You and your dentist may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.
The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, to bone loss and shifting teeth, which can have a major impact on your dental health.
To avoid these complications, in most cases, Drs. Marwan Bassil, Manisha Singh, Stacey Goldstein, and Bruce Hirshorn will discuss alternatives to extractions as well replacement of the extracted tooth.
The Extraction Process
At the time of extraction, the doctor will need to numb your tooth, jawbone, and gums that surround the area with a local anesthetic.
During the extraction process, you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.
You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.
If you do feel pain at any time during the extraction please let us know right away.
Sectioning a tooth
Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.
Most instances of extraction leave a defect in the bone as the bone recovers from the tooth loss. The socket fills in but left on its own will heal lower than the height of the bone of adjacent teeth.
Bone grafting at the time of extraction gives the bony socket a framework on which your new bone cells can grow with much less re-contouring of the surrounding bone.
This is important for adjacent teeth that share bony walls, and when an implant is planned after healing is complete. Partial and Full dentures are much more comfortable and stable when the underlying ridge is level and wide. There are many benefits to having the graft at the time of extraction.
There are different types of grafting material. Drs. Marwan Bassil, Manisha Singh, Stacey Goldstein, and Bruce Hirshorn can discuss the best option for you.
After Extraction Home Care
Some bleeding may occur. Placing a piece of moist gauze over the empty tooth socket and biting down firmly for 45 minutes can control this.
Blood clots that form in the empty socket.
This is an important part of the healing process and you must be careful not to dislodge the clot.
- Avoid rinsing or spitting for 24 hours after the extraction.
- Avoid the use of a straw, smoking or hot liquids.
If swelling occurs you can place ice on your face for 10 minutes and off for 20 minutes. Repeat this cycle as you feel necessary for up to 24 hours.
Pain and Medications
If you experience pain you may use non-prescription pain relief medications such as acetaminophen or ibuprofen.
For most extractions just make sure you do your chewing away from the extraction site. Stay away from hot liquids and alcoholic beverages for 24 hours. A liquid diet may be recommended for 24 hours.
Brushing and Cleaning
After the extraction avoid brushing the teeth near the extraction site for one day. After that, you can resume gentle cleaning. Avoid commercial mouth rinses, as they tend to irritate the site. Beginning 24 hours after the extraction you can rinse with salt water (1/2 teaspoon in a cup of water) after meals and before bed.
Dry socket occurs when a blood clot fails to form in the socket where the tooth has been extracted or the clot has been dislodged, and the healing is significantly delayed.
Following the post-extraction instructions will reduce the chances of developing dry socket. Dry sockets manifest themselves as a dull throbbing pain, which doesn’t appear until three or four days after the extraction. The pain can be moderate to severe and radiate from the extraction area. Dry socket may cause a bad taste or bad breath and the extraction site appears dry.
Drs. Marwan Bassil, Manisha Singh, Stacey Goldstein, and Bruce Hirshorn will apply a medicated dressing to the dry socket to soothe the pain.
When sutures (stitches) have been placed, you will need to return to have them removed. Suture removal can happen between seven and ten days after the day of the extraction.