Everything you need to know about having a tooth removed.

If a tooth has been broken or damaged by dental decay and is beyond repair, your Dentist may recommend your tooth be extracted.

Apart from damage or dental decay, there are other common reasons you may need a tooth removed:

• Extra teeth that block other teeth
• Baby teeth that never fell out
• Placement of braces, to create room for moving teeth
• Radiation treatment to the head and neck
• Wisdom teeth (also called third molars or eights) are removed if they are decayed, infected, or if there is not enough room for them in your mouth

What Type of Tooth Removal Will You Need?

There Are Generally Two Types of Extractions:

• A simple extraction – This extraction removes an erupted tooth in one single piece. Once numb, your Dentist loosens the tooth with a dental instrument called an elevator, then uses a pair of dental forceps to remove the tooth.
• A surgical extraction – This is a more complex procedure, performed if your tooth is broken or not erupted. your Dentist will make a small incision in your gum to surgically remove your tooth. He will usually cut your tooth into smaller pieces, use an elevator to loosen the pieces, then use dental forceps to remove the pieces of tooth.

How to Prepare Yourself for a Tooth Removal:

Ensure you provide your full medical and dental history and a list of all the medicines you take. This should include prescription and over-the-counter medication, along with vitamins and supplements which may need to be stopped or reduced when having a tooth removed.

Your Dentist will take an X-ray of the area to plan the best way to remove your tooth. If you are having wisdom teeth or multiple teeth removed, they may recommend an OPG, a Dental CBCT. This X-ray captures all of your teeth at once and will show several things that help to guide your Dentist during your tooth removal, including:

• Where the roots are in relationship to your other teeth
• If an upper tooth, its relationship to your sinuses
• If a lower tooth, its relationship to your inferior alveolar nerve that gives feeling to your lower jaw, lower teeth, lower lip and chin.
• Any infections, tumours or bone disease

Your Dentist may prescribe antibiotics, to be taken before and after your tooth removal. This varies from patient to patient, but you are likely to need antibiotics if:

• You have infection at the time of your extraction
• You have a weakened immune system
• You have specific medical conditions

If you are worried or anxious about dental treatment, you may like to consider having your treatment completed under sedation also known as Sleep Dentistry. If so, your Dentist will prescribe medication for you to take before your appointment.

What to Expect During Your Tooth Removal:

During an extraction, you can expect to feel pressure, but no pain. If you feel any pain or pinching, tell your Dentist right away.

What to Expect After Your Tooth Removal:

After your extraction, you will need someone drive you home and stay with you if you have had sedation. You will be given post-surgery instructions, and it is very important that you follow these instructions to avoid any infection or complications.

After your tooth removal, you may need to bite on a piece of gauze for 20 or 30 minutes. This allows the blood in the socket where your tooth once was to clot. You may still bleed a small amount, but this should taper off over the following 24 hours. It is important you do not disturb the clot that forms on the socket.

Your Dentist will decide if you need stitches, and whether they be stitches that dissolve or stitches that need removing. Dissolving stitches will usually take one to two weeks; rinsing with warm salt water will help your stitches dissolve.

How to Manage Your Pain After Having a Tooth Removed:

Having a tooth removed is surgery and you can expect some discomfort, even after a simple extraction. Surgical extractions generally cause more pain after the procedure than simple extractions.

Ice packs on your face will help to reduce any swelling, 20 minutes on and 20 minutes off. If your jaw is still sore and stiff after any swelling goes down, you can try warm compresses.

Your Dentist may prescribe pain medication; however, most pain is gone after a couple of days. If you can take an anti-inflammatory drug, this can decrease the pain greatly. Take the first tablets before your local anesthesia wears off and continue taking them for about three days. Your Dentist will recommend the appropriate dose for you.

It is recommended that you eat soft and cool foods for a few days.

Twenty-four hours after your tooth removal, you may gently rinse your mouth with warm saltwater; this will keep the area clean and help the healing process. Healing will take at least two weeks.

After Your Tooth Extraction You Should Avoid:

• Smoking
• Using a straw
• Spitting

Smoking, using a straw and spitting causes an action in your mouth that can pull the blood clot from your socket, leading to complications. Smoking also reduces blood flow to the mouth which can slow healing.

What to Watch out for 3-5 Days After Your Tooth Removal:

The most common complication after a tooth removal is a dry socket. A dry socket occurs when the blood clot does not form in your tooth socket or it breaks down too early. This can be very painful and usually occurs during the first five days after your tooth removal. To ease the pain of a dry socket, your Dentist will rinse out the empty socket, remove any debris and apply a medicated dressing to protect the area. A dry socket should take seven to 10 days to heal.

Other Potential Problems Include:

• A small piece of tooth root remains in your jaw
• Soreness in the jaw muscles or in your jaw joint
• Long-lasting numbness in the lower lip and chin – although uncommon, this may be caused by injury to the inferior alveolar nerve in your lower jaw. Healing may take three to six months, however in rare cases may be permanent
• A hole in your sinus may occur when removing an upper back tooth. A small hole usually closes up by itself in a few weeks however, more surgery may be needed

Call Dr Peter Korpal If:

• Swelling gets worse instead of better
• You have fever, chills or redness
• You have trouble swallowing
• You have uncontrolled bleeding in the area
• The area continues to ooze or bleed after the first 24 hours
• Your tongue, chin or lip feels numb more than six to eight hours after
• The area becomes very painful – you may have a dry socket

To find out more read this article about Having a Tooth Removed.