Dental Extraction

A dental extraction procedure refers to a routine tooth extraction performed by your dentist. The procedure depends on where and how the tooth is positioned. The procedure can be very quick, sometimes lasting only seconds. Reasons for dental extraction include:

  • Tooth decay.

  • Infections (abcesses).

  • The need to make room for other teeth.

  • Gum disease s where the supporting bone has been destroyed.

  • Fractures of the tooth leaving it unrestorable.

  • Extra teeth (supernumerary) or grossly malformed teeth.

  • Baby teeth that have not fallen out in time and have not permitted the the permanent teeth to erupt properly.

  • In preparation for braces where there is not enough room to align the teeth properly.

  • Not enough room for wisdom teeth (particularly those that are impacted).

  • Prior to receiving radiation to the head and neck, teeth in the field of radiation may need to be extracted.

LET YOUR CAREGIVER KNOW ABOUT:

  • Any allergies.

  • All medicines you are taking:

  • Including herbs, eye drops, over-the-counter medications, and creams.

  • Blood thinners (anticoagulants), aspirin or other drugs that may affect blood clotting.

  • Use of steroids (through mouth or as creams).

  • Previous problems with anesthetics, including local anesthetics.

  • History of bleeding or blood problems.

  • Previous surgery.

  • Possibility of pregnancy if this applies.

  • Smoking history.

  • Any health problems.

RISKS AND COMPLICATIONS

As with any procedure, complications may occur, but they can usually be managed by your caregiver. General surgical complications may include:

  • Reaction to anesthesia.

  • Damage to surrounding teeth, nerves, tissues, or structures.

  • Infection.

  • Bleeding.

 With appropriate treatment and care after surgery, the following complications are very uncommon:

  • Dry socket (blood clot does not form or stay in place over empty socket). This can delay healing.

  • Incomplete extraction of roots.

  • Jawbone injury, pain, or weakness.

BEFORE THE PROCEDURE

  •  Your dental care provider will:

  • Take a medical and dental history.

  • Take an X-ray to evaluate the circumstances and how to best extract the tooth.

  • Do an oral exam.

  • Depending on the situation, antibiotics may be given before or after the extraction, or before and after.

  • Your caregivers may review the procedure, the local anaesthesia and/or sedation being used, and what to expect after the procedure with you.

  • If needed, your dentist may give you a form of sedation, either by medicine you swallow, gas, or intravenously (IV). This will help to relieve anxiety. Complicated extractions may require the use of general anaesthesia.

 It is important to follow your caregiver's instructions prior to your procedure to avoid complications. Steps before your procedure may include:

  • Alert your caregiver if you feel ill (sore throat, fever, upset stomach, etc.) in the days leading up to your procedure.

  • Stop taking certain medications for several days prior to your procedure such as blood thinners.

  • Take certain medications, such as antibiotics.

  • Avoid eating and drinking for several hours before the procedure. This will help you to avoid complications from the sedation or anaesthesia.

  • Sign a patient consent form.

  • Have a friend or family member drive you to the dentist and drive you home after the procedure.

  • Wear comfortable, loose clothing. Limit makeup and jewelry.

  • Quit smoking. If you are a smoker, this will raise the chances of a healing problem after your procedure. If you are thinking about quitting, talk to your surgeon about how long before the operation you should stop smoking. You may also get help from your primary caregiver.

PROCEDURE

Dental extraction is typically done as an outpatient procedure. IV sedation, local anesthesia, or both may be used. It will keep you comfortable and free of pain during the procedure.

There are 2 types of extractions:

  • Simple extraction involves a tooth that is visible in the mouth and above the gum line. After local anesthetic is given by injection, and the area is numbed, the dentist will loosen the tooth with a special instrument (elevator). Then another instrument (forceps) will be used to grasp the tooth and remove it from its socket. During the procedure you will feel some pressure, but you should not feel pain. If you do feel pain, tell your dentist. The open socket will be cleaned. Dressings (gauze) will be placed in the socket to reduce bleeding.

  • Surgical extractions are used if the tooth has not come into the mouth or the tooth is broken off below the gum line. The dentist will make a cut (incision) in the gum and may have to remove some of the bone around the tooth to aid in the removal of the tooth. After removal, stitches (sutures) may be required to close area to help in healing and control bleeding. For some surgical extractions, you may need a general anesthetic or IV sedation (through the vein).

After both types of extractions, you may be given pain medication or other drugs to help healing. Other post operative instructions will be given by your dental caregiver. 

AFTER THE PROCEDURE

  • You will have gauze in your mouth where the tooth was removed. Gentle pressure on the gauze for up to 1 hour will help to control bleeding.

  • A blood clot will begin to form over the open socket. This is normal. Do not touch the area or rinse it.

  • Your pain will be controlled with medication and self-care.

  • You will be given detailed instructions for care after surgery.

PROGNOSIS

While some discomfort is normal after tooth extraction, most patients recover fully in just a few days.

SEEK IMMEDIATE DENTAL CARE

  • You have uncontrolled bleeding, marked swelling, or severe pain.

  • You develop a fever, difficulty swallowing, or other severe symptoms.

  • You have questions or concerns.