Extracting teeth
What Is It?
Tooth extraction is the removal of a tooth from its socket in the bone.
Why should I extract my tooth?
If a tooth has been broken or damaged by decay, your dentist will try to fix it with a filling, crown or other treatment. Sometimes, though, there’s too much damage for the tooth to be repaired. In this case, the tooth needs to be extracted. A very loose tooth also will require extraction if it can’t be saved, even with bone replacement surgery (bone graft).
Here are other reasons:
- Some people have extra teeth that block other teeth from coming in.
- Sometimes baby teeth don’t fall out in time to allow the permanent teeth to come in.
- People getting braces may need teeth extracted to create room for the teeth that are being moved into place.
- People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted. People receiving cancer drugs may develop infected teeth because these drugs weaken the immune system. Infected teeth may need to be extracted.
- Some teeth may need to be extracted if they could become a source of infection after an organ transplant. People with organ transplants have a high risk of infection because they must take drugs that decrease or suppress the immune system.
- Wisdom teeth, also called third molars, are often extracted either before or after they come in.
Do I have to get my wisdom teeth extracted?
No, not all wisdom teeth have to be extracted. About 1 in 3 people need to have their wisdom teeth extracted so it’s not even the majority of people. Many people don’t actually have wisdom teeth.
Wisdom teeth need to be extracted when they’re:
- Not coming through on their own
- Impacted on other teeth
- Difficult or impossible to clean and maintain them
Why do we extract remaining roots even if it does not cause pain?
Remaining roots act as a source of infection. Also when the patient is willing to have any prothesis (implant, bridge or removable prothesis) they should be preferably extracted as well.
How is the extraction done?
There are two types of extractions:
- A simple extraction is performed on a tooth that can be seen in the mouth. General dentists commonly do simple extractions. In a simple extraction, the dentist loosens the tooth with an instrument called an elevator. Then the dentist uses an instrument called a forceps to remove the tooth.
- A surgical extraction is a more complex procedure. It is used if a tooth may have broken off at or below the gum line or has not come into the mouth yet. Surgical extractions commonly are done by oral surgeons. However, they are sometimes done by general dentists. The doctor makes a small incision (cut) into your gum. Sometimes it’s necessary to remove some of the bone around the tooth or to cut the tooth in half 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 after extraction?
Your doctor will give you detailed instructions on what to do and what to expect after your surgery. If you have any questions, make sure to ask them before you leave the office.
Click here for detailed postoperative instructions.
Having a tooth taken out is surgery. You can expect some discomfort after even simple extractions. Usually it is mild. Research has shown that taking nonsteroidal anti-inflammatory drugs (NSAIDs) can greatly decrease pain after a tooth extraction. Take the dose your doctor recommends and ask your doctor for complete instructions.
Surgical extractions generally cause more pain after the procedure than simple extractions. The level of discomfort and how long it lasts will depend on how difficult it was to remove the tooth. Your dentist may prescribe pain medicine for a few days and then suggest an NSAID. Most pain disappears after a couple of days.
Tips after extraction
After an extraction, you’ll be asked to bite on a piece of gauze for 20 to 30 minutes. This pressure will allow the blood to clot. You will still have a small amount of bleeding for the next 24 hours or so. It should taper off after that. Don’t disturb the clot that forms on the wound.
You can put ice packs during the first couple of hours on your face to reduce swelling. Typically, they are left on for 20 minutes at a time and removed for 20 minutes. If your jaw is sore and stiff after the swelling goes away, try warm compresses.
Eat soft and cool foods for a few days. Then try other food as you feel comfortable.
A gentle rinse with warm salt water, started 24 hours after the surgery, can help to keep the area clean. Use one-half teaspoon of salt in a cup of water. Most swelling and bleeding end within a day or two after the surgery. Initial healing takes at least two weeks.
If you need stitches, your doctor may use the kind that dissolve on their own. This usually takes one to two weeks. Rinsing with warm salt water will help the stitches to dissolve. Some stitches need to be removed by the dentist or surgeon.
You should not smoke, use a straw or spit after surgery. These actions can pull the blood clot out of the hole where the tooth was. Do not smoke on the day of surgery. Do not smoke for 72 hours after having a tooth extracted.
Risks
A problem called a dry socket develops in about 3% to 4% of all extractions. This occurs when a blood clot doesn’t form in the hole or the blood clot breaks off or breaks down too early.
In a dry socket, the underlying bone is exposed to air and food. This can be very painful and can cause a bad odor or taste. Typically dry sockets begin to cause pain the third day after surgery.
Dry socket occurs up to 30% of the time when impacted teeth are removed. It is also more likely after difficult extractions. Smokers and women who take birth control pills are more likely to have a dry socket. Smoking on the day of surgery further increases the risk. A dry socket needs to be treated with a medicated dressing to stop the pain and encourage the area to heal.
Infection can set in after an extraction. However, you probably won’t get an infection if you have a healthy immune system.
When To Call a Professional
Call your dentist or oral surgeon if:
- The swelling gets worse instead of better.
- You have fever, chills or redness
- You have trouble swallowing
- You have uncontrolled bleeding in the area
- The area continues to ooze or bleed after the first 24 hours
- Your tongue, chin or lip feels completely numb more than 6 hours after the procedure
- The extraction site becomes very painful — This may be a sign that you have developed a dry socket.
If you have an infection, your dentist usually will prescribe antibiotics.
Post Extraction Instructions
1.Bite on the sterile gauze for 30 mins.
2.Exchange the gauze with a new one and place it over the extraction site for another 30 mins
(If bleeding persists then place a wet tea bag inside a piece of sterile gauze and place it over the extraction site until bleeding stops.
A slight amount of blood oozing with saliva from the extraction site is normal, but if there is still severe thick bleeding after applying the tea bag for 45 mins then contact us or go to the nearest hospital.)
3.Place external cold packs during the first 2-3 hrs.
4.Drink ice-cold water during the first 2-3 hrs allowing the water to pass gently over the extraction site by tilting your head towards it.
5.Avoid during the first 24 hrs the following:
a) Hot food and beverages.
b) Vigorous mouth washing (even during washing-up for prayers – wudou).
c) spitting
d) smoking
e) Using a straw for drinking.
f) Blowing your nose hardly.
g) Sneezing with your mouth closed.
h) Brushing the teeth adjacent to the extraction site
i) Using mouthwashes containing alcohol.
j) Spicy food.
6.After 24 hrs of the extraction, it is preferable to use a warm glass of water with a half tea spoon of salt to gently mouthwash after each meal for the following 3 days.