Extractions

You and Wendel Family Dental Centre may determine that you need a tooth removed for any number of reasons. Some teeth are removed because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.  To avoid these complications, in most cases, Wendel Family Dental Centre will discuss alternatives to extractions as well as replacement of the extracted tooth with an implant, bridge, or partial denture.

Anesthesia

We are always concerned about your comfort. Tooth removal is a surgical procedure that can be mentally as well as physically traumatic. Even though the procedure may be pain free, patients feel pressure when teeth are removed. For some individuals, use of a local anesthetic may be sufficient for adequate anesthesia. For others, either intravenous or oral sedation will help calm them and make the procedure endurable. You can discuss your sedation options with your dentist.

Methods

Removal of teeth is a surgical procedure, which may require incisions, bone removal and/or sectioning of teeth.  Sectioning of teeth is done in order to facilitate tooth removal and to protect delicate surrounding structures. In most cases dissolvable stitches are placed and sometimes a post-operative visit is necessary.

Dry Socket

A dry socket is the most common complication with tooth removals. It happens when the blood clot is dislodged or one fails to form in the socket where the tooth was removed.  Following the post-extraction instructions will reduce the chances of developing a dry socket. Dry sockets manifest themselves as a dull throbbing pain, which doesn’t appear until three to four days after the extraction.  The pain can be moderate to severe and radiate from the extraction area. Dry sockets may cause a bad taste or bad breath. The extraction site will appear dry. These symptoms require treatment. Please call our office if these symptoms occur.

Numbness or tingling

Nerves that are close to the surgical site can become irritated from either direct trauma or pressure due to swelling. Usually these symptoms are temporary, but in rare cases they can be permanent.  It is important that you report any symptoms that are still present more than 24 hours after surgery, or if they develop gradually after a period of normal sensation.

Bone fragments

Often small pieces of bone will dislodge around the socket. They will feel like a rough or sharp spot in your gum. They will usually remove themselves, but sometimes will require surgical removal.

After Tooth Extraction

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.

After the blood clot forms, it is important not to disturb or dislodge the clot because it aids in healing. Do not rinse vigorously, suck on straws, smoke or drink alcohol for 72 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling.  An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum.  Take pain medications as prescribed. The swelling usually is most evident on the third or fourth post-operative day and will gradually subside.  Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.  After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately at (360) 254-5254.

The socket produced from a tooth removal heals from the bottom up, so there may be a “hole” present in the gum for several weeks or months after the removal.  In time, it will fill in with bone and the gum will assume a smooth consistency over the extraction site. Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.

A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. Avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately.  If you have had an immediate denture placement, do not remove the denture. You can expect some oozing around the side of the denture.  If it comes out, replace it immediately; otherwise your gums could swell preventing you from replacing the denture. After you have seen your dentist, take out the denture and rinse 3 to 4 times and rinse gently with warm salt water or as otherwise directed.

The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:

• The surgical site will swell reaching a maximum in three to five days and bruising may occur. The application of a moist warm towel will help eliminate the discoloration quicker.
• A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is normal and should subside in 2-3 days.
• If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If temperature continues, notify our office.

If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.