Tooth extraction is defined as the removal of a tooth from its socket in the bone.
When is it necessary to extract a tooth?
Dr. Pool will evaluate each tooth for extraction and determine if the extraction will be completed in our office or referred to an oral surgeon for treatment. Dr. Pool will generally refer wisdom teeth extractions to an oral surgeon.
If a tooth is broken or severely damaged by decay, the dentist will try to fix it with a filling, crown or other restoration. However, there may be too much damage for the tooth to be repaired. In these instances, the tooth will need to be extracted. In addition, a very loose tooth will need to be extracted if it cannot be saved with a surgical bone graft procedure. Some patients elect to extract teeth over having them restored.
Here are other reasons to extract a tooth:
When a tooth is blocking other teeth from erupting
When baby teeth don’t fall out in time to let permanent teeth come in
Before braces are put on to create room for teeth that are being moved into place
When a patient is receiving radiation to the head or neck and has teeth in the field of radiation
When cancer drugs are being administered, the immune system is impacted, making it possible for teeth to become infected
Wisdom teeth may need to be extracted, either before or after they come in. They need to be removed if they are decayed, become a source of infection or are causing pain. Wisdom teeth often become impacted or stuck in the jaw, causing irritation in the gum, pain and swelling. In this case they would need to be surgically removed
Preparation for tooth extraction
An x-ray will be taken of the affected area in order to plan the best course of action for an emergency extraction. Before the procedure, be sure to inform the dentist of your full medical and dental history, as well as a list of the medicines you take.
If you are having wisdom teeth removed, a panoramic X-ray may be required. This type of X-ray shows all of your teeth in one image and it can help guide the dentist in planning the extraction.
Two types of extractions
Simple extraction – this type of procedure is performed on a tooth that can be seen in the mouth. General dentists are able to perform a simple extraction with a local anesthetic. The dentist will use a device called an elevator to loosen the tooth, and then a forceps for removal of the tooth.
Surgical extraction – a more complex procedure than a simple extraction, surgical extractions are required when a tooth is broken off at the gum or has not yet come into the mouth. A small incision is made in the gum and it may be necessary to cut the tooth or remove some of the bone around the tooth in order to extract it.
During a tooth extraction, you can expect to feel pressure, but no pain. If you feel any pain or pinching, tell your doctor.
What happens after a tooth extraction?
You can expect to have some discomfort, even after a simple extraction but it is usually mild. Some patients avoid pain entirely by taking non-steroidal anti-inflammatory drugs (NSAIDs) 3 to 4 times a day, immediately following the procedure. These drugs include brand names of Ibuprofen, such as Motrin and Advil. In addition to pain management, the doctor will provide detailed instructions on what to expect after a tooth extraction and how to prevent infection.
The level of discomfort and how long it lasts will depend on how difficult it was to remove the tooth or if an infection was present. Your dentist may prescribe pain medicine for a few days and then suggest a NSAID. Most pain disappears after a couple of days.
After an extraction you can expect a recovery time. A cut in the mouth tends to bleed more than a cut on the skin because it cannot dry out and form a scab.
Until the bleeding subsides, you’ll be asked to bite on a piece of gauze for 60 minutes. This pressure allows the blood to clot, but you still might have some minor bleeding for the next 24 hours. Be careful not to disturb the clot that is forming around the wound. Any time there is bleeding in the mouth it will mix with saliva and tint the salvia red. If there is still oozing after the gauze has been removed placed another gauze pack in your mouth and bite firmly for another 60 minutes. Do not talk while biting on the gauze pack, so that you can apply constant pressure. Bleeding should never be severe, but expect some oozing for a couple of days. If you feel like the bleeding cannot be controlled, please get in contact with the office that extracted the tooth.
To reduce swelling that follows a tooth extraction, use ice packs for 20 minutes on and 20 minutes off.
For the first few days after the procedure eat soft foods (eggs, soups, pudding, yogurt, milk, shakes, smoothies etc.). Avoid straws. Do not eat anything hot until the numbness wears off so that you do not burn your mouth. Avoid hard crunchy foods (nuts, seeds, chips, etc.) until the sockets are closed. Nutrition is important for you healing. Make sure that you are eating a balanced diet and drinking enough water. If you take nourishment regularly, you will feel better, gain strength, have less discomfort, and heal faster.
A gentle rinse with warm salt water should be started 24 hours after the surgery, as this helps keep the area clean. Use one-half teaspoon of salt in a cup of water. Do not forcefully spit it out when finished, allow it to gently flow out of your mouth.
You should never smoke, use a straw, drink carbonated beverages, or spit after a surgical tooth extraction. These actions can pull the blood clot out of the hole where the tooth was and cause a painful condition known as dry socket.
What is dry socket?
A problem known as dry socket develops in about 3% to 4% of all tooth extractions. This occurs when a blood clot doesn’t form in the socket or the blood clot breaks down too early. This condition is painful because of the exposed underlying bone and nerves that the blood clot should be covering.