Extraction

What is Dental extraction?

An extraction is the removal of a tooth from the mouth.

When is an extraction necessary?

An extraction is necessary when:

1. Periodontal disease or gum disease has compromised the health of bone and gum surrounding the tooth and they become loose.

2. Decay in the tooth has reached the living nerve part of the tooth causing pain, the tooth cannot be filled and root canal treatment is not an option

3. Trauma to the tooth has resulted in the tooth becoming mobile and splinting the tooth has had (or will have) poor results.

4. Overcrowding, sometimes when permanent teeth erupt into the mouth, baby teeth may not shed in time and these baby teeth will need to be removed to allow for the permanent teeth to move into place properly.

5.  For braces, when having orthodontic treatment carried out, your orthodontist may ask you to have a few teeth removed.

6.  Infected wisdom teeth, wisdom teeth are your third molars and often start erupting around 18 years of age (although it is not uncommon for them to appear later on in life). These teeth are often difficult to clean and easily decay or become infected. If this is the case, the usual treatment for these teeth are to have them removed. Please see more information on wisdom teeth below.

What does an extraction involve?

Most extractions are done under a local anaesthetics. Once the tooth is numb the dentist will use instruments to remove the tooth. Sometimes, with very decayed teeth or teeth with long or curved roots, the crown of the tooth may snap leaving the roots in the jaw. The dentist will then have to surgically remove these pieces either with instruments or a dental drill.

How long will it take to recover?

Every person is different, but usually for a straightforward extraction, you should be able to return to regular activities within 1-2 days of having the extraction done, if it was a particularly difficult extraction, this may take 3- 4 days or more.

It is important to take pain relief straight after the extraction and for the first 24-48 hours after having the tooth removed as this will help relieve any discomfort you may have.

Some people develop infections as a complication after the extraction is carried out and may or may not need antibiotics. If you feel any discomfort or undue pain, contact your dentist immediately.

What am I expected to do after the extraction?

1. Rest. Immediately after the extraction it is very important to rest as well as to refrain from strenuous physical activities.

2. Take pain relief before the anaesthetics wears off then every 4 hours after in the first 24 hours after the extraction. Ibuprofen or Paracetamol based pain relief should be suitable for this.

3. Do not spit. Spitting may dislodge the blood clot in the socket where the tooth has been removed and may result in continued bleeding as well as delayed healing.

4.  Do not smoke for at least 24 -36 hours. While the chemicals in nicotine are detrimental to your general health, it can also get into the socket area and cause infections such as dry sockets.

5. Do not aggravate the area buy putting your finger, tongue or other foreign body in the area where the tooth has been removed as this may introduce unwanted bacteria to the area that may result in infections.

6.  Do warm salt water rinses several times during the day especially after eating, a day after your extraction (and for a few days after). This will help flush out any food debris caught in the extraction site as well as help with healing.

7.  Sometimes after an extraction, the bone surrounding the tooth may protrude from the extraction site, where possible the dentist will try and remove this at the appointment but occasionally they are left behind and may cause some discomfort. If you think that this may have happened to you please contact your dentist as soon as possible.

8.  If you have any complications or feel any pain or discomfort, contact your dentist as soon as possible.

What are wisdom teeth?

Wisdom teeth are your third molar teeth located at the back of your mouth. They generally start coming into your mouth in your late teens or early twenties. In some people, where there is not enough room for these teeth to come through or erupt, these teeth fail to come though properly , either remaining completely under the gums or partially in the mouth.

Why are these teeth such a problem?

Often these teeth are very hard to keep clean and will decay easily.

With partially erupted wisdom teeth, food can become trapped under the gums causing painful and inflamed gum condition called pericoronitis, pain and facial swelling.
They may damage the second molar through crowding or by causing an entrapment area where bacteria and food builds up, causing decay in the second molar.

What can be done about them?

The most common treatment for troublesome wisdom teeth is to have them removed.

How long does it take?

Depending on how difficult an extraction it will be, most appointments take between 30 minutes to 1 ½ hours.

What can I expect after the extraction?

Because these teeth are located far back in the mouth, they are often very difficult for the dentist to work on. Some swelling and bruising is expected after the extraction. You may need to take a few days away from work after very difficult extractions.

If you have been given sutures to close the extraction site, you must return to the dentist after a week to have them removed.

It is advisable that you have someone take you home after the procedure especially if you have been told that it is a difficult extraction.

You will be expected to take a lot of rest after the procedure as well as a cold, soft diet.

It is not advisable that you exercise or partake in strenuous activities after the extraction as this could result in delayed healing of the extraction site.

Are there any complications after removing wisdom teeth?

1. Bleeding
After the extraction, a blood clot will form inside the tooth to start the healing process. The initial bleeding after the extraction should ease within half an hour after the procedure, however, you may have some slight oozing for another 3 days after . It the bleeding is excessive, bite down on clean gauze for 20 minutes, apply a cold pack and contact your dentist as soon as possible.

2. Infection
The most common complication after extracting wisdom teeth; our mouths are full of bacteria which can cause infection, along with poor post operative care. Your doctor may or may not prescribe you antibiotics; this depends on the situation of the tooth.

3. Dry socket
Another common complication after extractions; it is a painful and acute condition where the pain may not subside after taking pain killers. It is caused by the dislodgement of the blood clot from the socket. Should this occur, please return to your dentist as soon as possible. He will clean the extraction area, and in the case of infections, prescribe antibiotics and pain killers.

4. Dental nerve damage
Wisdom teeth may occur in close proximity to the dental nerves that control the sensations to the teeth, lips tongue in the lower jaw. Injury to this nerve is a very rare occurrence and depending on the type of injury, the damage may be temporary or prolonged and permanent.

Before starting the procedure, you dentist will tell you if there is any potential for damage to the nerves.

What will happen if I do not remove my wisdom teeth?

1. Tooth decay
   Teeth are very hard to keep clean and are more prone to decay.

2. Infection
The decay is left untreated, the decay could spread to the pulp of the tooth causing pain, infection and facial swelling.

3. Pericoronitis
Food and bacterial may become trapped under the gums around the wisdom tooth, causing pain and infection.

4. Cyst formation
In rare occasions, a cyst may form around the wisdom tooth and can damage the bone around the wisdom tooth and may be a risk for cancer

5. Crowding.
As wisdom teeth erupt into your mouth, they may push other teeth forward, resulting in crowding.

If you have any further questions, please feel free to call us on 0800 268 954 or send an email to appointment@hillparkdental.co.nz