You and the doctors may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed. Others may have advanced periodontal disease or are broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth) or in preparation for orthodontic treatment. More recently, teeth are removed after failing endodontic therapy (root canals) that has made the outcome of keeping the tooth unpredictable.
The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.
To avoid these complications, we will discuss alternatives to extractions as well replacement of the extracted tooth.
The Extraction Process
At the time of extraction the doctor will need to numb your tooth, jawbone, and gums that surround the area with a local anesthetic.
During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal. You feel the pressure without pain because the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.
If you do feel pain at any time during the extraction, please let us know right away.
Sectioning A Tooth
Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.
Some bleeding may occur. Placing a piece of moist gauze over the empty tooth socket and biting down firmly for about one hour after the extraction can control this.
Blood Clots That Form In the Empty Socket
This is an important part of the healing process and you must be careful not to dislodge the clot.
- Avoid rinsing or spitting for 24 hours after the extraction.
- Avoid use of a straw, smoking, or drinking hot liquids and carbonated beverages.
To keep the swelling to a minimum, you can place ice on your extraction side for ten minutes and then off for ten minutes. Usually on the post op instructions we give you will be the time that you should be doing this. You can repeat this cycle as you feel necessary for up to 24 hours.
Pain & Medications
If you experience pain, you might use non-prescription pain relief medications such as acetaminophen or ibuprofen. If we feel it was a particularly difficult extraction, we will prescribe a medication like Tylenol with Codeine or Vicodin for pain relief.
For most extractions, make sure you do your chewing away from the extraction site. Stay away from hot liquids and alcoholic beverages for 24 hours. A liquid diet may be recommended for 24 hours. Do not use carbonated drinks for a few days after the extraction because it will destroy the clot that is forming.
Brushing & Cleaning
After the extraction, avoid brushing the teeth near the extraction site for one day. After that you can resume gentle cleaning. Avoid commercial mouth rinses, as they tend to irritate the extraction site. Beginning 24 hours after the extraction, you can rinse lightly with salt water (one teaspoon salt in a cup of warm water) after meals and before bed.
A dry socket is when a blood clot fails to form in the socket where the tooth has been extracted or the clot has been dislodged and the healing is significantly delayed. About 10% of all extractions of back teeth can get a dry socket.
Following the postoperative extraction instructions will reduce the chances of developing a dry socket. Dry sockets manifest themselves as a dull throbbing pain that usually doesn’t appear until three to four days after the extraction. The pain can be moderate to severe and radiate from the extraction area. Dry socket may cause a bad taste or bad breath and the extraction site appears to have a dry hole where the tooth was.
Please call our office and we will see you immediately and apply a medicated dressing to the dry socket to soothe the pain and help with the healing. It is imperative to tell us that you are experiencing a problem with the socket healing.
After a tooth has been extracted there will be a resulting hole in your jawbone where the tooth was. In time, this will smooth and fill in with bone. This process can take 3-4 months to have the bone regenerate in the socket site. However after 1- 2 weeks you should no longer notice any inconvenience.
If we have to take a tooth out and we are considering placing an implant in that location, we might be telling you that we need to “graft” the site to increase the potential of bone growth. As we have mentioned before, we need a large amount of healed bone before we can place an implant. Many times when a tooth needs to come out, the bone that is left will not heal to the volume that we need and we will then place a bone material in the socket. Grafting materials are numerous and we will decide at the time of placement which would be the best in your case. Please ask us more about grafting socket sites at your consultation visit.