Dental Extractions

The removal of a tooth, also known as an extraction, is a procedure conducted by a dentist that will see a whole tooth and its roots completely removed from your mouth. Often a last resort after failed treatment or injury, the removal of a tooth will leave a gap in the teeth that can then be filled by a number of artificial substitutes.

What is the Cause of Dental Extractions?

There are a number of reasons why you may require an extraction, including:

  • Injury – If you have experienced facial impact that’s resulted in a jaw injury or tooth damage then you may require an extraction in order to aid recovery.
  • Lack of space – Wisdom teeth begin growing through from around 17 years onwards, but often there isn’t enough space in the mouth to accommodate them. If this is the case, the new teeth will have to be removed in order to prevent infection. Extraction may also be required to make space before the use of braces.
  • Tooth decay and infection – Some teeth may require extraction following decay or the onset of infection. In both cases, alternative options may be considered beforehand, but removal will be necessary if infection or disease is likely to spread to surrounding teeth.

What is the dental extraction process?

Before the treatment begins, your dentist will need to take an x-ray to establish the position of the root to assess the appropriate method of removing the tooth. Many extractions will require the widening of the socket that holds the tooth, separating the tissue and bone that holds the tooth. Once the tooth is loosened, it will then be removed completely. However, if the tooth has deep roots your dentist may instead decide to cut through the gums and removed some of the bone in order to reach the tooth.
The procedure will take place under local anaesthetic, which will keep you awake during the treatment while blocking the pain. However, if the tooth will be particularly challenging your dentist may recommend general anaesthetic.

Dental extraction aftercare?

You may experience some swelling or throbbing for a few days after the extraction but the pain should disappear quickly. After the procedure, your dentist may provide antibiotics or painkillers to help reduce the discomfort.

Artificial dental substitutes?

After the removal, you may prefer to have the gap filled with an artificial substitute. There are a number of options available, although some may only be appropriate in certain circumstances.
Partial dentures provide a removal substitute and can be custom-made to ensure a comfortable fit. However, dentures require maintenance and you may require six months of healing time prior to the fitting.
A bridge is a permanent substitute that allows the use of a crown by fixing on the adjacent teeth. This prevents the teeth from leaning into the gap and creates the impression of a full set of teeth.
A dental implant is the closest alternative to a natural tooth. During the procedure, an artificial root is inserted into the gum, before a crown is placed on top. The implant then has the same strength and life-span of a natural tooth but an temporary substitute may be required after the insertion of the artificial root if the gum requires time to heal.

Dental Extraction Precautions?

Avoid hot food or drinks until the anaesthetic wears off. This is important as you cannot feel pain properly and may burn or scald your mouth. Also, be careful not to chew your cheek. This is quite a common problem, which can happen when there is no feeling.

If you do rest, try to keep your head higher for the first night using an extra pillow if possible. It is also a good idea to use an old pillowcase, or put a towel on the pillow, in case you bleed a little.

Use of mouthwash after tooth extraction?

Do not be tempted to rinse the area for the first 24 hours. It is important to allow the socket to heal, and you must be careful not to damage the blood clot by eating on that side or letting your tongue disturb it. This can allow infection into the socket and affect healing.

Is there anything else I should avoid?

Avoid alcohol for at least 24 hours, as this can encourage bleeding and delay healing. Eat and drink lukewarm food as normal but avoid chewing on that area of your mouth.

When should I brush?

It is just as important, if not more so, to keep your mouth clean after an extraction. However, you do need to be careful around the extraction site.

What do I do if it bleeds?

The first thing to remember is that there may be some slight bleeding for the first day or so. Many people are concerned about the amount of bleeding. This is due to the fact that a small amount of blood is mixed with a larger amount of saliva, which looks more dramatic than it is.

If you do notice bleeding, do not rinse out, but apply pressure to the socket. Bite firmly on a folded piece of clean cotton material such as a handkerchief for at least 15 minutes. Make sure this is placed directly over the extraction site and that the pad is replaced if necessary.

If the bleeding has not stopped after an hour or two, contact your dentist.

Can I smoke after a dental extraction?

It is important not to do anything which will increase your blood pressure, as this can lead to further bleeding. We recommend that you avoid smoking for as long as you can after an extraction, but this should be at least for the rest of the day.

Helping the healing process of the extraction socket?

Different people heal at different speeds after an extraction. It is important to keep your mouth and the extraction site as clean as possible, making sure that the socket is kept clear of all food and debris. Don’t rinse for the first 24 hours, and this will help your mouth to start healing.

After this time use a salt-water mouthwash, which helps to heal the socket. A teaspoon of salt in a glass of warm water gently rinsed around the socket twice a day can help to clean and heal the area. Keep this up for at least a week or for as long as your dentist tells you.

Pain medication?

There will usually be some tenderness in the area for the first few days, and in , most cases some simple pain relief is enough to ease the discomfort. What you would normally take for a headache should be enough. However, always follow the manufacturer’s instructions and if in doubt check with your doctor first. Do not take aspirin, as this will make your mouth bleed.

Medicines that I should avoid?

As we have said, it is important not to use anything containing aspirin as this can cause further bleeding. This happens because aspirin can thin the blood slightly. Asthma sufferers should avoid Ibuprofen-based pain relief. Again check with your chemist or dentist if you are worried or feel you need something stronger.

Persistent pain after extraction?

Sometimes an infection can get in the socket, which can be very painful. This is where there is little or no blood clot in the tooth socket and the bony socket walls are exposed and become infected. This is called a dry socket and in some cases is worse than the original toothache!

In this case, it is important to see your dentist, who may place dressing in the socket and prescribe a course of antibiotics to help relieve the infection. You may also feel the sharp edge of the socket with your tongue and sometimes small pieces of bone may work their way to the surface of the socket. This is perfectly normal.