Image by Tetbirt Salim

There are two types of extractions:

 

A simple extraction  is performed on a tooth that can be seen in the mouth. In a simple extraction, we loosen the tooth with an instrument called an elevator and sometimes use forceps to remove the tooth.  

 

A surgical extraction is a more complex procedure that is done when it’s necessary to remove the bone around the tooth or to section the tooth in pieces in order to extract it.  

 

This is commonly done when a tooth is impacted, or there are roots that prevent the tooth from coming out whole.  We often place sutures (stitches) over the healing socket in order to place the gums back in a favorable position and help facilitate healing.  These stitches typically dissolve on their own after 7-10 days and you do not need to return to have them removed.

Most extractions can be done using just an injection (a local anesthetic). The option of a sedative is available in some cases to relax the patient.

 

During a tooth extraction, you can expect to feel pressure, but no pain.  

Extractions

What to expect

 

Surgical extractions generally cause more pain after the procedure than simple extractions. The level of discomfort and how long it lasts will depend on how difficult it was to remove the tooth. You may be prescribed pain medicine for a few days and then we may suggest an NSAID. Most pain disappears after a couple of days. 

 

A cut in the mouth tends to bleed more than a cut on the skin because it cannot dry out and form a scab.

 

After an extraction, you’ll be asked to bite on a piece of gauze for 20 to 30 minutes. This pressure will allow the blood to clot. You will still have a small amount of bleeding for the next 24 hours or so. It should taper off after that. Don’t disturb the clot that forms on the wound.

Follow-up

 

We will give you detailed Instructions on what to do and what to expect after your surgery.  The instructions given should be followed for the next 7 days.  

 

No carbonated beverages, No alcohol of any kind (including mouthwash), Do not use a Straw, No Smoking, No Dairy Products, Bite on the gauze given after the appointment for 1 hour.  

 

If you have any additional questions contact our office.  

 

You can expect some mild discomfort after having a tooth removed. Research has shown that taking nonsteroidal anti-inflammatory drugs (NSAIDs) can greatly decrease pain.

Image by Jakob Cotton

Medications

 

After an extraction or dental surgery, we often recommend over-the-counter medications or will prescribe medications for pain or infection. 

 

If you have no medical restrictions, we typically recommend a combination of ibuprofen (Advil) and acetaminophen (Extra Strength Tylenol) for pain control and inflammation. 

 

Before your dental visit is complete, we will provide you with written instructions for medications and any prescriptions that may be necessary.

​Helpful tips

You can put ice packs on your face to reduce swelling. Typically they are left on for 20 minutes at a time and removed for 20 minutes. If your jaw is sore and stiff after the swelling goes away, try warm compresses. 

 

Eat soft and cool foods for a few days. Then try other food as you feel comfortable. 

 

A gentle rinse with warm salt water should start 24 hours after the surgery, this can help you to keep the area clean. Use 1/2 teaspoon of salt in a cup of water. Most swelling and bleeding end within a day or two after the surgery. Initial healing takes at least two weeks. 

 

You should not smoke, use a straw or spit after surgery. These actions can pull the blood clot out of the hole where the tooth was. Do not smoke on the day of surgery. Do not smoke for a week after having a tooth extracted. 

Risks

 

A problem called a dry socket develops in about 3 to 4% of all extractions. This occurs when a blood clot doesn’t form in the hole or the blood clot breaks off or breaks down too early.

 

In a dry socket, the underlying bone is exposed to air and food. This can be very painful and can cause a bad odor or taste. Typically dry sockets begin to cause pain the third day after surgery.

 

Dry sockets occur Up to 30% of the time when impacted teeth are removed. It is also more likely after difficult extraction. Smokers and women who take birth control pills are more likely to have a dry socket. Smoking further increases the risk. A dry socket needs to be treated with a medicated dressing to stop the pain and encourage the area to heal.

Lambs