The removal of wisdom teeth, which are the four teeth furthest back in your mouth – one in each corner – and are the last of your teeth to grow, is a common procedure. Wisdom teeth can cause problems for some people because of the lack of space available in a person’s mouth at the point they break through the gum. This can cause them to emerge at an angle, get stuck and/or impact other teeth, which can cause irritation, pain, swelling and/or infection. For further detail about wisdom teeth removal, please refer to the following link. Read more.
A Short Video: Why We Don’t Need Wisdom Teeth
A tooth may also need to be extracted if the centre of it, which contains nerves and blood vessels, has a severe infection. This is may be necessary, if antibiotics don’t work, to prevent the spread of infection. Gum disease or to prepare a mouth for orthodontic treatment are two more reasons why a tooth or teeth may need to be extracted.
One or more teeth can be removed per appointment. Sometimes it’s advisable to do more than one, sometimes not. We will discuss this with you and you can let us know what you’re most comfortable with. We can replace an extracted tooth or teeth for you. For example, with a dental bridge or dental implants. We will explain the replacement options to you at your appointment.
Procedure for Tooth Extractions
Before undergoing an extraction your dentist will give you a thorough oral examination and discuss your dental and medical history. At this stage you should tell your dentist about any medical conditions or medications which you have been prescribed.
How long the removal of a tooth takes depends on the problem with it and how and where it sits in your mouth. It could take 5 minutes or it could take 30 minutes. We will advise on this prior to starting the procedure.
The extraction procedure is performed under local anaesthetic, so while you will be conscious, the affected area will be numbed to reduce discomfort during the procedure. Once the anaesthetic has taken effect, your dentist uses a tool called an elevator or forceps to widen the socket and loosen the tooth. Then, your dentist carefully holds the root of the tooth before moving it softly from side to side until it is ready to be completely removed. It is normal to feel some pressure in your mouth during the procedure, but the local anaesthetic should keep any discomfort to a minimum.
After the tooth has been successfully removed, there tends to be some bleeding and your dentist may use stitches to fasten the affected area. You will also be told to bite down on some padding so that the bleeding from your socket ceases. In some cases, tooth extraction can be quite tricky to perform, so your dentist may have to cut through your gum to reach the tooth’s root. Drilling through the bone to reach the root is also an option. It is important to remove the entire root as any remaining tissue could lead to an infection or even worse, an abscess.
Having a tooth out is the same as having an operation and, because of this, you must look after the area to speed healing and to reduce the risk of infection. Here are some pointers:
- For the first 24 hours, try to avoid eating hot food, don’t smoke, don’t drink any alcohol and try not to disturb any blood clot which might have formed.
- Don’t rinse your mouth for six hours after extraction. After that, rinse gently with warm salty water – half a teaspoon of salt in a glass of water is enough.
- Brush your teeth as normal to keep your mouth as clean as possible.
- You may feel some small pieces of bone work their way out of the socket – don’t worry, this is perfectly normal.
- There may be some swelling and a bit of discomfort in the first two to three days. If you need to, take some ordinary painkillers – aspirin, ibuprofen or paracetomol will be fine.
- If you feel pain immediately after the tooth has been removed, it might be where the blood clot has broken down leaving an empty hole in the gum. This is called a ‘dry socket’ and will need to be looked at by your dentist. Simply go back and the dentist will pack the wound to ease your discomfort.
- Your dentist may have given you some gauze to place onto the area where the tooth has been removed – if not, a clean cloth handkerchief will do just as well (but not a paper tissue).
- Roll it into a small firm pad large enough to fit over the gap (probably around 1cm by 3cm).
- Sit up and gently clear away any blood clots around the gap using the gauze or hanky.
- Put a clean pad over the gap (from tongue side to cheek side) and bite down on it firmly for 10 to 15 minutes.
- Take the pad off and check whether the bleeding has stopped. If not, apply a fresh pad and contact your dentist
Risks involved in a Tooth Extraction
Although the vast majority of extractions are performed safely, as with all surgical procedures there are some risks involved. Potential complications of the surgery include; swelling, extended bleeding, severe pain and a fever.
The most common complication of a tooth extraction is a dry socket, where the blood fails to clot and the socket heals very slowly. This can be very painful and may happen immediately after extraction.
Fortunately, your dentist will be able to treat this problem easily using antibiotics and dress the wound. If you are taking the contraceptive pill or if you are a smoker, then you are at increased risk of developing dry socket after surgery.
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