Tooth extraction is one of the commonest dental procedures performed. Although it is advisable to save teeth to prevent their loss, several indications make it necessary to have a tooth extracted for example:

1. Milk teeth need to be shed/removed to make room for the permanent teeth
2. Badly decayed/broken teeth that cannot be restored
3. An impacted tooth that is infected or at risk of infection
4. Severe gum disease where the bone supporting the teeth is at an advanced stage of destruction
5. Overcrowding of teeth where the jaw size is small compared with the size of teeth
6. A failed root canal tooth in a patient with compromised immunity

Tooth Extraction Procedure:

It is important to mention to your dentist if you have any medical conditions such as hypertension, heart or liver disease or if you are taking any medications.  
In most cases, an x-ray will be taken in order to properly visualize the tooth with its roots. In cases of a severely infected tooth, your dentist may put you on antibiotics a few days prior to the procedure.
If having a simple extraction, a topical anaesthetic is applied, followed by a local anaesthetic injection. This should make the area numb. The extraction is then done and it should be painless. You will then be instructed to bite down on a piece of gauze to control the bleeding and further instructions on caring for the extraction site will be given to you.

If having a difficult extraction or open disimpaction, the anaesthesia is applied after which the gum around the tooth is raised to expose the supporting bone. Some bone around the tooth is trimmed away to create space for the tooth to be lifted out of its socket. After which the gum is sutured back in position. The sutures will usually require removal a week after the procedure.

How to care for extraction socket

1. Bite on the gauze pad after the extraction for at least 1 hour
2. Limit the amount of talking/physical activity following the procedure to minimize bleeding
3. Avoid rinsing or spitting forcefully for 24 hours after the extraction to avoid dislodging the clot that forms in the socket.
4. Start mildly rinsing with warm salt solution twice a day 24 hours after the extraction
5. Avoid hot drinks or drinking through a straw for at least 24 hours after extraction to avoid dislodging the blood-clot within the socket.
6. Take a soft diet and avoid chewing on the side of the extracted tooth for about a week
7. Brush normally but avoid the area around the extraction until it heals

Contact your dentist if the bleeding continues a few hours after the extraction if there is excessive pain or swelling.
After the extraction site has healed- in about 1-3 weeks, it is important to have tooth replacement to avoid movement of other teeth into the gap. Talk to your dentist about the options available.
Most importantly as they say prevention is better than cure. Visit your dentist twice a year for a check-up. That will give you and your teeth the best chance of growing old together!