Tooth extraction is the removal of a tooth, using forceps, from the dental alveolus or the socket in the alveolar bone. There comes a time in everyone’s life when one has to get his tooth extracted. Though your tooth is supposed to last a lifetime, but almost everyone has to get his tooth extracted. For some it’s early, for some it’s late.

Reasons for Tooth Extraction:

• Damage to tooth because of trauma
• Preparing the mouth for orthodontia wherein you properly align the teeth, which may not be possible if your teeth are too big for your mouth. So, some teeth need to be extracted.
• If there is no room for a tooth to erupt through the gum
• If tooth decay or damage extends to the pulp, bacteria in the mouth can enter the pulp, leading to infection
• If periodontal disease (an infection of the tissues and bones that surround and support the teeth) have caused loosening of the teeth, it may be necessary to the pull the tooth or teeth
• When your tooth becomes extremely loose
• When your baby teeth do not fall out automatically in time, to make way for the growth of permanent teeth
• A patient requiring radiation to the head or neck, due to certain medical conditions, and may need to have the teeth lying in the areas of radiation extracted

Once you find any of the reasons mentioned above, you should consult your dentist or your oral surgeon. He will recommend you the best advice. Also, during your visit or before the procedure, you should inform about your complete medical history, the medications, and supplements you take, any health conditions you have, and so on. Special care should be taken to not forget to inform about any blood thinners and any allergies you have.

After the procedure, it is extremely important to visit your dentist for a post-operative check-up. Periodic examinations at six-month intervals and regular cleanings, will help you maintain your oral health.

What to expect during Tooth Extraction?

• The doctor may prescribe some antibiotics that you may have to take prior to the extraction. An x-ray will be taken to determine the best way to extract the affected tooth.
• The doctor will ask you to refrain from smoking, at least, a day before the procedure, as smoking might lead you to suffer from a dry socket and alveolar bone exposure after the extraction.
• Before the tooth extraction procedure, your dentist will give you an injection of a local anesthetic to numb the area where the tooth will be removed. Sometimes, mostly while extracting your wisdom tooth, you might need a strong general anesthetic to prevent pain throughout your body and make you sleep through the procedure.
• If the tooth is impacted, the dentist will cut away gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces.
• It is common for a blood clot to forms in the socket, once the tooth has been extracted. The dentist will pack a gauze pad into the socket and have you bite down on it to help stop the bleeding. Sometimes the dentist will place a few self-dissolving stitches to close the gum edges over the extraction site.
• At times, the blood clot in the socket breaks loose, exposing the bone in the socket. This is a painful condition called dry socket. In such cases, your dentist might place a sedative dressing over the socket for a few days to protect it as a new clot form.

Types of Tooth Extraction:

Simple Extraction

This is generally done when tooth can be extracted through force. In this procedure, after the tooth and the surrounding areas become numb, the dentist loosens the tooth with an instrument called the elevator. The elevator helps to break down the tissues supporting the tooth and expand the bony socket which holds the tooth. The dentist then easily pulls out the tooth using a pair of forceps. You may feel some amount of pressure when the dentist pulls out the tooth, but no pain. The dentist will place a gauze over the socket and ask you to bite down on it to stop the bleeding.        

Surgical extraction

Sometimes, because of the tooth being not erupted or it being too big surgical extraction procedure is needed. During the procedure, the dental surgeon makes a small incision on the gum to access the affected tooth. If the tooth is too large the surgeon may break the tooth to small pieces to remove it. For a tooth which is impacted, the dental surgeon will cut away some gum and bone tissue, then use forceps to rock the tooth, loosen it from the jaw bone, and finally pull it out. In certain cases, post the surgery, the dentist may bring the gum edges together and stitch them. The stitches dissolve automatically in a few days. A blood clot usually forms in the socket after the surgery. The dentist will put a gauze over the clot and ask you to bite on it till the bleeding stops.

What does it feel like to get your wisdom teeth removed?

The process is painless as you will be given either a local, IV sedation or general anesthesia during the surgery. However, everyone responds differently to anesthesia. Your face and cheek will be a bit swollen, or you will have a numb and “fat feeling face.” You will feel feverish and fatigued. It will be difficult to open mouth, and immediately after the extraction, you will be dizzy.  Initially the mouth will be bleeding a bit, but eventually, after a few hours it would stop, but you would experience constant spitting. If you had local anesthesia and feel alert, you might be able to drive home to begin your recovery.You might even be able to go back to work or do your normal activities. If you had general anesthesia or still feel drowsy, you’ll need someone to drive you home. Most people have little to no pain after any teeth extraction. Wisdom teeth extraction you are likely to have swelling and mild discomfort for a week or so. You will function normally, but you have to pay attention to eating, chewing, drinking, and brushing your mouth. After a day you will feel weird twinges of pain, but they will be brief until the hole fills itself eventually. Cleaning with pure salt water would be helpful.

To reduce the risk of infection, discomfort and increase the speed of recovery; the following things are recommended:

• Do not eat, drink or talk for the first two hours after the extraction
• Take medicines and painkillers as prescribed by the dentist
• Bite firmly but gently on the gauze pad placed by your dentist for 30 mins to reduce bleeding and allow a clot to form in the tooth socket. Change gauze pads before they become soaked with blood. Otherwise, leave the pad in place for three to four hours after the extraction
• Apply an ice bag to the affected area immediately after the procedure for around 10 minutes so the swelling can come down
• Limit any activity for the next 24 to 48 hours and rest to recover quickly
• Avoid rinsing or spitting forcefully for 24 hours after the extraction to avoid dislodging the clot that forms in the socket
• After 24 hours, rinse with your mouth with a solution made of 1/2 teaspoon salt and 8 ounces of warm water
• Do not drink from a straw for the first 24 hours
• Avoid smoking as it can slow down your healing process
• Eat soft foods, such as soup, pudding, yogurt, or apple sauce the day after the extraction. Slowly and steadily add solid foods to your diet as you recover
• Use pillow while sleeping as lying flat may prolong bleeding
• Continue to brush and floss your teeth, and brush your tongue. Avoid the extraction site during brushing and flossing to prevent infection
• Drink plenty of cold liquids after the bleeding stops

When to call the dentist?

It is normal to feel some minor pain after the anesthesia wears off. For 24 hours after having a tooth pulled, you may also expect minor swelling and residual bleeding.

You should be calling the dentist if you notice the following symptoms:

• If either bleeding or pain is still severe for more than four hours after your tooth is extracted
• Signs of infection, including fever and chills
• Nausea or vomiting
• Redness, swelling, or excessive discharge from the affected area
• Cough, shortness of breath, chest pain, or severe nausea or vomiting

The initial healing period usually takes about one to two weeks. New bone and gum tissue will grow into the gap. Over time, however, having a tooth (or teeth) missing can cause the remaining teeth to shift, affecting your bite and making it difficult to chew. For that reason, your dentist may advise replacing the missing tooth or teeth with an implant, fixed bridge, or denture.

At Implants Pro Center™, San Francisco, we accept all major dental and medical PPO insurances, thereby reducing your worry about the cost of dental implant treatment, or any oral surgeries. We also have a tremendously experienced and caring staff who will provide life-long care, maintenance, and support. Implants Pro Center™, San Francisco, is also equipped with all the modern technologies like CT-Scan, Intravenous Sedation, Platelet Rich Fibrin, etc. in order to provide nothing less than the best of services. You will be completely at ease for any of your procedure. Feel free to get in touch with us to schedule your free consultation.