Extractions

Teeth Extraction - Bradley A. Cherry - Cherry OMS

Tooth extraction is the removal of a tooth from the mouth. Extractions may be performed because of decay and broken down teeth that cannot be restored. Extractions may also be used to remove teeth to make room for orthodontic treatment.

Consultation

Your initial appointment will consist of a consultation explaining your diagnosis and your treatment options. Occasionally, the extraction can be performed the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.

Procedure


Simple Extractions

These are performed on teeth that are visible in the mouth and that require only the use of instruments – usually under local anesthetic – to elevate and/or grasp the visible portion of the tooth. Typically, an instrument called a dental elevator is used to lift the tooth. Dental forceps are then used to rock the tooth back and forth until the periodontal ligament has been sufficiently broken and the supporting alveolar bone has been adequately widened so that the tooth is loose enough to remove. Typically, when teeth are removed with forceps, slow, steady pressure is applied with controlled force.

Surgical Extractions

These involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line or because they have not erupted fully. Surgical extractions almost always require an incision. In a surgical extraction, the doctor may elevate the soft tissues covering the tooth and bone and may also remove some of the overlying and/or surrounding jawbone tissue with a drill or osteotome. Frequently, the tooth is split into multiple pieces to facilitate its removal. Surgical extractions are usually performed under a general anesthetic.

Postoperative Recovery

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we will ask you to bite on a gauze pad for 30–45 minutes after the appointment. If the bleeding or oozing still persists, insert another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.

After the blood clot forms, it is important not to disturb or dislodge the clot, as it aids healing.

The following are highly discouraged for the first 72 hours after a tooth extraction:

  • Rinsing vigorously
  • Sucking on straws
  • Smoking
  • Drinking alcohol
  • Brushing teeth next to the extraction site

These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours, as this will increase blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling will usually subside after 48 hours.

Use the pain medication as directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid, and eat nutritious soft food on the day of the extraction. You will be able to eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

After a few days, you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for two to three days, or a reaction to the medication, call the office immediately at (904) 230-6399.

Risks & Side Effects

Infection can set in after an extraction, although you probably won’t get an infection if you have a healthy immune system.

A common complication called a dry socket occurs when a blood clot doesn’t form in the hole or the blood clot breaks off or breaks down too early. In a dry socket, the underlying bone is exposed to air and food. This can be very painful and can cause a bad odor or taste. A dry socket needs to be treated with a medicated dressing to stop the pain and encourage the area to heal.

Other potential problems include:

  • Accidental damage to teeth near the surgical site, such as fracture of fillings or teeth.
  • An incomplete extraction, in which a tooth root remains in the jaw. Your dentist usually removes the root to prevent infection, but occasionally it is less risky to leave a small root tip in place.
  • A fractured jaw caused by the pressure put on the jaw during extraction. This occurs more often in older people with osteoporosis (thinning) of the jaw.
  • A hole in the sinus wall caused during removal of an upper back tooth (molar). A small hole will usually close up by itself in a few weeks. If not, more surgery may be required.
  • Soreness in the jaw muscles and/or jaw joint. It may be tough for you to open your mouth wide. This can happen because of the injections, the strain of keeping your mouth open during the procedure and/or lots of pushing on your jaw during the extraction.
  • Long-lasting numbness in the lower lip and chin. This is caused by injury (trauma) to the inferior alveolar nerve during removal of the lower wisdom teeth. Complete healing of the nerve may take three to six months. In rare cases, the numbness may be permanent.

Call Dr. Cherry if the swelling gets worse instead of better. Call if you have fever; chills; redness; trouble swallowing; uncontrolled bleeding in the area; or your tongue, chin or lip feels numb.

Also call our office if the area of the extraction site becomes very painful. This is a sign that you may have a dry socket. If the area continues to bleed after the first 24 hours, notify Dr. Cherry.