There are times when patients may need to have a natural, permanent tooth extracted. Patients may have a large area of decay, breakage that cannot be repaired or may have experienced periodontal disease that leaves the tooth loose and susceptible to removal. Some patients have teeth removed in preparation for orthodontic treatment or because of poor positioning such as impaction.
It is important to understand that the removal of a single tooth can have a major impact on your overall dental health and can result in shifting teeth, jaw joint issues and reduced chewing efficiency. To avoid these complications, dentists will discuss with patients alternatives to extractions (such as root canal therapy) or ways to replace the teeth following removal (bridges, dentures, and dental implants).
The process of extraction
When teeth are extracted, the dentist numbs the area with local anesthetics. This may include the jawbone, gums, and the tooth itself. Patients experience firm pressure while the tooth is rocked back and forth to widen the socket. There is no transference of pain during the extraction—if you experience discomfort, let the dentist know right away.
Sectioning of the tooth
There are times when teeth require sectioning. This is common and is done when the tooth has a firm anchor in the socket or the root is curved making it more difficult to remove in a more traditional sense. The dentist cuts the tooth structure into sections and removes the sections one at a time.
* Bleeding – patients are expected to deal with some bleeding. Following the extraction, the empty tooth socket should be covered with a moist gauze, patients should bite down firmly to control. Blood clotting is expected and necessary in the empty socket for proper healing. Do not dislodge the blood clot. Avoid using straws, hot liquids, and smoking within the first 24 hours, avoid spitting and rinsing.
* Swelling – swelling can occur following tooth extraction. Patients can use ice on the face for 10 minutes on, 20 minutes off. This cycle can be repeated over the first 24 hours.
* Pain medication – non-prescription pain relief medications (ibuprofen and acetaminophen) can be used if patients experience pain and discomfort.
* Eating – it is important to chew foods away from the extraction site following removal. Alcoholic beverages and hot liquids should be avoided for 24 hours, and some patients may find a liquid diet during the first day to be beneficial.
* Brushing and cleaning – avoid brushing the teeth surrounding the extraction site for 24 hours. Then resume gentle cleaning while avoiding commercial mouth rinses. These can irritate the extraction site. After 24 hours, patients can rinse with a salt water rinse (1/2 teaspoon of salt in a cup of water) following meals and before bedtime.
* Dry socket – when the blood clot fails to form, it can result into a dry socket. Healing is significantly delayed when this happens. Dry sockets appear as dull throbbing pain days after the extraction and pain can be moderate to severe. It can also result in a bad taste in the mouth and bad breath. Patients should contact their doctor if they are experiencing dry socket to sooth pain with a medicated dressing.
* Healing – once a tooth has been extracted, there will be a noticeable hole in the bone of the jaw where the tooth was once in place. Over several months, this will smooth out and the bone will regrow in the area. After 1-2 weeks, most patients no longer notice any inconvenience with the extraction site.