• Tooth Extraction

    Definition

    This is a procedure to remove a tooth.
    Surgical Removal of a Tooth
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    Reasons for Procedure

    While dental techniques can save many teeth, a tooth may need to be removed if it:
    • Is too badly damaged or decayed to be saved by a root canal
    • Has an infected nerve
    • Is affecting normal tooth growth
    • Is loose from advanced gum disease
    • Has a loss of supporting bone, gums, or tissue

    Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have a tooth extracted, your dentist will review a list of possible complications, which may include:
    • Bleeding
    • Infection
    • Nerve damage
    Factors that may increase the risk of complications include:
    • Smoking
    • Poor nutrition
    • Poor overall health
    • Use of some prescription and non-prescription drugs—Talk to your dentist about any medicine you are taking.
    Be sure to discuss these risks with your dentist before the procedure.

    What to Expect

    Prior to Procedure

    Your dentist will likely:
    • Do a thorough dental exam
    • Do an x-ray of the mouth—a test that uses radiation to take a picture of structures inside the body, especially bones

    Anesthesia

    Depending on the procedure, your dentist will choose:
    • Local anesthesia—just the area that is being operated on is numbed; given as an injection
    • General anesthesia —blocks pain and keeps you asleep through the procedure

    Description of the Procedure

    If the tooth is impacted (buried in the gum), the dentist will remove the overlying gum tissue to expose the tooth. Using forceps, the dentist will grasp the tooth and gently rock it back and forth. This action will loosen the tooth and break the ligaments that hold the tooth in place. The tooth will be pulled, and a blood clot will form in the empty socket. The dentist will pack a gauze pad into the socket. In some cases, the dentist will place a few stitches to close the gum edges.

    Immediately After Procedure

    You will need to bite firmly but gently on the gauze pad. This will reduce bleeding and permit a clot to form in the tooth socket. If rapid bleeding continues, replace with a fresh pad every 20-30 minutes. Otherwise, leave the pad in place for 3-4 hours.

    How Long Will It Take?

    It often takes about 20 minutes but may take longer for impacted teeth.

    How Much Will It Hurt?

    You will feel pain in your jaw. Your dentist may give you pain medicine.

    Post-procedure Care

    When you return home, do the following to help ensure a smooth recovery:
    • To reduce swelling, apply an ice pack to the area. Apply for 10 minutes at a time.
    • Do not dislodge the blood clot that forms in the wound. Do not spit or rinse forcefully in the first 24 hours.
    • Do not smoke.
    • Do not allow food particles to pack into the socket.
    • Do not use drinking straws in the first 24 hours.
    • Begin rinsing your mouth 24 hours after the procedure. Use a solution made of ½ teaspoon salt and 8 ounces warm water.
    • Eat a soft or liquid diet for the first 24 hours.
    • Avoid activity for the first 24 hours. For the next 1-2 days, limit your activity.
    • Continue to brush and floss other teeth. This will help prevent infection in the extraction site.
    • Be sure to follow your doctor's instructions .
    In the first 24 hours, expect some swelling and bleeding. The initial healing period usually takes about 1-2 weeks. New bone and gum tissue will grow into the gap.
    Having a missing tooth can lead to shifting teeth, improper bite, or difficulty chewing. Your dentist may attempt to restore the area with an implant, fixed bridge, or denture.

    Call Your Dentist

    After arriving home, contact your dentist if any of the following occurs:
    • Signs of infection, including fever and chills
    • Redness, swelling, increasing pain, or any discharge from the open socket
    • Excessive bleeding continuing for more than four hours after surgery
    • Pain that you cannot control with the medicines you have been given
    • Cough, shortness of breath, chest pain, or severe nausea or vomiting
    • Any new symptom
    In case of an emergency, call for medical help right away.

    RESOURCES

    American Dental Association http://www.ada.org/

    National Institute of Dental and Craniofacial Research http://www.nidcr.nih.gov/

    CANADIAN RESOURCES

    Canadian Dental Association http://www.cda-adc.ca/

    Canadian Dental Hygienists Association http://www.cdha.ca/

    References

    Tooth decay. American Dental Association website. Available at: http://www.ada.org . Accessed September 17, 2009.

    Tooth extractions. American Dental Association website. Available at: http://www.ada.org . Accessed September 17, 2009.

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