. An extraction cannot be undone, and nobody should feel rushed into it. Ask what the alternatives are, ask what happens if you wait, and ask to see the X-ray. A straight answer to all three is what you are entitled to. If you have been told elsewhere that a tooth has to go and you are not sure, you are welcome to come and hear a second view.
No obligation
Ask about tooth extractions
Tell us what is going on and we will call you back to arrange a time. If it turns out you need something other than tooth extractions, we will tell you that too.
Prefer to talk now? (480) 547-8034
Not sure what you need?
That's okay.
Many patients come in knowing something isn't right but aren't sure what treatment they need.
We'll start with a conversation and a thorough evaluation. Dr. Sandstrom will explain what he sees, discuss your options, answer your questions, and help you decide what makes sense for you.