Extraction

These are performed on teeth that are visible in the mouth. General dentists commonly do simple extractions, and most are usually done under a local anesthetic, with or without anti-anxiety medications or sedation.

These involve teeth that cannot easily be seen or reached in the mouth, either because they have broken off at the gum line or they have not fully erupted. Performed by dentists or oral surgeons, surgical extractions require some type of surgical procedure, such as bone removal, removing and/or lifting and folding back all or part of the gum tissue to expose the tooth, or breaking the tooth into pieces (called tooth sectioning). Surgical extractions can be done with local anesthesia and/or conscious sedation. Patients with special medical conditions and young children may receive general anesthesia.

• Tooth Extraction Aftercare

  Since bleeding is normal after an extraction, your dentist will have you bite on a piece of gauze for about 45 minutes to put pressure on the area and allow the blood to clot. Some swelling and discomfort are normal after a tooth extraction.

  Cold compresses or ice packs can help decrease the swelling. If your jaw is sore and stiff after the swelling dissipates, apply warm compresses. Sleeping with your head face upward to relieve pressure on the jaw, and keeping your head elevated with extra pillows also may help. In addition, your dentist may recommend you take an OTC pain reliever such as ibuprofen (Motrin or Advil) for several days. With surgical extractions - which generally cause more pain afterwards - your dentist may prescribe a prescription pain medication.

  Other aftercare tips include:

  • Do not rinse your mouth for the first 24 hours immediately following a tooth extraction.
  • Stick to a soft or liquid diet (milk, ice cream, mashed potatoes, pudding) the day of and the day after a tooth extraction, gradually progressing to eating other easy-to-chew foods. Chew with teeth that are far from the extraction site.
  • Brush and floss the other teeth as usual, but avoid the teeth and gum next to the extraction socket.
  • After the first 24 hours, for at least five days after extraction, gently rinse the socket with warm salt water (1/2 teaspoon of salt in a cup of water) after meals and before bed.

• Things to Avoid After Tooth Extraction

  In addition to the aforementioned aftercare considerations, tooth extraction aftercare also involves avoiding certain foods and activities.

  • Do not rinse your mouth for the first 24 hours immediately following a tooth extraction.
  • Avoid anything that might dislodge the blood clot and delay or prevent normal healing.
  • Do not smoke, vigorously rinse or spit, engage in strenuous activities, or drink through a straw for at least two days after an extraction.
  • Stay away from hot liquids, foods that are crunchy or contain seeds or small grains, alcohol, and carbonated soft drinks for two to three days after tooth extractions.
  • Do not brush your gums or use an OTC mouth rinse (you can use homemade water-and-salt washes).

• Possible Tooth Extraction Complications

  There are several potential complications that may occur as a result of a tooth extraction. These complications may include:

  • Accidental damage to adjacent teeth.
  • Incomplete extraction, in which a tooth root remains in the jaw. Your dentist usually removes the root to prevent infection, but sometimes it's less risky to leave in a small root tip.
  • Alignment problems associated with chewing ability or jaw joint function. Misaligned teeth may cause pain, teeth grinding (bruxism) and cracking or splintering of teeth withstanding the force of the jaw. Additionally, misaligned teeth can trap food and be harder to clean, thereby increasing the risk for tooth decay and gum disease.
  • Fractured jaw (most often occurring in older people with osteoporosis of the jaw) caused by the pressure put on the jaw during extraction.
  • If an upper tooth was extracted, a hole may have been made into one of the sinus areas. Normally, it will heal quickly on its own; but if it doesn't, you may need to return to your dentist.
  • Infection, while rare, does occasionally occur. Your dentist may prescribe antibiotics before and after the extraction if determined you may be at risk of infection.
  • Nerve injury - while primarily an issue with extractions of lower wisdom teeth - can occur with the removal of any tooth if the nerve is near the extraction site. Typically caused by damage from a surgical drill, nerve injuries are rare and usually temporary.
  • Bisphosphonates - drugs used to prevent/treat osteoporosis, multiple myeloma, bone cancer and bone metastasis from other cancers - may put patients who undergo tooth extractions at risk for developing osteonecrosis of the jaw (a rotting of the jaw bones). It is thought that bisphosphonates attack the teeth and bone, and may prevent cells that break down bone from working. If you are taking an osteoporosis medication such as Fosamax, try to avoid extraction whenever possible, rather than opt for removal of the tooth/teeth.
  • Without an opposing tooth, the tooth above or below the extraction socket will, over time, move out of its socket, likely exposing its roots and becoming sensitive to temperature changes. Particularly when several teeth have been extracted, another possible long-term problem is thinning of the jawbone, which then becomes easier to break.
  • Tooth extractions - particularly of front teeth - may negatively affect your appearance.

  Unless it is a wisdom tooth, your dentist likely will advise replacing any extracted tooth to avoid possible complications, such as shifting of the teeth, gum recession and bone loss. Dental implants are the ideal tooth replacement; dental bridges and dentures are other options.