Can a Dentist Pull a Tooth With An Active Infection?

Updated: 3 days ago

Your dentist can always pull an infected tooth but sometimes they may not be able to because of the extent and severity of the infection. Well, they still can but you won't be very happy about it because it'll be a very painful experience if they do.


Our purpose here today is to explain why it can be done and also situations for when it can't and also why you may not want to. After all, there are always exceptions in life aren't there?



Table of Contents:



Can an infected tooth be extracted?

Of course an infected tooth can be pulled because the infection does not preclude the tooth from being physically extracted. There is literally nothing physically stopping your dentist from taking that tooth out.


That makes sense if you think about it logically because a tooth extraction is a treatment for an infected tooth. That means the removal of the tooth is one of the ways for how you get rid of the infection. The other two ways would be a root canal and draining it.


This study demonstrated that for dental infections stemming from a tooth, extracting the offending tooth resulted in faster healing. This is when compared to trying to drain the infection and prescribing antibiotics without an extraction.


Here is a picture of what an infected tooth that needs to be taken out looks like:


dental abscess from broken tooth
Credit: Damdent

The picture above shows a tooth that looks fractured. Half of the tooth is missing and the remaining piece looks extremely jagged. In addition to that, right underneath it on the gums is a huge pimple. That gum boil looks like it is literally about to pop if you accidentally scratch it while eating.


A tooth like this is severely infected and most likely cannot be restored or saved. The only treatment option for it would be to have it extracted. Once that is done, everything should clear up and the gum boil should disappear after a week or so.


Situations like this are very common and your dentist can extract the infected tooth with no problem. However, there are certain situations which may make them hesitate which we'll explain in the next section.


Related content: What we said above also applies to emergency removal of wisdom teeth. Yes, it can be done!


Why you may not want to pull an infected tooth

There are situations where your dentist may not want to pull the infected tooth even though they can. Such is the case when the infection is so severe that literally everything in your mouth hurts.


When this happens, it may be difficult for your dentist to pinpoint where the toothache and infection is coming from. You may be pointing to a specific tooth because you think that is the one hurting you but sometimes it is not coming from the one you think it is. There is this phenomenon called referred pain, where you feel pain from somewhere that isn't actually causing you pain.


If your dentist can't precisely determine where the source of infection is, it wouldn't be wise to extract the tooth. After all, you could have the wrong tooth taken out and unfortunately that does happen sometimes. We wouldn't want that to happen to you.


Here is an example of what we mean, this picture shows severe gum swelling around multiple crowns.


Severe infection and swelling around multiple crowns

For the picture above, the question is where is the infection coming from? Which tooth is the source? Everything is swollen and everything most likely hurts. So are you going to pull all of the teeth?


That wouldn't be a wise decision because it is more likely that only one of the teeth is the one causing you pain. The rest of them are just experiencing referred pain. If you decided to pull all of them you would probably regret it later on because some of them may not have been infected at all.



What you should do instead

Instead of making a knee jerk reaction and start taking out teeth left and right, you should take a more prudent approach. What you need to do is to pinpoint the exact source of the infection so that you can take out just the tooth that is bothering you.


What can help is try to relieve some of the swelling and infection. After you do that, it may be easier to identify where the infection is coming from.


Here is what you can do:

  1. Drain the infection to help reduce the swelling.

  2. Take antibiotics for 2-3 days to reduce some of the infection.

  3. Take pain medication in the meantime.

  4. Return to your dentist after 2-3 days and have them reassess the teeth.


Usually if you can do all of the above, you'll find that you can much more easily identify the source of the infection. At that point in time you can be much more certain about which tooth to take out in order to resolve the infection.




When you can't pull a tooth with an infection

Aside from not wanting to pull a tooth because you're not sure where the infection is coming from, there are situations when you can't pull it. There is one common situation where your dentist literally can't pull your infected tooth. That is when it is so severely swollen and infected that you literally can't get numb.


Here is a video of what we mean by large infections with severe facial swellings:



Treatment for these type of infections involve draining it as well as extracting the offending tooth. However there are times where the patient simply cannot get numb for the procedure. Other times we're fortunate and we are able to get the patient numb.


Here is what the aftermath may look like after having a dental abscess drained:


facial abscess with drain in place
Credit: Dr Jin Park

The reason why the numbing may not work is because of an excessive amount of swelling and abscess in the area. When you try to numb it with the novocaine, the anesthesia may not be able to reach the nerves properly because there is so much infection. It is similar to if you were on a crowded bus and you're trying to squeeze more people on. It is difficult to do so when the bus is that full. That is essentially what happens if you're trying to numb the area.


In addition to that, the tooth and surrounding tissues also become hypersensitized to pain when it is very inflamed. This means that even if something normally does not elicit pain, it would feel painful since it is inflamed. This adds to the increased perception of pain during the procedure.


What can be done?

If the swelling is mild-moderate and does not appear life threatening, your dentist may try to prescribe you antibiotics. The medication will help decrease some of the infection. Basically you would take it for about two days and then return to the dentist to try again. Most of the time this works and you are able to get numb the second time around.


Unfortunately if you come in with very severe facial swelling and it seems like it may be life threatening, your dentist may not be able to wait those two days with antibiotics. You may still need to have the abscess drained right away. These situations are extremely rare but we do encounter them from time to time. It is at the discretion of your dentist.


What you should know and take away from this is that if you have a dental problem or infection, you should have it taken care of while its still early. That way you can avoid all of the potentially complicated aftermath.




Takeaway

An infected tooth can certainly be pulled because an infection does not preclude it from being extracted. However there are certain situations where it may be beneficial to wait a little before having it taken out. Why you may want to do that is because there are times where the pain is so ambiguous that you're not able to pinpoint where the source is.


Last but not least there are also situations where you may not be able to have the tooth taken out such as if you're not able to get numb. The swelling and abscess can be so severe that your body simply won't get numb!


This is why it is important to go in for your biannual dental check ups so that you can catch problems while they're small. It'll lead to more conservative and less expensive treatments if you do!


If you happen to be in the long island city area of NY, our office does offer tooth extractions. If not, you should try to find a dentist close to you. You definitely don't want to delay treatment.

David Chen 200 x 200.jpg

About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!