Tooth Extraction

Tooth extractions can form the basis of many cosmetic dental treatments. For example, dental implant treatment typically requires tooth extraction to prepare the mouth for insertion of the implant and it is sometimes the case with orthodontic treatment that teeth need to be removed to create space. There are also instances when teeth become rotten beyond repair and the tooth has to be removed in order to prevent infection. Whatever the reason, the following guide will give you a comprehensive insight into the tooth extraction procedure.

Why would an extraction be needed?

There are many different reasons why a tooth may need to be extracted; in many cases, teeth have to be removed because they are decayed, which means the nerves and blood vessels inside the tooth are damaged and the tooth is effectively dead; these teeth are removed to prevent abscesses from developing. There are also a number of other possible reasons for extraction, including:

  • Injuries and accidents: sports injuries or accidents, such as trips or falls, can cause the teeth to become damaged. If the teeth are not salvageable, they will usually be extracted.
  • Periodontal disease: this condition refers to a severe case of gum disease. Periodontal disease affects the sockets and tissue in the gum that hold the teeth in place; if they become damaged, the teeth may become loose.
  • Overcrowding: many people do not have enough space in their mouth and the teeth become crowded; this is usually the result of having a smaller jaw than normal, but people who lost their primary set of teeth at an earlier age than usual may also suffer with crowded teeth.
  • Wisdom teeth: wisdom teeth can cause problems because many people don’t have enough room in their mouths for the teeth to develop properly; if this is the case the wisdom teeth will usually be removed.

Are there any alternatives to tooth extraction?

In some cases, alternative treatments may be available but extraction is really the only option if the tooth is severely damaged or decayed. If the teeth are crowded, the patient will usually be referred to an orthodontist, who may advise that they wear a brace to correct the positioning of the teeth and the spacing between the teeth; some patients may have to have teeth removed prior to having a brace fitted. If the tooth is not severely decayed, it may be possible to save the tooth by having a procedure known as root canal treatment; this replaces the damaged root portion of the tooth without having to have the whole tooth extracted.

Before the procedure

Before the extraction procedure your dentist will discuss the treatment with you and ask if you have any questions; if you are nervous or anxious, you should discuss this with your dentist as they may be able to give you a sedative to help you relax. Your dentist will ask you questions about your medical history; they will ask you if you are taking any prescription medications, if you have any allergies and if you have any particular concerns about having the treatment. Immediately before the procedure, the dentist will give you an injection of local anaesthetic.

What does the procedure involve?

The local anaesthetic will begin to take effect almost immediately and the area of your mouth where the tooth is will begin to feel numb. Once the area is completely numb, the dentist will start the extraction process; initially, the dentist will increase the size of the socket around the affected tooth using an instrument called an elevator. The dentist will then gradually pull the tooth from one side to the other and then will pull the tooth out using a special kind of forceps. In rare cases, if the socket of the tooth is particularly tight or small, the dentist may need to make a small incision on either side of the tooth in the gum tissue.

Is a tooth extraction painful?

The anaesthetic will prevent the patient from feeling pain but they may feel pressure on the affected tooth while it is being manoeuvred and then pulled out. This may cause mild discomfort but there should be no sensation of pain.

What happens after the tooth is extracted?

After an extraction, the gum tissue will usually bleed for a short period of time; to stem the bleeding the dentist will usually encourage the patient to bite down on a cotton wool pad, which will also absorb the blood. In some cases, the dentist may place a small stitch in the tissue but this is not always needed. If you have had local anaesthetic, you will usually be free to leave when the bleeding has stopped; this usually only takes around 15 minutes.

If you have had general anaesthetic or have been sedated throughout the operation, you will need slightly longer to come round; you should ask a friend or relative to drive you home or arrange for a taxi to take you home as it is not safe to drive or operate heavy machinery after having general anaesthetic.

As the anaesthetic wears off you may experience mild pain and discomfort; your dentist will usually recommend you take over the counter pain relief to ease these symptoms.

Will I be able to eat and drink normally?

Your dentist will discuss eating and drinking with you after the procedure; most dentists recommend that you avoid drinking or eating very hot foods until the anaesthetic has worn off, as the numbness may cause you to burn your mouth. For the first 24 hours after the extraction, you should try and stick to soft foods and avoid chewy and hard foods. After 24 hours, your mouth should feel completely normal and you should be able to eat and drink normally.

The recovery process

Most people recover quickly after a tooth extraction; dentists recommend that patients avoid smoking and drinking alcohol for the first few days afterwards and stick to soft foods. Over the counter pain relief can be taken to ease any pain. It is important to keep the mouth as clean as possible after the extraction; this will help to prevent infection. Patients should brush their teeth and rinse their mouth on a regular basis. Patients that have had stitches will be advised to return to their dentist after a period of time to have the stitches removed.

Are there any risks involved?

Tooth extractions are a routine procedure and are generally considered very safe. However, as with all procedures there is a possibility of side-effects and complications but your dentist will explain these before you have the procedure. Side-effects are generally very mild and most people find they subside very quickly after the procedure; examples of possible side-effects include:

  • Swelling around the area where the tooth was extracted
  • Tenderness in the gums
  • Stiffness in the jaw
  • Mild pain
  • Light bleeding

Most patients find that taking over the counter pain relief helps to ease symptoms. It is important to read the labels carefully and if you are unsure ask your dentist, doctor or pharmacist for advice about which medication to take.

Complications are more severe than side-effects; they occur during or after the procedure and can potentially be very serious. The risk of complications during or after a tooth extraction operation is extremely low. However, possible complications include:

  • Raised temperature
  • Extreme swelling
  • Severe pain
  • Heavy and persistent bleeding

Another possible complication is a ‘dry socket’, which occurs when the blood doesn’t clot properly and the wound in the socket doesn’t heal as effectively as it should; this can be extremely painful and you should see your dentist as quickly as possible. The dentist may prescribe antibiotics and will wash and dress the wound.

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