Extracting a tooth comprises of removing a tooth from its cavity in the bone. When cracks and damages are observed because of decay one of our dentists will try to rectify it by using a filling, crown or any other treatment. On occasions, our dentists observe too much damage which cannot be fixed. In such conditions, the tooth must be gently removed. A tooth which is extremely loose also needs to be pulled if chances of saving it are not available even by conducting a bone graft.
- Some individuals have extra teeth which block fresh ones from developing.
- At times baby teeth do not fall out to let the permanent ones develop.
- People opting for braces may require some to be extracted to make the place for the ones which need to be moved into position.
- Cancer patients undergoing radiation to the head and the neck may need to have some in the area of the radiation to be extracted.
- People being treated for cancer and receiving cancer drugs can develop infections because the drugs weaken the immune system. They may also be susceptible to tooth extraction.
Some may need to be extracted when they develop infections after an organ transplant. The risk of infections among people who have undergone an organ transplant is high as the drugs prescribed them may decrease or suppress their immune systems.
Wisdom teeth or third molars are generally extracted either before or after they make an appearance. They commonly develop during the early 20s or the late teens. It is necessary to remove them if they are causing pain, have an infection or are decayed. They often become impacted or stuck back in the jaw and do not come in. This leads to irritations in the gums, triggering pain and swelling. In such cases, the tooth needs to be extracted. If all four need to be pulled the wisdom teeth extraction is typically done all at once.
An x-ray of the area is initially obtained to determine the best plan for the extraction. You need to provide your entire medical and dental history along with a list of any medications you have been advised to take. If you are having your wisdom teeth extracted you may need to have a panoramic x-ray. This picture will capture all of them at the same time. It can display a lot of information which would guide the procedure including:
- Impacted Wisdom Teeth which often leads to orthodontics or extractions
- The relationship of the upper ones with the sinuses.
- The relationship of the lower ones to a nerve in the jawbone that provides feeling to the mandible – lower jaw, lower lip, and chin. This nerve is identified as the inferior alveolar nerve.
- Any diseases or bone conditions which may be prevailing in the mouth.
We may prescribe antibiotics to be used before and after the surgical procedure. The likelihood of antibiotics being prescribed is higher in the following cases:
- An infection is observed as the surgery draws closer.
- The patient has a weakened immune system.
- The duration of the surgery is expected to be lengthy.
- The patient has a specific therapeutic condition.
The doctor performing the surgery will give the patient instructions to follow after the procedure is completed. It is extremely essential for the patient to adhere to the instructions provided by the doctor. Help must also be at hand to drive the patient back home after the procedure or same day tooth removal.
Two methods are adopted for performing extractions and the methods are described below:
- A simple extraction is performed on a tooth which is visible in the mouth. Dentists generally perform simple extractions quite often. The procedure is simple as the dentist will simply loosen the tooth with an instrument known as an elevator. After, the dentist will use an instrument known as forceps to extract the tooth.
- Surgical extractions are more complicated compared to a simple extraction. A surgical extraction is needed if the tooth has broken off at the gum line or has not developed fully. Oral surgeons need to be contacted for performing surgical extractions despite the services also being offered by general dentists. The surgeon will make a small incision in the gum in order to remove some of the bone around it or cutting it in half if needed to make way for the extraction.
Most simple procedures are performed by injecting a local anesthetic. Alternatively, you may be given drugs to help you relax. When surgical extraction is needed you are given a local anesthetic or the anesthesia may be administered intravenously.
If you are receiving conscious sedation you may receive steroids and other medications in the IV line. The steroids will help to reduce swelling and pain after the procedure.
Pressure can be expected during the procedure without pain. However, if you do feel any pain you are suggested to inform your doctor.
- The doctor will provide you with a full set of instructions on how to prepare and what to expect before and after the procedure. Should you have any questions you must ensure you also receive answers to the same before you leave the doctors office.
- Even after a simple extraction, you can expect to undergo some discomfort. You may be prescribed some painkillers by the doctor but you also have the option of taking over-the-counter medications such as ibuprofen, Motrin, Advil, and other varieties. You just need to stick to the dosage recommended by your doctor.
- Surgical extractions generally cause pain following the procedure. The duration of the discomfort along with the levels depend on the difficulty experienced during the removal. The pain, however, subsides after a couple of days.
- Incisions in the mouth often lead to more bleeding than an injury on the skin because the incisions cannot dry out or scab. You would be instructed to bite on a piece of gauze for approximately 20 to 30 minutes after the procedure in order to allow the blood to clot and form coagulation. Hemostasis is needed to happen which will stop blood flow.The bleeding generally stops in approximately 24 hours. However, care must be taken not to disturb the clot which forms on the wound.
- In order to reduce any swelling and to heal, you can apply ice packs and/or warm compresses.
- Have cool and soft food for several days until you begin to feel comfortable when you can make an attempt to have other foods.
- Starting from 24 hours after the surgery you can gently rinse your mouth with warm water and salt because this is helpful for keeping the site clean.
- If you need sutures your doctor may utilize the dissolving kind. These remain in your mouth for one or two weeks but generally dissolve when you rinse your mouth as suggested above. Some sutures may need to be removed by the dentist or surgeon.
- Avoid smoking, using the straw or spitting after the surgery. This can lead to the blood clot being pulled away from the area from where the tooth was extracted. Avoid smoking on the day of the surgery for up to 24 to 72 hours after the extraction procedure is completed.
A problem known as a dry cavity develops in approximately 3 to 4% of all extractions. This happens when a blood clot does not form in the hole or breaks down earlier than expected
In a dry cavity, the underlying bone becomes exposed to the oral environment causing plenty of pain and also leaving behind a bad taste or odor. Dry cavities generally begin causing pain after 72 hours of the surgery. The problem of a dry cavity is encountered approximately 30% of the time when affected teeth are extracted. Extractions that are difficult can also make dry cavities more likely. The habit of smoking on the day of the surgery only adds to the risk. Smokers and women that are using birth control pills are potential candidates for developing dry cavities. A dry cavity must be treated by using a medicated dressing to allow the pain to subside and to encourage healing. Chances of infections occurring following the procedure are also present. However, you are unlikely to develop an infection if your immune system is in perfect order.
In most cases, it is performed without any issues. However, complications may occur during or after the procedure. Tooth extractions complications may happen like any surgical procedure. And for that you need to understand the risks.
Some pain, bruising, and swelling in the area are expected after surgery, which will subdue over time. Continued bleeding and infection in the area are less common, but if it happens it further treatment is recommended.
Depending on the type of extraction, a local or general anesthesia is used to reduce the pain associated with the extraction. The anesthetic used can be associated with other risks such as nausea, dizziness, and damage to the mouth.
Other potential issues are the following:
- Accidental damage to surrounding teeth such as fracture of fillings.
- An incomplete extraction where a tooth root remains in the jaw — the dentist generally attempts to remove the root in order to prevent an infection. However, at times it is less risky to leave a tiny root tip in position.
- A fractured jaw because of the pressure applied on the jaw during the extraction — this is a problem which is frequent in the elderly with osteoporosis [thinning] in the jawbone.
- A hole in the sinus during the procedure on an upper back molar — a tiny hole usually closes by itself in a few weeks. If it does not it may need additional surgery.
- Soreness in the jaw muscles and/or jaw joint – you may have difficulties in opening your mouth wide. It may be due to the injections forcing your mouth open or alternatively plenty of pressure on the jaw.
- In extreme cases, Alveolar osteitis can happen. It is a painful condition that can occur after you have permanent adult teeth removed.
- Socket Preservation happens to reduce bone loss after tooth extraction to preserve dental tooth socket.
- Numbness in the lower lip and chin lasting for an extended period — this is not a common issue but is caused by an injury to the inferior alveolar nerve in the lower jaw. Complete healing can occur in approximately 3 to 6 months. The numbness could be permanent in certain rare situations
You should be calling your surgeon or dentist if:
- The swelling and inflammation worsens.
- You begin experiencing fever, chills or redness.
- Swallowing becomes a difficult.
- Bleeding in the area cannot be controlled.
- The area continues to ooze or bleed even after 24 hours.
- Numbness exists in your tongue, lip, chin for over 3 to 4 hours following the procedure.
- The site of the extraction becomes extremely painful — this may be a sign of a dry cavity.
Get teeth pulled safely by our expert doctors. Our office will help you with any cost or dental insurance questions. Make an appointment today with our office in Frisco,TX near The Colony and Prosper. We take pride in bringing you a smile during your dental care visit.
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