Extraction

What Happens During Tooth Extractions?

Initially, your dentist will take a small x-ray (radiograph) of the tooth and its immediate area. This better informs your dentist of the tooth’s full structure below the gum line and can also help predict the simplicity of the extraction.

Anaesthetic

To ensure your comfort, your dentist will administer local anaesthetic. A special gel (topical anaesthetic) is placed around the gum. This gel freezes the gum in the injection site area. A carefully measured injection is then administered. You may have a feeling of “pins and needles” as the anaesthetic takes effect.

Comfort

Importantly, your dentist will undertake a number of checks to ensure that you are comfortably numb. Once your dentist is satisfied that the area is fully anaesthetised, they will proceed with the removal of the tooth.

Usually the dentist will gently ease the tooth from its socket and safely remove it. Occasionally, a suture/stitch can be placed to protect the recovering socket.

Post-Operative Care

You will be given written advice on how to manage your socket and also how to minimise discomfort once the anaesthetic wears off.

Dry Socket

A small minority of extraction sites can continue to be uncomfortable after extraction if they become infected, which is known as a “dry socket.” This can happen in teeth that have been infected or that were difficult to extract. It is important to attend for a follow up appointment if you feel you may have a dry socket. Your dentist will manage this in the appropriate way – occasionally with pain-relieving medications and/or a special dressing.

Surgical Extraction

Sometimes a tooth can be badly broken down, which may mean that a simple means of extraction is not possible. The remaining root structure can sometimes also cause discomfort. If this is indicated, a “surgical extraction” can be performed. It follows similar steps to a regular extraction – though with the placement of sutures/stitches, and sometimes a small amount of supporting socket bone is removed to allow better access and successful removal.

Your dentist will always discuss these options before proceeding with your treatment.

Post Extraction Advice

Eating & Drinking

A soft diet is advisable after having a tooth removed.  Take care to ensure that food does not become trapped in the socket where the tooth was.  Try to avoid alcohol and hot drinks in the period immediately following the extraction, especially if the local anaesthetic effect is still present.

Rinsing

Do NOT repeatedly rinse your mouth out after your extraction. A blood clot forms in the socket where the tooth was; frequent rinsing will tend to dislodge this clot thus causing bleeding to start again and impede the healing process. 24 hours following the extraction, you should rinse your mouth with warm salty water (a half teaspoon of salt in a warm glass of water). Repeat this 3-4 times a day after meals until the socket is healed.

Cleaning

Continue to brush your remaining teeth as you normally would, taking extra care around the socket so as not to disturb healing.

Bleeding

If bleeding occurs after leaving the practice, please roll a handkerchief/tissue into a small pad (about the thickness of your finger), place it over the bleeding socket and bite down on it for 20-25 minutes. If after this period, bleeding is still occurring, please contact your dentist immediately. Minor oozing of blood from the extraction is normal up to 24 hours after having the tooth removed).

Swelling

You should expect to have some degree of swelling after the extraction. This can take up to 10 days to resolve in some cases.

Smoking

We strongly recommend that you avoid cigarettes and other tobacco products for the 24 hours following the extraction.  Cigarette smoke can delay or prolong the healing of the extraction site, and in some cases, cause infection and severe pain 1-4 days after the extraction (dry socket).

Pain Relief

You should expect to have some minor discomfort following an extraction. Your dentist will discuss suitable over-the-counter pain relief medication.

Stitches

If you have had stitches (sutures) placed after an extraction, please do not touch them or pull at them. You should return normally one week after the extraction to have these stitches removed. Certain types of sutures will dissolve on their own – your dentist will advise.

Local Anaesthetic

The type of anaesthetic used by your dentist can leave your lip and other soft tissues numb for up to 4 hours.  Please be extremely careful not to bite your lip or cheek during this time period (this is especially important for parents to take note of if their child has had local anaesthetic). In addition, take care not to burn yourself with very hot drinks – you will not realise what has happened until after the anaesthetic effect has worn off.

Dry Socket

An infection in and around the extraction site is also known as a “dry socket”. Dry socket usually will not present until a couple of days after the extraction and may feel like a dull, throbbing jaw pain. If this happens, please contact the practice as you may need a follow up appointment.

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