An extraction means to have a tooth removed, usually because of disease, trauma or crowding.
If you need an extraction, your dentist will first numb the area to lessen any discomfort. After the extraction, your dentist will advise you of what post extraction regimen to follow. In most cases a small amount of bleeding is normal. Your mouth will slowly fill in the bone where the tooth root was through the formation of a blood clot.
Types of Dental Extraction:
There are two main types of dental extraction, simple extraction and surgical extraction. Simple dental extraction is used to remove teeth that can be seen and are easily accessible, whereas surgical dental extraction typically requires an incision into the connective tissue to gain access to the tooth to be removed. Both types of dental extraction are covered in more detail below.
Simple Dental Extraction:
Simple dental extraction involves the removal of teeth that are visible in the mouth. General dentists often carry out this procedure in their dental practices, using a local anesthetic to numb the area and reduce the pain experienced by the patient.
Instruments to elevate the affected tooth and grasp the visible portion are needed, such as an elevator and dental forceps. The elevator is used to loosen the tooth and the forceps to grasp the tooth for its extraction.
The tooth can then be moved back and forth until the periodontal ligament breaks enough to loosen the tooth from the alveolar bone so that it can be removed. This requires applying a controlled force on the tooth with steady pressure from the dental forceps.
Surgical Dental Extraction:
Surgical dental extraction involves the removal of teeth that are not easily accessible inside the mouth. This may be because they have not erupted through the gum completely or they have been fractured under the gum line.
In this case, it is necessary to make an incision into the connective tissue surrounding the tooth to gain access to it for extraction. For example, the soft tissues that cover the tooth may be elevated, or a drill or osteotome may be needed to remove some of the nearby jawbone during the extraction procedure.
In many cases of surgical dental extraction, the tooth may need to be fragmented into several pieces to allow it be removed.
Comparing Simple and Surgical Extraction:
Both types of dental extraction help to reduce the overall risk of complications, such as infection, pain, and inflammation. Other complications associated with both types of dental extraction include:
Osteitis or dry socket caused by premature loss of the blood clot that occurs following extraction.
Delayed healing may occur with medications such as bisphosphonates or corticosteroids, which should therefore be temporarily ceased before dental extraction to reduce the risk of complications.
Osteoradionecrosis or secondary bone death for patients who have a history or radiation treatment in the area of the head and neck.
What are the risks of a tooth extraction?
There are a few risks for undergoing a tooth extraction; however, if your dentist recommends the procedure, the benefits likely outweigh the small chance of complications.
Usually after a tooth extraction, a blood clot naturally forms in the socket — the hole in the bone where the tooth has been extracted. However, if the blood clot does not form or dislodges, the bone inside the socket can be exposed — referred to as “dry socket.” If this happens, the dentist will protect the area by putting a sedative dressing over it for a few days. During this time, a new clot will form.
Other risks include:
- Bleeding that lasts longer than 12 hours
- Severe fever and chills, signaling an infection
- Nausea or vomiting
- Cough
- Chest pain and shortness of breath
- Swelling and redness at the surgical site
Contact your dentist if you experience any of these symptoms.
What is the recovery period from a tooth extraction?
It normally takes a few days to recover after a tooth extraction. The following steps help ensure that your recovery goes smoothly.
Apply an ice pack to your cheek directly after the procedure to reduce swelling. Use the ice pack for 10 minutes each time.
After the dentist places the gauze pad over the affected area, bite down to reduce bleeding and to aid in clot formation. Leave the gauze on for three to four hours, or until the pad is soaked with blood.
Take any medications as prescribed, including over-the-counter painkillers.
Rest and relax for the first 24 hours at least.
Don’t use a straw for the first 24 hours.
Don’t smoke.
Don’t rinse for 24 hours after the tooth extraction, and spit only gently.
Use pillows to prop your head up when you lie down.
Brush and floss your teeth like normal, but avoid the extraction site.
The day after the procedure, eat soft foods, such as yogurt, pudding, and applesauce.
After 24 hours, add a half-teaspoon of salt to eight ounces of warm water to rinse out your mouth.
As you heal over the next few days, you can slowly reintroduce other foods into your diet.
If you are experiencing pain that isn’t going away after several days or signs of an infection —including fever, pain, and pus or drainage from the incision — make an appointment to see your dentist as soon as possible.