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TOOTH EXTRACTION

Although permanent teeth were meant to last a lifetime, there are a number of reasons why you may need tooth extraction – the most common reasons being extensive decay and periodontitis (causing tooth to become loose).

What are the indications for tooth extraction?

  • Tooth decay or trauma extending to the pulp, which is the centre of the tooth containing nerves and blood vessels – bacteria in the mouth can enter the pulp, leading to infection. Although certain cases can be treated with root canal treatment (RCT), teeth which do not respond to RCT may need to be extracted to prevent the spread of infection
  • Advanced periodontitis is an infection of the tissues and bones that surround and support the teeth. If left untreated, this condition can lead to loosening of the teeth and gum abscess, necessitating extraction of the offending tooth
  • Crowded mouth – sometime you need to extract teeth to assist orthodontic treatment. The goal of orthodontic treatment is to properly align the teeth, which may not be possible if there is not enough room to align them. Likewise, if a tooth cannot break through the gum (erupt) because there is not enough room in the mouth for it, your dentist may recommend extracting it
  • Risk of infection – if your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant), even the risk of infection in a particular tooth may be reason enough to extract the tooth
  • What to tell your dentist before a tooth extraction?

    Although having a tooth extracted is usually very safe, the procedure can allow harmful bacteria into the bloodstream. Gum tissue is also at risk of infection. If you have a condition that puts you at high risk for developing a severe infection, you may need to take antibiotics before and after the extraction. Before having a tooth extracted, you need to let your dentist know your complete medical history, the medications and supplements you take, and if you have one of the following conditions:

  • Damaged or man-made heart valves
  • Congenital heart defect
  • Impaired immune system
  • Liver disease (cirrhosis)
  • Artificial joint, such as a hip replacement
  • History of bacterial endocarditis
  • Chronic smoker
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    What to expect during tooth extraction?

    Before the extraction, your dentist will give you an injection of a local anaesthetic to numb the area where the tooth will be removed. Using a forceps, the tooth is grasp and gently rocked back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth may need to be removed in pieces.

    What to expect after tooth extraction?

    Once the tooth has been extracted, a blood clot usually forms in the socket. The dentist will pack a gauze pad into the socket and have you bite down on it to help stop the bleeding. Sometimes the dentist will place a few stitches to close the gum edges over the extraction site.

    In certain circumstances such as when you’re a heavy smoker, the blood clot in the socket breaks loose, exposing the bone in the socket. This is a painful condition called dry socket. If this happens, your dentist will likely place a sedative dressing over the socket for a few days to protect it as a new clot forms.

    Helpful tips to minimize discomfort, reduce the risk of infection and speed recovery

  • Bite firmly but gently on the gauze pad to reduce bleeding and allow a clot to form in the tooth socket. Change gauze pads before they become soaked with blood. Otherwise, leave the pad in place for three to four hours after the extraction
  • Avoid rinsing or spitting forcefully for 24 hours after the extraction to avoid dislodging the clot that forms in the socket
  • Practice soft diet for the first few days
  • Avoid brushing around the extraction site for the first week, as brushing can dislodge the blood clot and sutures (you can clean other teeth as usual)
  • Gently rinse your mouth with the prescribed anti-bacterial mouthwash as instructed by your dentist
  • Reduce facial swelling by placing an ice pack over the swollen area
  • Take painkillers as prescribed to help with pain & swelling
  • Relax for at least 24 hours after surgery. Limit activity for the next day or two
  • Do not smoke, which can inhibit healing
  • When to call your dentists?

    It is normal to feel some pain after the anaesthesia wears off. For the first 24 hours, you should also expect some swelling and residual bleeding. However, if either bleeding or pain is still severe more than four hours after your tooth is pulled, you should call your dentist. You should also call your dentist if you experience any of the following:

  • Redness, swelling, or excessive discharge from the affected area
  • Signs of infection, including fever and chills
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting

  • The initial healing period usually takes about one to two weeks. New bone and gum tissue will grow into the gap. Over time, however, having a tooth (or teeth) missing can cause the remaining teeth to shift, affecting your bite and making it difficult to chew. For that reason, your dentist may advise replacing the missing tooth or teeth with a denture, bridge or an implant.
    Should you need any further information, please do not hesitate to contact us.
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