The Short Answer
When is pulling a tooth the right call?
At Precision Dentistry of Olympia, Dr. Eric Xu recommends removing a tooth when it’s too damaged or infected to repair, or when advanced gum disease has destroyed the bone holding it in place. Impacted wisdom teeth that cause problems often need to come out too, and sometimes a tooth is removed to make room for orthodontic treatment or to prepare for dentures or an implant. If a tooth is hurting, call (360) 995-0025 early in the day and we’ll do our best to see you the same day.
Dr. Xu takes a conservative approach to dentistry, which means removing only what’s damaged and keeping as much of your natural tooth as possible. So before we recommend a tooth extraction, we check whether it can be saved.
Common Reasons for Tooth Extraction
The tooth is too damaged to repair
A filling or crown needs enough healthy tooth to hold onto. When decay reaches deep below the gumline, or a fracture runs into the root, there may not be enough left to rebuild. Leaving a tooth like that in place usually leads to more pain or infection.
An infection can’t be cleared
Bacteria that reach the soft tissue inside a tooth cause pain, swelling, or an abscess. Root canal treatment clears most of these infections. When the tooth is too broken down to restore afterward, or the infection keeps coming back, removing the tooth stops it from spreading.
Gum disease has destroyed the tooth’s support
Advanced periodontal disease breaks down the gums and jawbone that hold teeth in place. Teeth start to loosen, shift, or hurt when you chew. Once a tooth has lost too much bone, gum disease treatment can’t stabilize it long term.
A wisdom tooth is impacted and causing problems
Wisdom teeth usually come in between ages 17 and 25, and many don’t have room. An impacted wisdom tooth can stay trapped under the gum or grow at an angle into the molar next to it. That can cause pain that spreads toward the ear, bleeding or swollen gums at the back of the mouth, trouble opening your mouth, and damage to the neighboring tooth. A healthy impacted tooth that isn’t causing problems can often just be monitored. One that is causing problems usually needs wisdom teeth removal.
There isn’t enough room for orthodontic treatment
Most crowding is corrected without removing teeth. With severe crowding, an orthodontist may plan to remove one or more teeth so the rest have space to line up. That decision is based on your bite, jaw structure, and treatment goals.
A tooth is in the way of dentures or an implant
A tooth with a poor long-term outlook may need to come out before you get dentures or a dental implant. Healthy teeth stay.
Can the Tooth Be Saved Instead?
Often, yes. Dr. Xu uses digital X-rays and intraoral cameras, so you’ll see the tooth on the screen while he explains what he finds. If there’s more than one way to treat it, he’ll go over each option, including its pros and limitations.
| Treatment | What it does | When it’s used |
|---|---|---|
| Dental filling | Repairs a cavity | Enough healthy tooth structure remains |
| Dental crown | Caps and protects a weakened tooth | The tooth is damaged but can still support a crown |
| Root canal treatment | Removes infection from inside the tooth | The tooth can be restored afterward |
| Gum disease treatment | Controls periodontal disease | The tooth still has enough bone support |
| Tooth extraction | Removes the tooth | The tooth can’t be restored or kept healthy |
What Our Patients Say
If I could give Dr. Xu and his team 10 stars I would. Everyone in this office is a compassionate, communicative expert who truly cares. My dental anxiety is extreme and I came to them last month with no insurance, and teeth that hadn’t been worked on in over 5 years. Sarah, Danielle and Dr. Xu have been nothing but kind and patient with me despite my nerves. Just had my first extraction a few hours ago and it could not have been a more comfortable experience. These people are just above and beyond what they do. I didn’t think I’d ever say this, but I’m very much looking forward to the rest of the dental work I have ahead of me thanks to this team. It is worth every penny and more. The high standards and quality of care this office holds themselves to will forever set the bar for medical professionals in my book. Thank you so much for being you. See yall again next month for Round 2 ❤️❤️❤️
After having an infection from a root canal done in Thailand I was in a lot of pain. Precision Dental was able to see me the same day. The staff at Precision Dental is very kind and helpful. Dr. Xu is very knowledgeable and helped me find the right course to take to save the tooth. I highly recommend Precision Dental to anyone in need of dental assistance.
They took me in on an emergency basis for a tooth removal when my regular dentist could not fit me in. Excellent staff. Dentist was wonderful. First time I have ever had shots in the top of my mouth without them hurting at all. This is the best experience I have ever had in a dentist’s office.
What to Expect During a Tooth Extraction
Numbing the area
Dr. Xu numbs the tooth and the gum around it with a local anesthetic before he starts. You’ll feel pressure as the tooth loosens, but you shouldn’t feel pain. If dental visits make you anxious, he may recommend sedation.
Removing the tooth
A tooth that’s fully erupted can usually be loosened and removed as a simple extraction. If it’s impacted or broken below the gums, Dr. Xu removes it surgically. He makes a small incision, removes the bone covering the tooth if needed, and sometimes divides the tooth into sections so it comes out more easily.
Smoothing or preserving the jawbone
If the bone underneath needs reshaping so the area heals evenly and a future denture or implant sits properly, Dr. Xu does it during the same visit. This is called an alveoloplasty. If you’re planning an implant, he may also recommend bone grafting, which he performs here in our office, to preserve the bone that will support it.
The first 48 hours
A blood clot forms in the empty socket and protects it while it heals. Keep the gauze in for an hour. For the next 48 hours, our post-operative instructions say to avoid spitting, straws, and smoking, because they can dislodge the clot. Hold off on rinsing for the first 24 hours, then rinse gently with warm salt water. Stick to soft, cool foods during that time. Our tooth extraction recovery guide covers the days after that.
Frequently Asked Questions
How sore will I be after an extraction?
Some soreness and swelling are a normal part of healing. Our post-op instructions recommend ibuprofen for the first 48 hours, along with an ice pack on the outside of your face, 15 minutes on and 15 minutes off. Don't use heat, because it can make swelling worse.
When should I call the office after an extraction?
Call us if bleeding, swelling, or pain doesn't let up, or if swelling is still there after 4 to 5 days. After hours, call (360) 995-0025 and leave a message. Dr. Xu reviews these messages and usually responds within a day. If swelling affects your breathing or swallowing, go to the nearest emergency room.
Do I need to replace a tooth after extraction?
Usually, but not always. Wisdom teeth and some orthodontic extractions don't need replacing. For other missing teeth, Dr. Xu generally recommends a dental implant first, because it doesn't require reshaping the teeth on either side the way a bridge does. Dentures are another option.
Talk to an Olympia Dentist About Your Tooth
If a tooth is painful, cracked, or loose, call (360) 995-0025 or schedule an appointment. We’re open Monday and Wednesday through Friday, 8 a.m. to 5 p.m., at 2728 Westmoor Court SW, Suite D, and see patients from Olympia, Lacey, Tumwater, and the surrounding communities.