Extractions

What is a tooth extraction?

A tooth extraction involves the complete removal of a tooth or teeth from your mouth. There are several reasons why your dentist may recommend tooth extraction, such as:

  • Gum disease
  • Tooth decay
  • Broken or irreparable teeth
  • Crowded teeth
  • Impacted wisdom teeth
  • Failed root filling

In situations where a tooth is beyond saving, tooth extraction may be recommended.

abscess2

Heavily restored,previously root filled tooth with infection would be beyond saving.

What will my dentist do?

Following a check of your medical history and x-rays, your dentist will look at all other options and discuss with you pre post operation instructions.

A local anaesthetic (an injection in your mouth) will be used to numb the tooth before it is extracted; this is the best treatment for most patients. In some cases a referral for sedation (something to make you relaxed)may be arranged, for children or nervous patients, or where a tooth might prove difficult to remove. On rare occasions a general anaesthetic may be considered. If a general anaesthetic is needed, you will have to go to a hospital or a specialist treatment centre (you are likely to be able to go home the same day, but not all patients are able to do so).

While the tooth is being taken out

You may hear some noise and feel some pressure as the tooth is being eased out- but you should not feel pain. Sometimes stitches are put into the gum to minimise any post extraction bleeding, to make the area more comfortable and help it heal quickly.

Afterwards:

Your dentist will give you post operative instructions:

The gauze pad placed over the surgical area should be kept in place for 20 – 30 minutes. After this time, the gauze pad should be removed and discarded.  It is not necessary to replace the gauze unless there is active bleeding.

Your mouth may continue to feel numb for an hour or two after the extraction. You should take care to not bite your lip, cheek or tongue during this time. Also if you have something to eat or drink, make sure that it is not too hot, so that you do not burn your mouth.

Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.

Over-the-counter pain medications are usually all that is necessary after routine surgical extractions.

Bleeding

Some bleeding is to be expected following removal of teeth, but this is usually minimal. Even after biting on the gauze pads, it is  normal to have slight bleeding and oozing for the next 12 – 24 hours. Excessive bleeding is  characterized by mouthfuls of bright red blood, or large rubbery clots. If this occurs, please try  the following:

Rinse the mouth (gently, not forcefully) with warm salt water or corsodyl or hydrogen peroxide (dilutes as instructed)
Bite firmly on a moistened gauze pad placed directly over the extraction site for 30 minutes. If no gauze is available, you may substitute a moistened cotton handkerchief.

Strenuous exercise, jogging, or sporting activities that may cause an increase in the blood pressure should be avoided for the first 48 hours.

Some bleeding when brushing the teeth may occur for the first week following the surgery.  This is normal, and should not be a reason to avoid brushing in this area.

If bleeding does not subside contact the practice.

Swelling

Some degree of swelling is normal after tooth removal, especially with the extraction of lower teeth.  This is the body’s normal inflammatory reaction to any injury.  When you get home, place ice packs on the face in the area adjacent to the surgical site.

If swelling or jaw stiffness has persisted for several days after the surgery, there is no cause for alarm.  This is a normal reaction to surgery.

Pain

As with any surgical procedure, there will always be some postoperative pain and discomfort. We normally recommend that as soon as the patient returns home from their surgery, they take the pain medication, even though they are still “numb” and not experiencing any pain. Patients should remember that one should not drive cars or do anything that requires coordination or balance while taking any prescription pain medication.

Diet

We recommend that you maintain a relatively soft and bland diet for the first few days after surgery.  In general, most normal foods are O.K. after the first few days, but it would be best to avoid anything with seeds or particles, such as poppy seeds or sesame seeds.

Oral Hygiene

Do not forcefully rinse for the first several days.  You can brush your teeth the night of surgery but, use a very soft bristle brush, and rinse gently.  Expect to see a small amount of blood in the sink when brushing your teeth.  This is very normal, and does not mean that you should stop brushing.

Infection

Sometimes an infection can get in the socket, which can be very painful. This is where there is little or no blood clot in the tooth socket and the bony socket walls are exposed and become infected. This is called a dry socket and in some cases is worse than the original toothache! In this case, it is important to see your dentist, who may place a dressing in the socket and prescribe a course of antibiotics to help relieve the infection. You may also feel the sharp edge of the socket with your tongue and sometimes small pieces of bone may work their way to the surface of the socket. This is perfectly normal. If the pain or swelling does not subside or gets worse after a few days following the extraction, contact the practice.

Smoking & Alcohol

If you smoke avoid this for as long as possible after the extraction. (At least 24 hours. This is because smokers are much more likely to have problems with extraction sockets than patients who do not smoke ) You should also avoid drinking alcohol for the same reasons.

If you have any concerns, or if you feel anything is happening that should not be happening, please contact the practice:

 

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