Tooth Extractions
Tooth extraction is also known as exodontia or exodontics. It is the removal of a tooth from the dental alveolus (socket) in the alveolar bone.
- A crowded mouth – Sometimes dentists extract a tooth for orthodontic reasons and often this is before treatment with braces or Invisalign. Sometimes if the tooth is impacted and stuck within the bone, your dentist may recommend extracting it to mitigate future problems that could develop.
- Infection – If decay extends deep into the pulp of the tooth making it non-restorable, you may be recommended for an extraction. In other cases, the infection could be on the external surface of the tooth affecting the supporting gum and bony structures to the point when an extraction is the only viable treatment.
- Vulnerable teeth before Chemotherapy – Some forms of medical treatments like chemotherapy for cancer can suppress the body’s immune system. In instances like this, the extraction of a tooth that is likely to cause acute or chronic infection might outweigh the risk of keeping and managing the tooth.
- If baby teeth don’t fall out (exfoliate) in a timely manner to allow for the permanent teeth to grow in, the delay in removal may cause mal-alignment.
- Wisdom teeth – Also known as third molars may be extracted for hygiene or orthodontic reasons.
A local anesthesia given chairside will be given to numb the area around your teeth. If there is adequate anesthesia, you will feel pressure and not pain during the procedure. Then, the dentist uses an instrument called an elevator to loosen the tooth, then a forcep is used to grip and remove the tooth to be extracted.
Our sedation services are provided by a registered specialist anaesthetist. They will provide an intravenous agent which helps you feel calm and relaxed. In other circumstances, you may opt for a general anesthesia where you will be unconscious throughout the procedure. General Anaesthetics are always performed at one of the day surgery centres where our dentists and surgeons are accredited and also always with the services of a specialist anaesthetist.
During your consultation, an X-ray of your tooth will be taken. For more complex cases a digital 3D CT scan to visualize the anatomy in 3D may be required. Your dentist will ask but you should always update your dentist about any medications that you are on, including your vitamins, supplements and over-the-counter drugs.
You should also tell your dentist if you have any of the following conditions:
- A congenital heart defect
- Diabetes
- Liver disease
- Thyroid disease
- Renal disease
- Hypertension
- An artificial joint
- Damaged heart valves
- Adrenal disease
- An impaired immune system
- A history of bacterial endocarditis
Not only that, it is rather helpful to you to keep the following pointers in mind for the day of the procedure to ensure quality treatment:
- If you will be receiving an intravenous IV anesthesia, wear a short-sleeved shirt or loose-fitted clothing
- Do not eat for six to eight hours before your appointment
- Do not smoke before your procedure
- Inform your dentist if you have a cold or have any respiratory issues
- Inform your dentist if you had nausea or vomiting the night before
- If you are receiving sedation or general anesthesia, please arrange to have someone drive you back home and monitor your post operatory home care.
For a healthy person there are few risks of getting your tooth extracted, and if your dentist recommends the procedure, the benefits of it will likely be higher than the risk of complications.
It is normal after a tooth extraction for a blood clot to form in the socket, which is the hole in the bone where the tooth has been extracted. This clot will eventually be replaced by gum and remodelled bone over time.
There are some things to monitor for after the procedure and you should report this to your dentist if any of it occurs:
- Cough
- Nausea or vomiting
- Chest pain and shortness of breath
- Significant bleeding that lasts longer than a couple of hours
- Swelling and redness at the surgical site
- Severe fever and chills, possibly indicating an infection
Your dentist may give you painkillers before the effects of anaesthesia start wearing off. Most patients usually experience the most discomfort on the day of the extraction, after which the pain usually tapers off over the next day or two. You should be able to resume your daily activities by the 2nd or 3rd day, if there are no signs of swelling and bleeding. More complicated surgery might take 5 to 7 days before discomfort abates.
Once you are done with your extraction, your dentist will send you home to recover. It may take a few days to recover and when you follow these guidelines you will be able to minimise discomfort, recover much faster and reduce the risk of infection.
- Take your prescribed painkillers as and when required.
- After the dentist places the gauze pad over the affected area, bite down to reduce the bleeding and to aid in clot formation. Leave the gauze there for about 10 minutes
- Apply a cool damp towel to the external areas near the surgery. A cool towel against the cheek helps reduce the swelling. Minimise any unnecessary jaw movements.
- Take the next day off and relax at home. Do not engage in strenuous activities for at least 24 hours (like heavy lifting and exercise)
- Avoid rinsing or spitting forcefully for the next 24 hours after the extraction to avoid dislodging the blood clot
- After 4 hours, you can rinse your mouth with a mixture of 1/2 teaspoon of salt, and half a cup of warm water or any other prescribed mouth rinse
- Avoid using a straw to drink for the first 24 hours
- Avoid smoking as the particulates inhibit healing and increases your chances of a postoperative infection
- Consume soft food like soup, yogurt, pudding. Gradually add solid food to your diet over the course of the next few days
- When you’re laying in bed, prop your head with pillows and lay a towel over your pillow incase you drool blood in your saliva
- Continue brushing and flossing your teeth, along with brushing your tongue. Gently brush the teeth adjacent to the extraction site. The cleaner the site is, the faster it will heal.
