The most common reason for tooth extraction is tooth infection and/or tooth decay (beyond fillings). Tooth infection can generally be saved with a root canal treatment; in some instances, the decay might be too extensive that extraction is the only option.
Other indications for tooth extraction include (but not limited to),
prophylactic extraction of wisdom teeth,
pericoronitis (gum inflammation around partially erupted wisdom teeth),
unsavable tooth fracture, and
advanced gum disease
The complexity of tooth extraction varies depending on the tooth and its associate root anatomy. Generally, molar teeth are more challenging to extract than their anterior counterparts. Wisdom teeth can have varied root anatomy and can be difficult to extract in general practice. Hence, you may be referred to an oral surgeon or an oral & maxillofacial surgeon for complicated extractions.
Dental extraction is a surgical procedure. As such, your medical history is very important to ascertain whether it is safe to do the extraction in general practice.
You must disclose your full medical history to your dentist, including all the medications you are on and your allergies, if any. The most relevant medications you dentist needs to know are blood thinners, such as aspirin, clopidogrel (Plavix), prasugrel (Effient), warfarin, and any of the newer anticoagulants: apixaban (Eliquis), dabigatran (Pradaxa), and rivaroxaban (Xarelto). These medications affect your ability to form stable blood clots after extraction.
Blood thinners, are by no means, the only medications your dentist needs to know. There are many other medications that could potentially impact the outcome of your extraction.
Your allergy history is important because your dentist may need to prescribe you some medicines to which you may have developed adverse reactions in the past.
Your extraction appointment
The most common presentation for dental extraction is as an emergency appointment due to pain.
Having determined that the tooth requires extraction and that it is safe to do it in the chair, your dentist will talk through the procedure with you. You will also be provided with specific instructions you must follow after your appointment.
You will be well anaesthetized for the procedure. Your dentist will perform the extraction to the best of your comfort. Sometimes, a surgical extraction may be required to retrieve the entire tooth, in which case an incision to the gum will be made and some bone removal may be required. Your dentist will explain to you all of these as part of the inform consent.
After your extraction appointment
In addition to verbal postoperative instructions, you will be a given a print-out of postoperative instructions that you must follow.
You may be instructed to take some analgesics and/or antibiotics.