Extraction & Oral Surgical Procedures
There are two types of extractions (tooth removal procedures):
- A simple extraction – this procedure is on a tooth that can be seen in the mouth. For a simple extraction, the dentist loosens the tooth with an instrument called an elevator. Then the dentist uses forceps to remove the tooth.
- A surgical extraction – this is a more complex procedure, which is used if a tooth may have broken off at the gum line or has not erupted in the mouth. The oral surgeon will make a small incision into your gum to surgically remove the broken tooth or impacted wisdom tooth.
Indications / Applications
There can be a number of situations where the inclusion of one or more of the above surgical techniques might be needed to remove a tooth, either as a planned, anticipated or even impromptu addition. These situations include:
- Severely broken or fragile teeth.
- Teeth that have extreme root morphology. (For example, especially curved or exceptionally long roots.)
- Impacted teeth. (Wisdom teeth are a common example.)
- Dense or inelastic bone tissue surrounding the tooth.
- Root tip removal.
- Teeth not supported with enough bone due to periodontal disease
With surgical extractions, you’ll most likely have one or more stitches at the extraction site. Regardless of whether your extraction is simple or surgical, it’s always important to closely follow your dentist’s after-care instructions to speed recovery and avoid any complications.
- Bite firmly but gently on the gauze pad placed by your dentist 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 to keep down swelling. Apply ice for 10 minutes at a time.
- Drink plenty of lukewarm or cold liquids after the bleeding subsides.
- Maintain your diet, but start with clear liquids and soft foods for the first day.
- Don’t rinse or brush your teeth for 12 hours.
- Avoid the surgical area when brushing, although you can gently rinse with a diluted mouthwash or 1/4 teaspoon of table salt in a glass of lukewarm water
- Don’t use straws, smoke or spit forcefully as long as there is bleeding.
- Follow your dentist’s instructions on using any prescribed pain medications.
- Call your dentist if you have any persistent pain or bleeding.
Impacted wisdom teeth are those that are not able to fully erupt through the gums. It is a very common condition, and the number one reason that wisdom teeth end up needing removal.
Your third set of molars, commonly referred to as the wisdom teeth, often need to be removed in order to prevent them from causing you a multitude of dental problems. Most people do not have room in their mouths to accommodate them, and this can lead to pain, cause the teeth to crowd, and they often can become infected.
After tooth extraction, it is normal for the area to bleed and then clot, generally within a few minutes. It is abnormal if bleeding continues without clot formation, or lasts beyond 8 to 12 hours; this is known as post-extraction bleeding (PEB)
For most patients, painkillers are sufficient. We will prescribe you medication if you have a special case that is more uncomfortable. Take painkillers immediately after your extraction, while you’re still numb – that way, you’ll have support as the local anesthetic wears off.
That depends on the stitches. We may give you standard sutures, or dissolvable sutures, which will gradually degrade on their own. If you have to have your stitches removed, don’t get nervous about the appointment which will be scheduled one week post surgery– there won’t be any pain, just a little bit of pressure and a tugging feeling.
The pain after extraction will be noticeable, but it will only affect your daily life for a few days after treatment. After the first week of healing, things should be improving. If you find that your discomfort is growing after week one, you may be experiencing dry socket and should get in touch right away.
In most cases, recovery should take about a week. This depends on your particular situation, and on how strictly you follow your doctor’s post-surgery instructions.