Gentle Tooth Extractions in Fort Worth

Throughout most of our history, humans have had a complicated relationship with tooth extractions. Before the development of early root canal therapy in the 18^th century, pulling a tooth served as the go-to method for alleviating the pain and impaired function associated with extensive tooth decay. With the trend toward more conservative dentistry (dental care that preserves as much natural, healthy tissue as possible), extractions are often seen as a last resort although, in many situations, removing a tooth can restore the healthy balance of your mouth. Dr. David Tillman only recommends tooth extraction if it is absolutely necessary and if it will serve the larger purpose of helping you reach your optimal level of oral health.

When are Tooth Extractions Recommended?

Several situations might prompt Dr. Tillman to recommend a tooth extraction, including:

• Extensive decay has damaged a tooth beyond the point that other, less invasive therapies, like root canal, pulp capping, or placing a crown can help.
• A tooth has loosened in its socket as the result of advanced gum disease.
• Impacted wisdom teeth (third molars) developed in such a way that they are pushing against the neighboring teeth, creating a high risk for decay, or they have not fully erupted from the gums, leading to painfully infected gum tissue. 
• Removing a tooth prior to orthodontic therapy (such as braces or Invisalign) can help the remaining teeth shift into proper alignment.
• Patients at a high risk for infection, such as those with compromised immune function due to cancer therapy, may need to have at-risk teeth extracted.

What Happens During a Tooth Extraction?

The nature of any dental procedure will vary greatly from patient to patient and depend on a number of highly individual factors. As a general rule, tooth extractions are divided into two broad categories: simple and surgical.

During a simple extraction, Dr. Tillman will completely numb the extraction site so you feel nothing more than a bit of pressure. Using a series of special tools, he will gently rock the tooth back and forth until it has loosened adequately. Finally, Dr. Tillman will remove the tooth and pack the area with gauze to halt any bleeding. If dental procedures make you feel nervous, or if you feel like you will be better able to get through the appointment if you are more relaxed, you can talk to Dr. Tillman about sedation dentistry techniques like nitrous oxide or oral sedation.

If a tooth has not fully erupted from the gums or jawbone or if it is positioned in such a way that a simple extraction cannot address the problem, Dr. Tillman will recommend a surgical extraction. In almost all cases in which wisdom teeth need to be extracted, it is because they are impacted either within the jaw bone or beneath the gum line. A more complicated procedure that will necessitate more time in the treatment chair, surgical wisdom teeth extractions are almost always performed under oral sedation or nitrous oxide in addition to local anesthetic. While a simple extracted tooth can be removed in a single piece, surgical extractions often begin by sectioning the tooth into smaller pieces that can be easily extracted. Once the pieces have been removed, stitches and proper post-surgical aftercare are the final step.

Extraction Aftercare Advice from Your Fort Worth Dentist

After the tooth has been removed, Dr. Tillman will pack the site with gauze to absorb any fluids. Your mouth will still feel numb from the local anesthetic and, if you opted for oral sedation, you will still feel woozy and out of it. We will send you home with a few changes of gauze and post-op instructions and, in most cases, we will schedule you for a post-op appointment so Dr. Tillman can check in on how the extraction site is healing. In order to ensure optimal healing, follow these simple steps:

• Avoid drinking through a straw, smoking cigarettes, or performing any activities that create suction in the mouth. This can lead to a painful condition called dry socket.
• You should keep your mouth clean by gently rinsing with a lukewarm saltwater solution (dissolve 1 tablespoon of salt into 8 ounces of water) or by gently brushing your teeth being extra careful to avoid the extraction site.
• Do not perform any vigorous or strenuous activities for at least 24 hours after a tooth extraction. If you underwent a surgical extraction, you should plan on taking it easy for at least 2-4 days after surgery. For simple extractions, you can often return to normal activities after 24 hours.
• Take your prescribed pain medication (if any). Over-the-counter ibuprofen will also help reduce pain and swelling. Applying covered ice packs to the site in ten minutes increments will also reduce pain and swelling.
• For at least 24 hours after your procedure, you will need to restrict your diet to softer, blander foods of a moderate temperature. You should also avoid foods that can become lodged in the extraction site, such as rice, sunflower seeds, popcorn, and nuts.

Will a Tooth Extraction Hurt?

After concerns about the cost of dental care, most patients have reservations about whether their procedure will hurt. Rest assured that Dr. Tillman and our staff truly care about your comfort, from the moment you walk in the doors and through your appointment and recovery. All tooth extractions are performed using local anesthetic to block discomfort and, if you feel you need it, we can provide nitrous oxide and oral sedation to help you feel completely relaxed.    

About David Tillman, DDS

Drawing from a wealth of continuing education and hands-on experience, Dr. David Tillman and his staff are committed to providing individuals and families with exceptional general, restorative, and cosmetic dental care from our Fort Worth, TX dentist office. To schedule an appointment or complimentary consultation, call us today at (817) 870-4746. Located in the heart of the Downtown Fort Worth medical district, we proudly serve patients from across the Metroplex.