TOOTH EXTRACTIONS DOUGLASVILLE

What Is It?

Tooth extraction is the removal of a tooth from its socket in the bone.

What It’s Utilized For

If a tooth has been broken or destroyed by decay, your dentist will attempt to fix it with a filling, crown or other treatment. Sometimes, though, there’s too much damage for the tooth to be repaired. In this specific situation, the tooth has to be extracted. A considerably loose tooth also will require extraction if it can’t be saved, even with bone replacement surgery (bone graft).

Here are other reasons:

Some individuals have additional teeth that obstruct other teeth from coming in.

Sometimes baby teeth don’t fall out in time to enable the permanent teeth to come in.

People acquiring dental braces may need teeth removed to create room for the teeth that are being migrated into place.

Individuals receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.

Individuals receiving cancer drugs may develop infected teeth because these drugs minimize the immune system. Infected teeth may need to be extracted.

Some teeth may have to be extracted if they could become an origin of infection after an organ transplant. People with organ transplants have a high risk of infection because they must take drugs that diminish or suppress the immune system.

Wisdom teeth, also called third molars, are often extracted either before or after they come in. They commonly come out during the late teens or early 20s. They need to be removed if they are decayed, cause soreness or have a cyst or infection. These teeth often get stuck in the jaw (impacted) and do not come in. This can irritate the gum, causing discomfort and swelling. For this case, the tooth must be removed. If you need all four wisdom teeth removed, they are usually removed at the same time.

If you anticipate to have treatment with intravenous drugs called bisphosphonates for a medical condition, be sure to see your dentist first. If any teeth have to be extracted, this should be done before your drug treatment begins. Having a tooth extraction after bisphosphonate treatment increases the risk of osteonecrosis (death of bone) in the jaw.

Preparation

Your dentist or oral surgeon will utilize an X-ray of the area to help decide the best way to extract the tooth. Be sure to give your full medical and dental history and a list of all medicines you utilize. This should include both prescription and over the counter drugs, vitamins and supplements.

If you are getting wisdom teeth removed, you could have a panoramic X-ray. This X-ray takes a photo of all your teeth at once. It can show several things that help to advise an extraction:

The connection of your wisdom teeth to your other teeth
The upper teeth’s relationship to your sinuses
The lower teeth’s relationship to a nerve in the jawbone that gives feeling to your lower jaw, lower teeth, lower lip and chin. This nerve is called the inferior alveolar nerve.
Any infections, tumors or bone disease that may exist

A number of doctors prescribe antibiotics to be taken prior to and after surgery. This practice varies by the dentist or oral surgeon. Antibiotics are more likely to be given if:

You come with infection at the time of surgery
You possess a weakened immune system
You will have an extensive surgery
You have specific medical conditions

You may have intravenous (IV) anesthesia, which can range from conscious sedation to general anesthesia. If so, your doctor will have give you instructions to follow. You should wear clothing with short sleeves or sleeves that can be rolled up easily. This allows access for an IV line to be placed in a vein. Don’t eat or drink anything for six to eight hours before the operation.

If you have a cough, stuffy nose or cold up to a week before the surgery, get in touch with your doctor. He or she may need to avoid anesthesia until you are over the cold. If you had nausea and vomiting the night before the procedure, call the doctor’s office first thing in the morning. You may need a modification in the planned anesthesia or the extraction may have to be rescheduled.

Do not smoke on the day of surgery. This can enhance the risk of a painful problem called dry socket.

After the extraction, someone will need to drive you home and stay there with you. You will be given post-surgery guidelines. It is crucial that you follow them.

How It’s Done

There are two types of extractions:

A simple extraction is carried out on a tooth that can be seen in the mouth. General dentists often do simple extractions. In a simple extraction, the dentist loosens the tooth with a tool called an elevator. Then the dentist uses a tool called a forceps to remove the tooth.

A surgical extraction is a more intricate procedure. It is used if a tooth may have broken short at the gum line or has not come into the mouth yet. Surgical extractions commonly are done by oral surgeons. However, they are also done by general dentists. The doctor makes a miniature incision (cut) into your gum. Sometimes it’s required to remove some of the bone surrounding the tooth or to cut the tooth in half in order to extract it.

Most basic extractions can be accomplished using just an injection (a local anesthetic). You may or may not receive drugs that can help you relax. For a surgical extraction, you will receive a local anesthetic, and you may also have anesthesia through a vein (intravenous). Some people may require general anesthesia. They include patients with specific medical or behavioral conditions and young children.

If you are receiving conscious sedation, you may be given steroids in addition to other medicines in your IV line. The steroids help to decrease swelling and keep you pain-free following the procedure.

Throughout a tooth extraction, you can anticipate to feel pressure, but no pain. If you feel any pain or pinching, advise your doctor.

Follow-Up

Your doctor will give you detailed directions on what to work on and what to expect after your surgery. If you have any questions, see to it to ask them prior to you leave the office.

Having a tooth removed is surgery. You can expect some pain after even simple extractions. Usually it is light. Research has shown that taking nonsteroidal anti-inflammatory drugs (NSAIDs) can greatly decrease discomfort after a tooth extraction. These drugs include ibuprofen, including Advil, Motrin and others. Take the dose your doctor recommends, 3 to 4 times a day. Take the first pills before the local anesthesia wears off. Continue taking them for 3 days. Ask your doctor for complete instructions.

Surgical extractions normally cause more pain following the procedure than simple extractions. The amount of discomfort and how long it lasts will hinge on how difficult it was to remove the tooth. Your dentist may prescribe pain medicine for a few days and afterwards suggest an NSAID. Most pain goes away after a few days.

A cut in the mouth often tends to bleed more than just a cut on the skin because it can not dry out and develop a scab. After an extraction, you’ll be asked to clamp on a chunk of gauze for 20 to 30 minutes. This high pressure will allow the blood to clot. You will still have a touch of bleeding for the next 24 hours or so. It should wane after that. Don’t agitate the clot that forms on the wound.

You can put ice packs on your face to minimize swelling. Typically, they are left on for 20 minutes each time and removed for 20 minutes. If your jaw is hurting and stiff after the swelling goes away, try warm compresses.

Eat delicate and cold foods for a few short days. At that point try other food as you feel confident.

A delicate rinse with warm salt water, started 24 hours after the surgical procedure, can help to keep the area cleansed. Use one-half teaspoon of salt in a cup of water. The majority of swelling and bleeding end within a day or two after the surgical procedure. Initial healing takes at least two weeks.

If you need stitches, your doctor may use the kind that diffuse on their own. This generally takes one to two weeks. Washing with warm salt water will help the stitches to dissolve. Some stitches need to be removed by the dentist or surgeon.

You should not smoke, utilize a straw or spit after surgery. These practices can remove the blood clot out of the hole where the tooth was. Do not smoke on the day of the procedure. Do not smoke for 24 to 72 hours after having a tooth extracted.

Risks

A problem called a dry socket develops in about 3% to 4% of all extractions. This takes place 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 subjected to air and food. This can be very painful and can cause a bad odor or taste. Commonly dry sockets begin to induce pain the third day after surgery.

Dry socket occurs up to 30% of the time when impacted teeth are taken out. It is also more probable after challenging extractions. Smokers and women who take birth control pills are more likely to have a dry socket. Smoking on the day of surgery additionally increases the risk. A dry socket must be treated with a medicated bandaging to stop the pain and stimulate the area to heal.

Infection can arise after an extraction. However, you likely won’t get an infection if you have a healthy immune system.

Other plausible problems include:

Unintentional damage to adjacent teeth, such as fracture of fillings or teeth

An incomplete extraction, by which a tooth root remains in the jaw– Your dentist typically removes the root to avoid infection, but occasionally it is less risky to leave a small root tip in position.

A broken jaw caused by the pressure applied to the jaw during extraction– This occurs more often in older people with osteoporosis (thinning) of the jaw bone.

A hole in the sinus during removal of an upper rear tooth (molar)– A small hole usually will close up by itself in a few weeks. If not, more surgery may be mandated.

Pain in the jaw muscles and/or jaw joint– It may be difficult for you to open your mouth wide. This can happen because of the injections, keeping your mouth open and/or lots of pushing on your jaw.

Long-lasting numbness in the lower lip and chin– This is an uncommon problem. It is brought on by injury to the inferior alveolar nerve in your lower jaw. Complete healing may take three to six months. In rare cases, the numbness may be permanent.

When To Call a Professional

Call your dentist or oral surgeon if:

The swelling gets worse instead of better.
You develop fever, chills or redness
You have trouble swallowing
You have uncontrolled bleeding in the area
The area continues to ooze or bleed after the first 24 hours
Your tongue, chin or lip feels numb more than 3 to 4 hours after the procedure
The extraction site becomes very uncomfortable– This may be a sign that you have developed a dry socket.

If you have an infection, your dentist normally will prescribe antibiotics.