Tooth Extraction

You may need a tooth extraction for a variety of reasons, such as unrepairable tooth decay or damage from periodontal disease. Sometimes, if a tooth is broken and cannot be successfully reconstructed, or if a tooth is poorly aligned, it may need to be pulled out. The latter situation is frequently observed with wisdom teeth that positioned in ways that would not allow other teeth to function properly.

Tooth extraction should be done only if no alternative exists as it presents new challenges. For example, a single tooth removal can result in a compromised ability to chew, shifting teeth, or jaw issues. These risk factors are important to consider with regards to your overall dental health. If teeth are extracted, they need to be replaced, with the exception of wisdom teeth, which are removed to allow for normal function of the other teeth in the first place.

What Does the Extraction Procedure Involve?

To prevent pain and minimize discomfort during the tooth extraction, your dentist will anesthetize your jaw, your gum locally (around the affected tooth), and the tooth that needs extraction. As a result, you will only feel pressure once the process starts. The feeling of pressure comes from the dentist rocking the tooth back, forth and sideways to expand the gum socket and facilitate tooth removal.

Sometimes, for example when a wisdom tooth is too wide and too short to be adequately loosened in the socket, or if the root is too curved, your dentist may have to cut the tooth into pieces (also known as sectioning), in order to remove it in smaller segments one at a time. Thanks to the action of the local anesthetic, all you will feel while your dentist is working is a great deal of pressure.

The way the anesthetizing agent works is by numbing the nerve endings that directly connect to the tissues around the problematic tooth as well as the nerve in that tooth itself. That way, the transmission of pain is interrupted while the medication lasts and your nerves are still preserved.

Some people are less affected by anesthesia than others, meaning they may have more pain. If you happen to be one of those rare individuals, please let your dentist know prior to the procedure, as well as at any time you experience pain during the procedure.

Care in the Home after Tooth Extraction

There are several things to keep in mind with regards to mouth care after a tooth extraction:

  • Healing of the extraction site — once your tooth has been removed, the remaining hole will gradually fill with bone. After one or two weeks you will feel less discomfort. In some cases, this process could take weeks to months, depending on what other health conditions are present.
  • Pain — it is not uncommon to experience pain at the extraction site for several days after the procedure. Pain can be relieved with over-the-counter analgesic medications such as ibuprofen or acetaminophen. Make sure you take the ibuprofen with food and hydrate really well.
  • Swelling — ice provides excellent relief if applied to the affected side of your face for about 10 minutes and then off for 20 minutes. Repeat the cycle as many times as able for the next day or two while awake.
  • Bleeding — in case of bleeding at the extraction site, it is helpful to apply a piece of moist cold gauze over the bleeding tooth socket and bite down firmly for 30-45 minutes. The cold moist gauze will contract the blood vessels, causing the bleeding to stop.
  • Blood clots in the empty socket — blood clotting is a vital part in the closure of any wound. In order not to disrupt the healing process, do your best to avoid dislodging the clot. Do not rinse, spit smoke, drink hot liquids, or use a straw for at least 24 hours after your tooth has been removed.
  • Dry socket — any time a tooth is extracted, there is a small risk that the socket (the empty place where the tooth used to be) may not form a blood clot as expected, or that the clot may simply get dislodged. Clotting is an essential part of the wound healing, and the recovery process after a tooth extraction is no exception. Once the clot is compromised, healing is delayed. To prevent a dry socket, please follow the post-extraction care instructions given to you by your dentist. Throbbing, moderate to severe (possibly radiating) pain that starts 3-4 days after the procedure, as well as bad taste or breath are all manifestations of a dry socket. Contact your dentist immediately to get a time for a medicated dressing application to help with the pain
  • Food — when you eat after a tooth extraction has taken place, avoid hot and alcoholic beverages for at least 24 hours. Your dentist may suggest a liquid diet for the first 24 hours. If you are not on a liquid diet, chew all the food on the non-affected side of your mouth.
  • Oral Hygiene — for the first 24 hours after a tooth extraction, avoid brushing near the site. Do not use commercial mouth rinses. These can be quite irritating to your extraction site. Half teaspoon of salt in an 8-ounce cup of water is the recommended rinse solution after the first 24 hours. You need to rinse after meals and at bedtime. Start gentle cleaning, too.
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