Sometimes removal of a tooth is the ideal treatment option. There may be significant decay rendering it unrestorable, gum disease resulting in compromised support for the tooth, or a fracture extending below the gum line which cannot be repaired. Teeth are also sometimes removed for orthodontic purposes, or if they can adversely affect other teeth or pose a risk of infection (wisdom teeth).

How do I know if my wisdom teeth need to be removed?

Your dentist will make this recommendation based on your examination and radiographs, usually around age 17-22.

Not all wisdom teeth have to be removed. In some cases, there is sufficient room and wisdom teeth are able to erupt and function normally. In other cases, they remain buried in bone and are unlikely to erupt. And still in other cases, the wisdom teeth never develop.

The most common wisdom tooth that can cause issues is that which only erupts partially in the mouth. The main risk that this may pose is the potential for infection between the overhanging gum tissue and the tooth itself.

Wisdom teeth can be a valuable asset if they grow vertically and are aligned properly. However, these teeth have been known to grow diagonally and horizontally, thus causing problems. This uneven growth can cause a myriad of issues including infection of surrounding tissues and damage to the adjacent second molars.

Definition of impacted wisdom teeth

Impaction of a tooth occurs when there is insufficient space in the dental arch for proper eruption, and its growth is affected, by gum, bone or another tooth.  This results in the tooth remaining fully submerged within the gum and bone. The type of impaction present depends on the angle at which the tooth lies in bone.

Removal of impacted wisdom teeth

Impacted wisdom teeth are usually removed because of the problems they are causing or because of the problems that may arise if they remain in the mouth. In many cases, damage caused by wisdom teeth is not visible on the surface. X-rays of the mouth are therefore necessary to see what is going on underneath the gum, and to determine what type of extraction is required.

How do you remove an erupted tooth?

You may hear people talk about getting a tooth “pulled”. This is an unfortunate term, as we don’t pull out teeth to remove them. If we did, we could damage the surrounding teeth, gums, and bone. If a tooth needs to be removed, we numb the area around it, and then “luxate” it. That is, we move the tooth from side to side until it is loose and then lift it out. Sometimes we will cut the tooth into two or more pieces to remove it safely, especially if it has several roots going in different directions.

What can I expect after I have my tooth removed?

Every case is different, and after the tooth is removed your dentist will review with you what to expect. In general, a small amount of discomfort is normal right when the freezing comes out, and some patients will take an ibuprofen or acetaminophen at that time. Bleeding or swelling are usually minimal, but again, your dentist can tell you what to expect with your case.

Do I need to replace my tooth once it is removed?

It depends. Some teeth are important for function or aesthetics. For example, the first molar tooth is very important for chewing; so not replacing could result in tooth drift and unbalanced bite. However, some other teeth, such as wisdom teeth, are rarely replaced. To ensure no surprises down the road, this is an issue that is addressed prior to tooth removal.


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