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Article: Having A Tooth Pulled? Consider The Risks DR. JERRY GORDON
Considering the trauma that often accompanies an extraction, I often wonder why some people are quick to suggest that I pull a tooth instead having a root canal, a far less aggressive, as well as tooth-saving procedure.

Having a "tooth pulled" also known as an extraction, is a procedure that is classified as oral surgery by the dental profession. When we think about it, we may find it hard to believe that we are actually having "surgery" when we go to the dentist for an extraction. The procedure involves the dentist using anesthesia to numb the area, and then using surgical instruments to free a tooth from the jawbone. In some cases, pieces of the gum and jawbone will need to be cut away to remove a tooth. Considering the trauma that often accompanies an extraction, I often wonder why some people are quick to suggest that I pull a tooth instead having a root canal, a far less aggressive, as well as tooth-saving procedure.

Having a tooth extracted is not a procedure that you or your dentist should take lightly. To give you an idea of the potential risks associated with the procedure, I will share with you an excerpt from a consent form that a patient signs before an extraction is performed: Potential risks of the treatment include (but are not limited to) bleeding, swelling, pain, infection of the extraction site (dry socket), and damage to other teeth or tissue (gum or cheek) in the mouth. More remote risks include jaw fracture, temporary or permanent injury to the TMJ (jaw-joint), temporary or permanent numbness of the mouth, and life-threatening complications to the treatment or anesthesia. Due to the potential risks associated with an extraction, you should always make sure that your dentist has a complete understanding of your medical history. This includes all of disorders that you may suffer from, as well as all of the medications that you are taking. Some of the ailments that may be of particular concern to your dentist include heart disease, bleeding disorders, diabetes and other diseases affecting the immune system. Some of the medications that can increase the risk during an extraction include many of the medications used to treat hypertension and diabetes, cortisone, and blood thinners (anticoagulants) that are often used after a person has had a stroke, or used to prevent one. Please also inform you dentist about any over the counter medications you may be taking. For instance, aspirin can increase bleeding significantly after an extraction, so should be avoided for at least 5-7 days prior to treatment.

The safe completion of an extraction requires a dentist with both technical skill and excellent knowledge of the medical risks associated with the procedure. In some cases, it is wise for your dentist to discuss your medical condition with your family doctor who can have input into the procedure. With certain types of extractions, including wisdom teeth that are lodged into the jawbone, teeth that are fractured, and those that have unusually curved roots, a dental specialist known as an oral surgeon may be consulted or referred to by your dentist. An oral surgeon should also be considered for a person who has serious and complicated medical problems and requires an extraction.

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Dr. Gordon is the dental columnist for the Bucks County Courier Times. He has published more than 300 articles since 1998. Dr. Gordon was recently asked to provide commentary about mid-level providers for the influential dental journal Dental Abstracts.

Dr. Gordon responds to an article in Dental Abstracts challenging his views.

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