Tooth extraction, or the removal of a tooth, is a relatively common procedure for adults, even though their teeth are meant to be permanent. Here are a few of the reasons someone may need to get a tooth removed:
- tooth infection or decay
- gum disease
- damage from trauma
- crowded teeth
Read on to learn more about tooth extraction and what you need to do after this dental procedure.
You schedule a tooth extraction with your dentist or an oral surgeon.
At the procedure, your dentist injects you with a local anesthetic to numb the area and prevent you from experiencing pain, though you’ll still be aware of your surroundings.
If your child is having a tooth removed, or if you’re having more than one tooth removed, they may choose to use a strong general anesthetic. This means your child or you will sleep throughout the procedure.
For a simple extraction, your dentist will use a device called an elevator to rock the tooth back and forth until it becomes loose. They’ll then remove the tooth using dental forceps.
Molars or impacted teeth
If you’re getting a molar removed or if the tooth is impacted (meaning it sits beneath the gums), surgical extraction may be necessary.
In these cases, the surgeon will make an incision to cut away the gum and bone tissue that covers the tooth. Then, using forceps, they will rock the tooth back and forth until it breaks away.
If the tooth is especially difficult to extract, pieces of the tooth will be removed. More complex surgical extractions are likely to be performed under general anesthetic.
Once the tooth is removed, a blood clot will usually form in the socket. Your dentist or oral surgeon will pack it with a gauze pad to stop the bleeding. In some cases, a few stitches are also necessary.
Though aftercare may differ based on the type of extraction and location of your tooth, you can usually expect to heal in a matter of 7 to 10 days. It’s important to do what you can to keep the blood clot in place in the tooth socket. Dislodging it can cause what’s called dry socket, which can be painful.
There are a few things you can try to speed up healing time:
- Take painkillers as prescribed.
- Leave the initial gauze pad in place until about three to four hours after the procedure.
- Apply an ice bag to the affected area immediately following the procedure, but only for 10 minutes at a time. Leaving ice packs on for too long can result in tissue damage.
- Rest for 24 hours following the operation and limit your activity for the next couple of days.
- To avoid dislodging the blood clot, don’t rinse, spit, or use a straw for 24 hours after the procedure.
- After 24 hours, rinse your mouth with a salt solution, made with half a teaspoon of salt and 8 ounces warm water.
- Avoid smoking.
- When sleeping, prop your head up with pillows, as lying flat can prolong healing.
- Continue brushing and flossing your teeth to prevent infection, though avoid the extraction site.
During the healing process, you’ll want to eat soft foods, such as:
- soup
- pudding
- yogurt
- applesauce
You can add smoothies to your diet, but you must eat them with a spoon. As your extraction site heals, you’ll be able to incorporate more solid foods into your diet, but it’s recommended to continue with this soft foods diet for a week after your extraction.
You’ll most likely feel some discomfort, soreness, or pain after your extraction. It’s also normal to see some swelling in your face.
The painkillers you’ll get from your doctor will help reduce these symptoms. They may also recommend a number of over-the-counter medications.
If your discomfort doesn’t subside two or three days after the extraction, you’ll want to contact your dentist. If your pain suddenly worsens several days later, you’ll want to call your dentist immediately so they can rule out an infection.
After a healing period of one to two weeks, you’ll most likely be able to go back to a regular diet. New bone and gum tissue will grow over the extraction site as well. However, having a missing tooth can cause teeth to shift, affecting your bite.
You may want to ask your doctor about replacing the extracted tooth to prevent this from happening. This can be done with an implant, fixed bridge, or denture.
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. 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 at (303) 755-5768 so that we may address your concerns.