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Reasons for Pulling teeth

Even though our teeth are meant to last for our whole lifetime, there may be various occasions where we have to get our teeth extracted. The most common reason being a tooth that has been damaged by decay or an accident to an extent where it has gone beyond repair.

Some other reason would be:

A crowded mouth. In certain occasions the dentist extracts a tooth to ready the mouth for orthodontia. Orthodontia is a process carried out with the intention of aligning the teeth precisely, which at times may not be possible due to your teeth being too big for your mouth. Similarly, if there is not enough space for your tooth to erupt (break through your gum), your dentist may recommend that you get the tooth extracted. This would create some space for the teeth to spread and grow out adequately
Infection. The center of the tooth which contains nerves and blood vessels is known as the pulp. If the tooth has been decayed or damaged up to the point where the pulp is exposed, there is a risk of the bacteria in the mouth entering the pulp which will lead to an infection. Root Canal Therapy (RCT) along with antibiotics is one method to rectify this situation, failing in which, the only alternative being extraction of the infected tooth.
Risk of infection. For those who are undergoing chemotherapy for cancer, are having an organ transplant, or have a weak immune system, the risk of an infection in the tooth is enough reason to have the tooth extracted. The weak immune system is what makes the tooth susceptible to decay.
Periodontal (Gum) Disease. Periodontal Disease is a condition where the tissues and bones that surround the teeth are infected. If this condition has caused a loosening of the teeth, it may be necessary to extract a couple of teeth.

What to expect with tooth extraction

A tooth extraction is carried out by a dentist. The dentist will, prior to the extraction of the tooth, inject you with a local anesthetic to numb the surrounding area of the tooth to be extracted. In situations where your tooth is impacted or more than one tooth is being extracted, your dentist may put you under general anesthesia to ensure that you will sleep through the procedure and not experience any pain. For an impacted tooth, the dentist will gently cut away through the gum and bone tissue that covers the tooth prior to using forceps to grasp the tooth to loosen it from the jaw bone and ligaments that hold it in place by rocking it back and forth firmly. At times, in a situation where the tooth cannot be extracted with ease, the dentist will extract the tooth piece by piece but cutting it down.

After the tooth has been extracted, a blood clot is formed in the socket. The dentist will then gently place a gauze pad in to the socket and ask you to bite down on it to hold it in place and stop the bleeding. In some occasions, the dentist will place a few self-dissolving stitches to help the gum cover up and heal the wound easily. At times the blood clot may break open and expose the bone. This situation is called dry socket and is known to be extremely painful. If this situation occurs, your dentist will place a sedative dressing over the socket to protect it while a new blood clot is formed.

What to tell your dentist before you have a tooth extracted

Even though the process of having your tooth extracted is known to be a safe procedure, there is a risk of harmful bacteria entering your blood stream. Gum tissue may be infected as well. If you have a condition which makes you more prone to severe infections, you may have to take antibiotics prior to and after the procedure. It is important to inform your dentist of your complete medical history, all the medication and supplements you take, and whether you have any of the following conditions:

Damaged or man-made heart valves
Congenital heart defects
Impaired immune system
Liver disease (cirrhosis)
Artificial joint, such as a hip replacement
History of bacterial endocarditis

After you've had a tooth pulled out.

Your dentist will send you home after a tooth extraction is done to allow you to recover. A full recovery is achieved with a span of a few days. The following is a list of precautions that can be taken in order to minimize the risk of infection, speed up recovery, and reduce discomfort.

Use painkillers as prescribed by your dentist.
Bite firmly on the gauze pad to allow a blood clot to form in the socket while being held in place to reduce bleeding. The gauze pads must be changed before it is soaked in blood. Or else the pad could be kept in place for three to four hours since the completion of the extraction.
Apply an ice bag to the area from which the tooth was extracted to minimize swelling. Ice should be applied in ten-minute time gaps.
After the extraction of a tooth, it is advisable to rest for at least 24 hours. It is best to minimize your activities for at least a couple of days after the extraction.
Rinsing vigorously or forcefully spitting within 24 hours of the completion of the extraction may cause the blood clot to dislodge from the socket.
After 24hours, use a solution consisting of 1/2 a table spoon of salt and 8 ounces of water to rinse your mouth.
Refrain from drinking through a straw for at least 24 hours after the extraction of the tooth.
Refrain from smoking as it may inhibit healing
Eat soft foods such as soup, pudding, yoghurt, or apple sauce for at least 24 hours after the extraction.
You may gradually add solid foods to your diet as the are a from which the tooth was extracted heals.
Use pillows to keep your head elevated when lying down as lying flat may prolong the bleeding.
Continue brushing and flossing your teeth while also brushing your tongue as usual. Try to avoid the area from which the tooth was extracted in order to prevent an infection.

When to call the dentist

Feeling some amount of pain is normal as it is a result of the anesthesia wearing off. Some swelling and residual bleeding could be expected for 24 hours since the extraction of the tooth. However, if the pain you are feeling or the bleeding is of unbearable magnitude for up to four hours after the extraction, you should call your dentist. Also, please call your dentist If you experience any of the following:

Signs of infection, including fever and chills
Nausea or vomiting
Redness, swelling, or excessive discharge from the affected area
Cough, shortness of breath, chest pain, or severe nausea or vomiting

It takes around one to two weeks for the initial healing process. New gum tissue and bone will grow in to the gap. Having a missing tooth or missing teeth may cause the remaining teeth to shift as time passes.

This may affect how you bite and make it challenging to chew.

Taking that reason in to account, your dentist may recommend that you get an implant, fixed bridge, ordenture.