Extraction complications: What does a snap or breaking noise during a tooth extraction indicate?

During an extraction it is possible that a patient might hear a snap or breaking noise as their dentist applies pressure to their tooth. And in some instances, for some patients, this type of sound might be alarming. The fact of the matter is that this sound probably isn't as ominous as you might anticipate. Yes, it could indicate that a troublesome event has occurred but it is more likely that the sound just signals the occurrence of a minor issue. In some cases, even a non-issue.

Getting alarmed won't help anybody out.

We would like to suggest that with the exception that the sound you heard has triggered a cursing tirade by your dentist that you, the patient, aren't really in a position to suitably interpret what the sound you heard indicates. You can't really feel anything because you're numb, you absolutely can't see anything and you probably don't have any expertise in the matter of tooth extractions anyway.

There's no reason to get all excited about something you can't interpret. Certainly doing so isn't going to help your dentist get your tooth out any quicker. Tooth extractions aren't just performed on patients; they're performed with patients. A dentist can either focus their attention primarily on the tooth being removed or else, as your behavior dictates, share their attention between the tooth and you. Allowing for the first scenario will work out to your benefit.

What might a breaking sound indicate?

Here are some of the things that the "ominous" breaking sound heard during a tooth extraction might signal, not all of which are all that troublesome.

» The tooth's root has fractured.

Root fracture is the most common "complication" associated with tooth extractions. That's the bad news. The good news is that because it is so common you can expect that your dentist has dealt with many broken tooth roots before.

When reading your tooth's pre-operatory x-ray your dentist may pick up on hints that suggest to them that its root(s) may fracture. If so, they will probably give you a heads up about the matter. If they are overly concerned about the consequences of this happening, they may plan for a "surgical" extraction rather than first attempting a "simple" one.

If a "simple" (conventional) extraction approach is chosen, the dentist will first loosen the tooth up using an extraction instrument called an elevator (a lever that looks like a small flat-bladed screwdriver). Once the tooth has loosened up somewhat, the dentist will switch to tooth extraction forceps. With these forceps, they will rock back and forth and twist on the tooth as a way of loosening it up even further. This is the point where a root is most likely to break.

The consequences of a tooth's root breaking off can vary quite widely. In most cases the broken part that is left behind has already been loosened somewhat. If so, removing it can be a very straightforward and quick process. In other instances the broken part may prove to be uncooperative. It may be hard to see and/or manipulate. If so, retrieving it may add a fair amount of time to your appointment. If this is the way things work out, just be glad you're numb and, like we said earlier, be a good patient for your dentist so they can concentrate on their task and not so much managing you.

» The breaking sound you heard may have come from the jawbone's cortical plate.

The bone tissue that surrounds a person's teeth is actually composed of two different bone types. The bone that lies directly underneath a tooth's gum tissue is a thin layer of dense bone termed cortical plate. The bone found in the center of the jawbone that encases a tooth's roots is called cancellous bone. In comparison to cortical plate, cancellous bone is relatively spongy.

When a dentist performs an extraction they will rock the tooth back and forth so to "expand" its socket (so to increase the socket's dimensions so the tooth will come out). Each place where the tooth is forced against the walls of its socket the jaw's spongy cancellous bone will be compressed more and more. The jaw's denser cortical plate, however, isn't so compressible and in fact this socket-expanding action may instead fracture it.

In most cases this type of fracture will just be a hairline event. After the extraction has been completed the dentist will simply compress the empty tooth socket with their fingers so the bone is returned to close to its original position. In the majority of cases the bone will simply repair itself uneventfully in tandem with the extraction site as a whole.

It can be possible that the broken portion of cortical plate will come out either attached to the tooth or on its own. From a standpoint of healing, this typically doesn't offer much of a concern. Because some bone tissue has been lost the healed shape of the patient's gums will reflect this deficit. The manner in which the tooth's space will be restored will dictate how problematic this defect will be. In the case of a dental implant, this loss of bone may be a substantial concern. If a denture or dental bridge is planned, the defect will likely be much less of an issue.

Most tooth extractions sounds are associated with minor issues.

There can be other, more problematic, bone or tooth fracture related events that can occur during a tooth extraction. But at this point in our list we are getting down to those events that statistically are much less likely to occur.

Rather than dwell on the unlikely we feel it's much more important to understand the probable. In the case of hearing a breaking sound during a tooth extraction, just realize that as unsettling as the sound might initially be, in the vast majority of cases the event it signals is just a minor one.