what is dental extraction

Extraction

What is it?

A tooth which is very decayed or damaged, or loose because of gum disease, may have to be extracted (taken out of your mouth).

Wisdom teeth sometimes have to be extracted if they have come through at an awkward angle and are causing problems (such as decay in adjacent teeth or, being difficult to clean, causing infections).

Teeth are sometimes taken out from children’s mouths to help other teeth which are crowded to grow straight, usually on the advice of an orthodontist.

What will my dentist do?

Some teeth are easier to take out than others. 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, for children or nervous patients, or where a tooth might prove difficult to remove, sedation (something to make you relaxed) with a local anaesthetic may be used. 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).

After working out the best way to take the tooth out, your dentist will discuss with you:

• how to minimise what you feel while the extraction is happening

• whether you should bring someone with you if you are to have sedation or a general anaesthetic

• when it would be convenient for you to have the tooth removed

• you might also discuss other treatment you might need – for example, whether you may require a denture

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…

You may need a day or so off work to recover, depending on how difficult the extraction was and whether sedation or a general anaesthetic was used. Most people experience very little post-operation discomfort. The dentist will ensure that bleeding has stopped before you leave the practice. You should not smoke or drink for at least 24 hours after an extraction.

The dentist will give you advice on:

• how to look after the space where the tooth was while it is healing

• which painkillers are suitable to use so you are not in any discomfort when the anaesthetic wears off

• how to contact the practice if there are any problems

What to do after an extraction

You need to look after yourself carefully after you have had a tooth taken out, as with any operation, to speed up healing and prevent infection. This advice is to help you know what to expect and do, as your mouth recovers.

General Advice:

  • For the first 24 hours, don’t drink alcohol, eat hot food or disturb the clot, which will have formed in the space left by the tooth, because this may cause the socket to start bleeding again. Don’t smoke either, and avoid strenuous exercise for the rest of the day.
  • Don’t rinse your mouth for six hours after extraction.
  • After six hours, rinse gently with warm salty water to keep the socket clean and continue to do this for up to a week after meals and before bed. Use half a teaspoonful of salt in a glass or comfortable warm water.
  • Brush your teeth normally with toothpaste to keep the whole mouth clean but take care in the region where the tooth was extracted.
  • If you feel small pieces of bone working their way out of the socket, don’t worry – this is normal.
  • Some swelling or discomfort in the first few days is also normal.
  • Take painkillers if you need the. Ask your dentist for advice if you are not sure of what sort to take.

If the bleeding doesn’t stop:

  • Your dentist may have given you a small supply of gauze in case this happens. If not, clean cotton handkerchiefs will do, but not tissue papers. It is the effect of pressure from the gauze or handkerchief that prevents bleeding, this is why a tissue will not work.
  • Roll some small firm pads about on centimetre by three centimetres – a size that will fit over a socket.
  • Keep sitting up and gently clear away any clots of blood around the socket with the gauze of handkerchief.
  • Place a pad across the socket from the tongue side to the cheek and bite firmly on it for 10-15mins.
  • Take off the pad and heck whether the bleeding has stopped. If it hasn’t, use a fresh pad. If the socket is still bleeding, contact your dentist.

Occasionally after extraction of a tooth, the blood clot in the socket can break down, leaving a painful empty hole in the gum. This is called ‘dry socket’. If the socket becomes painful a few days after the extraction, this is usually the reason. If this happens, you should go back to your dentist to have the wound cleaned and packed with a dressing.; This will relieve the pain and reduce the risk of infection.

If you follow these instructions, your mouth should heal normally without becoming infected. But if anything in your mouth worries you, phone the practice for advice.