Reasons for extracting teeth
Although permanent teeth can last a lifetime, teeth that have become damaged or decayed may need to be removed or extracted.
Other reasons include:
A crowded mouth: Sometimes dentists extract teeth to prepare the mouth for orthodontics. The goal of orthodontics is to properly align the teeth, which may not be possible if your teeth are too big for your mouth. Likewise, if a tooth cannot break through the gum (erupt) because there is not room in the mouth for it, your dentist may recommend extraction.
Infection: If tooth decay or damage extends to the pulp — the centre of the tooth containing nerves and blood vessels — bacteria in the mouth can enter the pulp, leading to infection. If infection is so severe that antibiotics do not cure it, extraction may be needed to prevent the spread of infection. You may have severe pain from a dental infection and may want to be seen as an emergency. Please call us to book an emergency appointment and we will do our best to see you as soon as possible.
Risk of infection: If your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant) even the risk of infection in a particular tooth may be reason to remove the tooth.
Gum disease: If periodontal disease — an infection of the tissues and bones that surround and support the teeth — have caused loosening of the teeth, it may be necessary to extract the tooth or teeth.
What to expect with tooth extraction
Dentists and oral surgeons (dentists with special training to perform surgery) perform tooth extractions. Before removing the tooth, your dentist will give you an injection of a local anaesthetic (or pain medicine) to numb the area where the tooth will be removed. If you are having more than one tooth extracted or a tooth is impacted, your dentist may use a general anaesthetic, this will prevent pain throughout your body and make you sleep through the procedure.
If the tooth is impacted, the dentist will cut away gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a tooth that is difficult to remove must be taken out in pieces.
Once the tooth has been extracted, a blood clot usually forms in the socket. The dentist will pack a gauze pad into the socket and get you to bite down on it to help stop the bleeding. Sometimes the dentist will place a few stitches — usually self-dissolving — to close the gum edges over the extraction site.
Sometimes, the blood clot in the socket breaks loose, exposing the socket – causing a painful condition called dry socket. If this happens, your dentist will probably place a special dressing over the socket for a few days to protect it as a new clot forms.
I’ve had my tooth out – what should I do now?
Take it easy for the rest of the day. Take as little exercise as you can, and rest as much as you can. Keep your head up to avoid any bleeding.
What precautions should I take?
Avoid hot food or drinks until the anaesthetic wears off. This is important as you cannot feel pain properly and may burn or scald your mouth. Also be careful not to chew your cheek. This is quite a common problem, which can happen when there is no feeling.
If you do rest, try to keep your head higher for the first night using an extra pillow if possible. It is also a good idea to use an old pillowcase, or put a towel on the pillow, in case you bleed a little.
Should I rinse my mouth out?
Avoid alcohol and hot drinks. Do not be tempted to rinse the area for the first 24 hours. It is important to allow the socket to heal, and you must be careful not to damage the blood clot by eating on that side or letting your tongue disturb it. This can allow infection into the socket and affect healing.
Is there anything else I should avoid?
Avoid alcohol for at least 24 hours, as this can encourage bleeding and delay healing. Eat and drink lukewarm food as normal but avoid chewing on that area of your mouth.
When should I brush?
It is just as important, if not more so, to keep your mouth clean after an extraction. However, you do need to be careful around the extraction site.
What do I do if it bleeds?
The first thing to remember is that there may be some slight bleeding for the first day or so. Many people are concerned about the amount of bleeding. This is due to the fact that a small amount of blood is mixed with a larger amount of saliva, which looks more dramatic than it is.
If you do notice bleeding, do not rinse out, but apply pressure to the socket. Bite firmly on a folded piece of clean cotton material such as a handkerchief for at least 15 minutes. Make sure this is placed directly over the extraction site and that the pad is replaced if necessary.
If the bleeding has not stopped after an hour or two, contact your dentist.
How soon can I have a cigarette?
It is important not to do anything which will increase your blood pressure, as this can lead to further bleeding. We recommend that you avoid smoking for as long as you can after an extraction, but this should be at least for the rest of the day.
Is there anything I can do to help my mouth?
Different people heal at different speeds after an extraction. It is important to keep your mouth and the extraction site as clean as possible, making sure that the socket is kept clear of all food and debris. Don’t rinse for the first 24 hours, and this will help your mouth to start healing. After this time use a salt-water mouthwash, which helps to heal the socket. A teaspoon of salt in a glass of warm water gently rinsed around the socket twice a day can help to clean and heal the area. Keep this up for at least a week or for as long as your dentist tells you.
It is important to keep to a healthy diet; and take a Vitamin C supplement, which will help your mouth to heal.
I am in pain, what should I take?
There will usually be some tenderness in the area for the first few days, and in most cases some simple pain relief is enough to ease the discomfort. What you would normally take for a headache should be enough. However, always follow the manufacturer’s instructions and if in doubt check with your doctor first. Do not take aspirin, as this will make your mouth bleed.
Are there any medicines I should avoid?
As we have said, it is important not to use anything containing aspirin as this can cause further bleeding. This happens because aspirin can thin the blood slightly. Asthma sufferers should avoid Ibuprofen-based pain relief. Again check with your chemist or dentist if you are worried or feel you need something stronger.
I am still in pain, what could it be?
Sometimes an infection can get in the socket, which can be very painful. This is where there is little or no blood clot in the tooth socket and the bony socket walls are exposed and become infected. This is called a dry socket and in some cases is worse than the original toothache! In this case, it is important to see your dentist, who may place a dressing in the socket and prescribe a course of antibiotics to help relieve the infection. You may also feel the sharp edge of the socket with your tongue and sometimes small pieces of bone may work their way to the surface of the socket. This is perfectly normal.
Will my dentist need to see me again?
If it has been a particularly difficult extraction, the dentist will give you a follow-up appointment. This could be to remove any stitches that were needed, or simply to check the area is healing well.
Contact Us to find out more about it or book an appointment online!