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Tooth extractions

Publish date: 23/02/2015

Tags: teeth

If a tooth is badly broken down or decayed and painful sometimes there’s no option but to remove (extract) the tooth. Extractions are usually carried out by a dentist under local anaesthetic. An injection is given in the mouth near the offending tooth to numb the area before the actual extraction.

The dentist will then apply pressure with forceps to loosen the tooth. The tooth will then be rocked backwards and forwards to further loosen it and then it will be extracted. You will be asked to bite a sterile gauze pack for a few minutes as the pressure will allow the blood to clot and stop the bleeding. The dentist will then check the bleeding has stopped before sending you home.

The whole procedure should only take a few minutes. Your dentist will give you post-operative instructions including:

  • Don’t rinse your mouth with liquid
  • Don’t drink alcohol or smoke
  • Avoid hot liquids
  • Avoid strenuous activity

The dentist may also give you a sterile pack to take home to use in case the socket starts to bleed again later. If you don’t have a sterile pack and the socket starts to bleed use kitchen roll or clean tissue (not cotton wool) and bite on this firmly for 5 minutes. The pressure should stop the bleeding. If the bleeding continues after this you need to contact your dentist for advice. You may need to return to the practice for a suture (stitch) to be placed. Sutures are usually dissolvable.

Complications after surgery can include soreness as the socket hasn’t filled properly with blood or the clot has been lost. This is known as a dry socket and can be very painful. The dentist will put a dressing into the socket to aid healing.

Wisdom tooth extractions

Wisdom teeth that have come through at an odd angle or only partially can cause problems with gum infections. This would be known as an impacted tooth. Your dentist will advise if the tooth needs to be removed and if it’s necessary to have the tooth removed in hospital under a general anaesthetic by an oral maxillo facial surgeon or if they can extract it in the surgery.

To remove an impacted tooth the area would be numbed with an injection of local anaesthetic unless having a general anaesthetic. A small incision is made into the gum to access the tooth. The bone surrounding the impacted tooth may need to be removed. This would be done by drilling away the bone. The drill will also spray water over the bone to keep the area cool and keep access visible. The tooth may be divided into smaller parts to make it easier to remove through the opening that has been made in the gum.

You may feel pressure whilst the procedure is going on but there should be no pain. If you do feel any pain tell your dentist or surgeon immediately.

It’s usually necessary to put in dissolvable stitches to seal the wound. Your dentist will advise on post operative care which will usually include:

  • Don’t drink alcohol or smoke
  • Avoid hot liquids
  • Avoid strenuous activity
  • Use an extra pillow to support the head and reduce pressure. This will reduce additional pain.
  • Eat soft foods for the next few days
  • Rinse with hot salt water or an antiseptic mouthwash GENTLY after eating.

Removal of an impacted wisdom tooth can take a few minutes or longer if it’s particularly complicated.

You should take antibiotics and/or pain relief medication as advised.

Complications after wisdom tooth removal can include swelling of the cheeks and some soreness, a bad taste in the mouth and/ or stiffness of the jaws and bruising.

Allow a couple of days to recover especially if the operation has been done under a general anaesthetic.

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