If you have been advised a tooth extraction, it may be a daunting and nerve-wracking experience. But, do you know that extraction is a relatively standard dental procedure performed all over the world?
Let’s face the fear together. Here, we discuss extraction in detail to help you prepare for your upcoming procedure.
Extraction is the process of removal of your tooth from its socket in the jaw bone. If you need an extraction, the exact procedure which might be required will depend on various factors.
These factors include the tooth condition and its location in your mouth. The majority of extractions are ‘routine’ which effectively means that extraction is fairly straightforward and no complications are anticipated. Teeth that are harder to remove will require ‘surgical’ extraction procedures.
What to Expect During Tooth Extraction
Tooth extraction is performed by dentists and Endodontics (dentists with special training to perform surgery). Normally, the extraction procedure is usually safe, the procedure can allow harmful bacteria into the bloodstream. There is also a risk of contracting a gum tissue infection.
You must share your medical history and medications with your dentist, especially if you have a history of bacterial endocarditis, damaged or man-made heart valves, liver disease, artificial joints, such as a hip replacement, impaired immune system or a congenital heart defect.
Before proceeding with extraction (caused due to tooth decay), the dentist will numb the area where the tooth removal will take place by giving local anesthesia.
The dentist may have to cut away the gum and bone tissue covering the tooth and grasp the tooth using forceps and gently rock it back and forth to loosen it from the jaw bone and the ligaments.
If it is a hard-to-pull tooth, then it may have to be removed in pieces. Post extraction, blood clotting takes place in the socket and the dentist will pack a gauze pad in the socket.
Dentists may place some self-dissolving stitches to close the edges of gum over the extracted area.
In a few cases, the bone in the socket is exposed if the clot in the socket breaks.
In such a scenario, a sedative dressing is placed over the socket for a few days to protect it as new clot formation takes place.
Tooth Extraction Procedure
There are two kinds of extraction procedures namely, routine or simple extractions and another is surgical.
a. Simple or Routine Tooth Extraction Procedure
The majority of extractions are routine. This effectively means that the procedure is fairly straightforward, and there’s no anticipation of any problems. Your routine extraction can be carried out by any general dentist.
Before extracting your tooth, the dentist will take an X-ray of your tooth and the entire jaw.
If there is a severely spread infection in the area, then an antibiotic may be required. In a routine extraction, the area around the tooth is numbed completely. Your extraction could also be a wisdom teeth extraction.
On confirmation with the patient, the tooth is loosened with an instrument, and simultaneously, the socket is widened. Then forceps are used slowly yet firmly to remove the tooth from the socket.
During the extraction procedure, you will usually feel pressure but will not experience any pain.
If you feel any sharp or pinching pain, inform the dentist immediately.
On completion of extraction, the dentist will verify and ensure that the socket is clean and place a gauze on the socket to stop any bleeding.
The dentist will ensure that bleeding has stopped and given you instructions on aftercare.
b. Surgical Tooth Extraction Procedure
A surgical extraction is a complex procedure for extracting a tooth that may have broken off at the gum line or has not come into the mouth yet. Your oral surgeon will perform a surgical procedure.
However, general dentists can perform them as well. During a surgical extraction, the doctor will make a small incision into your gum and remove the underlying tooth.
Post extraction, stitches or additional procedures may be necessary to control the bleeding.
The dentist or surgeon will place a thick layer of gauze over the extraction site and have the person bite on it to absorb the blood and start the clotting process.
A surgical extraction becomes absolutely necessary with teeth that are more difficult to remove. Few examples below:
- It is very little or no tooth substance remaining above the gum. If the tooth hides beneath the gum tissue or bone, the surgeon may need to cut away the gum or remove the obstructing area of the bone.
- There exist very large roots or roots having a curve under the gum.
- The tooth is impacted, or it has not yet erupted, such as a wisdom tooth. The procedure of surgical extraction is more complex as compared to that of routine extraction procedure and may involve:
- Cutting of the gum to enable access to the tooth.
- Removal of some of the bone that holds it in place.
- Cutting the tooth into pieces and removing the pieces separately.
Tooth Extraction Aftercare
How to manage pain after your extraction? You will most likely feel some soreness, discomfort, or pain after your extraction. It is quite normal and your face might also have some swelling.
You should take the painkillers prescribed by your doctor as they will help reduce these symptoms. Your dentist might also recommend a number of over-the-counter medications. If your discomfort doesn’t subside in a couple of days after the extraction, you need to contact your dentist.
If your pain suddenly worsens a few days after your extraction, you should call your dentist immediately so that they can help to prevent infection in the area.
Discussed below are ways to help reduce discomfort and promote healing after your extraction.
a) Changing Dental Gauzes
Immediately after an extraction, your dentist will lay a thick layer of gauze over your gum from where the extraction has happened.
If you bite down on the gauze with firm pressure, it will help control bleeding. Leave the gauze in place for at least 20 to 30 minutes. You then need to replace the gauze whenever it becomes soaked with blood.
You can expect the bleeding to continue for 1 to 2 days after the surgery.
b) Controlling Pain
The numbness caused due to the local anesthetic -which should only last for a few hours following your extraction. In case the numbness persists, seek your doctor’s advice.
Your dentist would have prescribed medication to alleviate pain and inflammation after the procedure.
The over-the-counter medications like ibuprofen and acetaminophen should be enough to control your pain after a routine extraction.
c) Controlling Swelling
Following your extraction, you might experience mild facial swelling in the area of the extraction.
There is nothing to worry about. You can apply an ice pack to the face as it will help alleviate the swelling.
d) Avoiding disturbing the extraction site
You should remember that the first 24 hours after extraction are very crucial. A dry socket could sometimes happen after an extraction, which is a painful condition.
Irritating or disturbing the area can prevent blood clots from forming effectively and can slow down the healing process.
You should therefore avoid the following activities:
- touching the extraction area with your tongue
- sucking on your extraction site
- using a straw could disturb the site
- eating solid, crisp and crunchy food
- avoid rinsing the mouth vigorously
- using mouthwash that contains alcohol or drinking alcoholic beverages
- avoid smoking
e) Eating Carefully
After your extraction, drink plenty of fluids and eat soft, easy to chew food.
When chewing becomes comfortable again, try to reintroduce solid foods slowly. Your dentist will recommend chewing on the side opposite to the extraction site until the wound has fully healed.
f) Brushing and Flossing
You should continue to brush and floss as usual after your extraction, but be careful not to disturb the blood clotting.
After the day of the surgery, you can start rinsing your mouth every few hours with warm saltwater. You can prepare this by adding a teaspoon of salt to one cup of water.
After a healing period of one to two weeks, you will most likely be able to return back to your regular diet. New gum tissue and bone will grow in the extraction site, and the wound will slowly heal. You can do several things to help speed up the recovery.
Ultimately, it is crucial to avoid disturbing or irritating the extraction site for a few days.
However, having a missing tooth can cause your other teeth to shift and can also affect your bite.
You can ask your doctor about replacing the extracted tooth to prevent this from happening. Because your dentist is right to suggest the best procedure. Options could be – an implant, denture or fixed bridge.
It’s also important to get regular dental examinations and checkups to save your teeth from reaching a severe condition.
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