There are a number of reasons that your dentist might recommend a tooth extraction. Some dental patients suffer from tooth decay; others need to remove teeth hindering orthodontic treatment, whereas various patients simply need wisdom teeth removal.

Simple Tooth Extraction

If a tooth hasn’t been broken off too much to be visible in the mouth, a simple extraction will suffice. This procedure requires only local anesthetic, as well as anti-anxiety drugs depending on the patient.

The procedure is fairly quick, as the dentist will merely grip and loosen your tooth with forceps before pulling it out. Sometimes it is necessary to insert a dental elevator between the tooth and gum to assist in loosening the tooth.

After your tooth extraction, you will need to follow some steps for a quick recovery. Take the pain medication prescribed by your dentist exactly as directed and avoid eating solid foods for several hours afterward. Avoid chewing on that side of your mouth for a full day, because getting food in the extraction site can cause complications like dry socket. Rinsing your mouth with salt water and using warm compresses on your jaw will help keep your mouth healthy and control pain.

Surgical Tooth Extraction

In cases where the tooth cannot be seen in the mouth due to breakage or simply not coming in yet (as is the case with many people’s  wisdom teeth), your dentist will have to perform a surgical tooth extraction. The procedure may involve local or general anesthesia depending on the particulars of your case.

In order to access the remaining tooth, the dentist will cut and pull back the gums. In some cases the tooth will have to be cut into pieces to be removed.

After a surgical tooth extraction, it’s very important to follow aftercare instructions in order to reduce your risk of complications. Proper care after a surgical tooth extraction includes changing your gauze pads often, avoiding smoking or eating hard foods, keeping your mouth clean by washing with salt water, and relaxing. It’s important to take it easy and remember to keep your head elevated to reduce bleeding.

While a tooth extraction can be a serious dental procedure, aftercare is just as critical as the procedure itself. As the dental patient, it is important to understand that pain and the risk of infection can be lessened with proper care.

Care immediately following surgery:

• Keep pressure on the gauze pad that your doctor placed over the surgical area by gently biting down. Dampen the gauze sponge with water if it begins to dry out. Try to maintain constant pressure in intervals of 45-60 minutes, repeating as often as needed, or until bleeding lessens.  Change the gauze as needed. 
• Keep your head elevated and try to lower your activity level as much as possible.
• 48 hours after surgery, rinse mouth with warm salt water every 1-2 hours. Avoid using any mouthwash containing alcohol as it can irritate the wound.
• Keep your mouth clean by brushing areas around the surgical site, but be sure to avoid sutures. Touching the wounded area in any fashion should be prevented.
• Use ice packs to control swelling by placing them on facial areas near extraction.
• Take all prescribed medications accordingly. If any itching or swelling occurs, contact the practice immediately, or go to the nearest emergency room.
• Try to eat softer foods, preferably high in protein.
• Keep your body hydrated by drinking plenty of fluids, but do not drink through a straw for the next 5-7 days.
• If you are a regular tobacco user refrain from smoking for the next 3-4 days as smoking increases your chances of getting a dry socket as well as an infection.

After your tooth has been extracted, healing will take some time. Within 3 to 14 days, your sutures should fall out or dissolve. For sutures that are non-resorbable, your doctor will schedule a follow-up appointment to remove the stitches for you. Your tooth’s empty socket will gradually fill in with bone over time and smooth over with adjacent tissues.

Possible complications after a tooth extraction

Bleeding – Bleeding after a tooth extraction is entirely normal. A pinkish tinted saliva and subtle oozing is fairly common during the first 36 hours. If bleeding gets excessive, control it by using dampened gauze pads and biting down to keep pressure on the area. As an alternative to gauze pads, a moistened tea bag can be used, as the tannic acid helps blood vessels contract. Apply pressure to the gauze or tea bag by gently biting down for 30 minutes. Please remember that raised tempers, sitting upright, and exercise can all increase blood flow to the head, which can cause excess bleeding. Try to avoid these as much as possible. If your bleeding does not reduce after 48 hours, please call the practice.

Bone sequestra (dead tooth fragments) – Some patients have small sharp tooth fragments that were unable to be completely removed during surgery. During the recovery period, these dead bone fragments, or bone sequestra, slowly work themselves through the gums as a natural healing process. This can be a little painful until the sequestra are removed so please call our practice immediately if you notice any sharp fragments poking through the surgery site.

Dry socket – In the days that follow your tooth extraction, pain should gradually subside. Rarely, patients report that pain increases to a throbbing unbearable pain that shoots up towards the ear. Often this is a case of dry socket. Dry socket occurs when the blood clot becomes irritated and ousted before healing is complete. Food and debris can then get into the socket causing irritation. Tobacco users and women taking oral contraceptives are at a higher risk of getting dry socket. Dry socket is not an infection but does require a visit to our office. If you think you may be suffering from dry socket, please contact the practice immediately.

Lightheadedness - Because you may have been fasting prior to surgery, your blood sugar levels may be lower than normal. Until your body has had the chance to catch up and process some sugars, you should remember to stand up slowly when getting up from a relaxed position. For somewhat immediate relief, try eating something soft and sugary, stay in a relaxed position, and reduce the elevation of your head.

Numbness – Many patients report still feeling numb hours after their tooth extraction procedure. An extended lack of feeling around the mouth is normal and can last 10-12 hours after surgery.

Swelling – Swelling should subside almost entirely within 10 days after surgery. Immediately following your tooth extraction, apply an ice pack to the facial areas near the extraction. Continue using the ice in 15 minute intervals for the first 36 hours. After 36 hours, ice will no longer be beneficial in reducing swelling and moist heat should be used instead. To decrease swelling, apply a warm damp cloth to the sides of your face.

Trismus (difficulty opening and closing mouth) – If you experience a sore jaw and difficulty chewing or swallowing, do not be alarmed. Occasionally patients’ chewing muscles and jaw joints remain sore 3-5 days after surgery. This soreness can also make it difficult to open and close your mouth. Soreness should eventually subside.

If you have any worries, or are experiencing any complications not mentioned, please contact our practice immediately so that we may address your concerns.