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Tooth Extraction

Surgery Overview

Tooth extraction is the complete removal of a tooth, from the part of the tooth that you can see to the roots that are in the jawbone. Dental problems and infection caused by tooth decay is the most common reason for a tooth's extraction. However, tooth decay is not the only reason for removing a tooth. Removing the tooth can help keep an infection from spreading to other parts of the mouth and body. And some teeth may be removed to prevent or correct crowding in the mouth.

During your dental appointment, your dentist will talk to you about all of your treatment options. They will recommend what's best for you and make a referral to an oral surgeon if necessary. A tooth extraction can be a simple procedure or more complex. It depends on many factors including your general oral health, tooth position and condition, and your general health. The dentist will explain in detail what will happen during the procedure and will answer any questions or concerns you may have.

The dentist first numbs (freezes) the area around the tooth. You may also get medicine to help you relax. The dentist uses special tools to grasp the tooth and lift it out of the tooth socket. You may feel tugging on the tooth as it is being removed. If the tooth doesn't come out in one piece, the dentist uses other tools to remove the rest of the tooth. After the tooth comes out, you will be given a piece of gauze to bite down on. This will help stop bleeding. You may need stitches. You will be told if and when you should come back to have the stitches removed.

You may have some pain, bleeding, or swelling afterward. The dentist may give you medicine for pain. The pain should steadily decrease in the days after the extraction. It is important to follow the instructions from your dentist after tooth extraction. These are to help you have a fast recovery with fewer or no problems.

What To Expect

  • While your mouth is numb (frozen), be careful not to bite your tongue or the inside of your cheek or lip.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If the dentist gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your dentist if you can take an over-the-counter medicine.
  • If your dentist prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics. Not everyone will need antibiotics after extractions.
  • During the first 24 hours after your tooth extraction, gently bite on a lightly wetted gauze pad, folded thick, and placed over the area where your tooth was removed. Change the gauze pad every 30 to 60 minutes until the bleeding stops completely. If you run out of gauze, you can place a dampened tea bag and gently bite. You may eat and drink between gauze changes. When you can't see any bleeding, remove the gauze and stop using the gauze pad. Light oozing is normal for the day of surgery and sometimes the following day. Using the gauze pad for too long or talking with it in place can cause you to bleed more or for longer.
  • After 24 hours, rinse your mouth gently with warm salt water several times a day. Your dentist may recommend other mouth rinses if needed. Do not rinse hard. This can loosen the blood clot and delay healing.
  • Avoid rubbing the area with your tongue or swishing liquid in your mouth. And don't use a straw for the first few days. These actions can loosen the blood clot and delay healing.
  • Avoid chewing in the area where the tooth was removed until your mouth heals. Soft foods like gelatin or soup might be easier to eat and may help you heal.
  • If needed, put ice or a cold pack on your cheek for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice and your skin.
  • Do not smoke or use spit tobacco for at least 24 hours after the extraction. Tobacco use can delay healing.

Why It Is Done

There are many reasons for a tooth to be extracted. One of the most common reasons is tooth decay. In particular, when the decay has affected the nerve at the centre of the tooth. This can cause severe pain or infection that can't be taken care of in any other way. Another common reason is when gum disease has caused the tooth to loosen, or not have enough bone support.

How Well It Works

Removing the tooth when no other treatment option is reasonable helps take away the source of the problem. In the case of dental infection, it can keep the infection from spreading to other areas of your mouth and your body. In the case of gum disease, removing a tooth prevents the disease from spreading and damaging nearby teeth and bones.

Risks

Generally, tooth extraction is a simple procedure. It’s not expected to have major problems. However, not removing a tooth or having the appropriate dental treatment can lead to problems such as dental infection. Some dental infections can cause bacteria to enter the bloodstream and cause infections in other parts of the body. Before your tooth extraction, talk to your dentist about every health condition you have and all of the medicines you take, this includes over-the-counter and herbal medicines. This is important for your safety, to prevent problems, and for a quick recovery. You may need to take antibiotics if you:

  • Have certain heart problems that make it dangerous for you to get a heart infection called endocarditis.
  • Have an impaired immune system.
  • Have diabetes.
  • Had recent major surgeries or have man-made body parts, such as an artificial heart valve.

After an extraction, a blood clot forms in the tooth socket. The clot protects the bone while the healing process takes place. If that blood clot is loosened or dislodged, you may have a condition called dry socket, in which the bone is exposed. Dry sockets may last for several days and may cause severe pain that sometimes includes ear pain. You may be more likely to develop a dry socket if you’ve had one before or if you smoke. Problems such as dry socket, and others, are not common. When you review your x-rays and talk about your treatment plan, ask your dentist about possible problems. Follow up with your dentist in the case of any problems.

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