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Potential Risks and Complications of Tooth Extraction

A tooth extraction is a common procedure used to remove a seriously damaged tooth from its socket. The damage may include excessive tooth decay, abscessed tooth, impacted tooth and fractured or broken tooth. Sometimes it is necessary to remove relatively healthy teeth that are crooked and may crowd together in order to make space for orthodontic work or remove any remaining teeth to prepare the mouth for a complete denture.

Types of Tooth Extraction

There are two types of tooth extractions – simple and surgical extractions:

A simple extraction involves removing an erupted tooth without damaging the gum. This common procedure can be performed by a general dentist, usually with local anesthesia.

A surgical extraction requires removing the tooth through the gum and possibly the jawbone. It is typically performed on teeth that have not erupted and those that are broken at the gumline and cannot be removed with a simple extraction. This procedure is more complicated than simple extraction and it is usually performed by an oral and maxillofacial surgeon. Surgical extraction often requires stronger anesthesia (i.e., conscious sedation or general anesthesia).

Possible Risks of Tooth Extraction

Dry socket. The most common complication resulting in severe pain. Dry socket occurs when the blood clot that normally protects the socket and reduces healing time after extraction either did not form or was lost before the wound could heal.

Damage to nearby teeth and dental prosthesis. The neighboring teeth or dental prosthesis may occasionally be damaged during the tooth extraction.

Damage to the sinus cavities. Occasionally, the sinus cavities above the upper jaw may be damaged, which increases the risk of infection. As a result, another surgery may be required to repair the damage.

Damage and inflammation of the nerves. The inferior alveolar nerve in the lower jaw can also be sometimes damaged. Nerve damage is usually temporary and heals in 3 to 6 months although it may rarely cause permanent numbness in the lower chin and lip. Prolonged numbness may also occur due to inflammation of the nerves.

Damage to the jaw. Patients with a weak jawbone, for example those with osteoporosis, may have a high risk of jaw fracture.

Infection. In patients with a compromised immune system, with certain medical conditions (e.g., heart murmur) or artificial implants (e.g., knee or hip implants) an infection may occur after tooth extraction. Antibiotics can be prescribed before and after the extraction to prevent infection.

Incomplete extraction. In some cases, a portion of the tooth root may be left in the jawbone, increasing the risk of infection. However, sometimes when there is a potential for damaging a major nerve, a small root tip is intentionally left in the jaw because removing it could be too risky.

Prolonged pain or stiffness of the jaw. A tooth extraction can occasionally lead to jaw pain and stiffness of the jaw, which can make the mouth difficult to open.

Other complications. Rarely, certain medications may cause complications, such as poor healing or increased deterioration of the jawbone after tooth extraction.

Where to Find More Information: Oral Health Foundation