Teeth may need to be extracted for several reasons including:
- Damage: cavities or fractures may be so severe that they cannot be repaired.
- Infection: severe infections of the teeth or gums can cause teeth to become loose.
- Overcrowding: if the jaw is not big enough for all the teeth, some may need to be removed so the remaining teeth can be straightened with braces.
- Impaction: teeth sometimes will not come into the mouth and remain under the gums. This typically happens with wisdom teeth. It is possible for these impacted teeth to develop cysts or tumors around them if they are not removed.
If an extraction is necessary, your dentist will evaluate the difficulty of the extraction. Your tooth may be removed in the office or you may be referred to a specialist called an Oral Surgeon. Depending on your preferences, teeth can be removed by numbing the area. If you desire, an Oral Surgeon can sedate you for the procedure.
A tooth is extracted by using specialized instruments to loosen the attachment around the tooth. Once it is loosened, the tooth can be removed. Any associated infection is also cleaned and removed.
If it is appropriate, the socket may be filled with a type of bone replacement. This procedure is called a socket preservation. It is done to decrease the amount of bone loss that occurs after an extraction. The resulting bone will be more suitable for future placement of an implant of a bridge to replace the missing tooth.
Stitches may or may not be placed, If they are placed, you will be notified if they will need to be removed or if they dissolve on their own.
Injections relax the muscles to smooth out dynamic wrinkles, those that appear with muscles of facial expression
Key aspects to know before
- Bleeding: You may experience bleeding for several hours after an extraction. In order to stop the bleeding, place a folded, damp gauze over the extraction site and bite for 30-60 minutes. A small amount of bleeding may continue for several days.
- Swelling: Swelling is normal following an extraction. This is your body’s way of reacting to the extraction and beginning the healing process. Swelling typically reaches its peak 2-3 days after the procedure. It will gradually decrease from there. Ice packs can be used to decrease swelling. This is done by applying an ice pack to the face over the extraction area for 20 minutes on and 20 minutes off for the first 24 hours.
- Pain: You should expect some discomfort following an extraction. If you are able to take them, an over-the-counter pain reliever such as Ibuprofen can be taken. Your may receive a prescription for a stronger pain medication from the dentist. It is important to take these prescription medications as prescribed and not to combine them with any other pain relievers. When taking a narcotic pain medication, you should not drive or operate heavy machinery.
*NOTE: Ibuprofen or Aspirin medications should not be taken if you are taking blood thinners such as Plavix, Coumadin, Warfarin, etc.
- Dry Sockets: A dry socket occurs when the blood clot is lost from the socket. This can cause constant pain that may radiate to other areas of the face and jaws. Symptoms typically occur around the 3rd or 4th day after the procedure. If you are experiencing these symptoms, a medicated dressing can be placed to help relieve your discomfort. In order to help prevent a dry socket, avoid vigorous rinsing, sucking through a straw, spitting, smoking and exercising for 2-3 days after the procedure.
- Salt-Water Rinses: Starting the day after the procedure, you can rinse gently with a mixture of warm water and salt.
- Diet: While you are still numb care should be taken to avoid biting your cheeks or tongue. Hot liquids should be avoided so that you do not experience burns. You should start with a soft diet such as applesauce, pudding or Jell-o. As you become more comfortable, you can slowly resume your normal diet. Avoid foods such as nuts, seeds, etc. as they can become lodged in the extraction socket.
- Oral Hygiene: To help prevent infection, you should keep your mouth clean. Clean your mouth thoroughly after each meal starting the day after surgery. If bleeding resumes, use gauze as described above. Do not rinse your mouth the day of surgery.
- Sutures/Stitches: Most types of sutures will resorb and fall out on their own. If a suture comes out and bleeding occurs, bite on gauze to apply pressure as described above.
- Antibiotics: If an antibiotic is prescribed, take it as directed. The entire prescription should be taken until gone. If you have any unfavorable side effects, call the office. The prescription may need to be changed. Taking an over-the-counter probiotic while you are on antibiotics can help to decrease diarrhea and GI side effects.