TOOTH EXTRACTIONS MOBILE

What Is It?

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

What It’s Used For

If a tooth has been broken or destroyed by decay, your dentist will aim to fix it with a filling, crown or other treatment option. Sometimes, though, there’s too much damage for the tooth to be repaired. In this scenario, the tooth needs 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 good reasons:

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

Sometimes baby teeth never fall out on time to permit the permanent teeth to come in.

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

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

People receiving cancer prescriptions may develop infected teeth given that these drugs weaken the immune system. Infected teeth may need to be extracted.

Some teeth may need to be extracted if they could become a cause of infection after an organ transplant. Individuals with organ transplants have a high risk of infection because they must take drugs that decrease or subdue the immune system.

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

If you anticipate to have treatment with intravenous drugs called bisphosphonates for a medical condition, make sure to see your dentist first. If any teeth must be extracted, this should be done well 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 take 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 having wisdom teeth removed, you could have a panoramic X-ray. This X-ray takes an image of all your teeth simultaneously. 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 connection to your sinuses
The lower teeth’s connection 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 be present

Some doctors prescribe antibiotics to be taken before and following 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 have a weakened immune system
You will have an extensive surgery
You have specific medical conditions

You may have intravenous (IV) anesthesia, which can differ from conscious sedation to general anesthesia. If so, your doctor will have give you guidelines to follow. You should wear clothing with short sleeves or sleeves that could be rolled up conveniently. 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 and including a week a week before the surgery, get in touch with your doctor. He or she may need to avoid anesthesia until you end 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 an adjustment in the planned anesthesia or the extraction may ought to be rescheduled.

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

When you finish the extraction, someone will have to drive you home and stay there with you. You will be given post-surgery instructions. It is crucial that you follow them.

How It’s Done

There are two forms of extractions:

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

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

Most basic extractions are accomplished using just an injection (a local anesthetic). You may or may not receive drugs to help you relax. For a surgical extraction, you will receive a local anesthetic, and you may also have anesthesia via a vein (intravenous). Some people may need to have 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 minimize swelling and keep you pain-free following the procedure.

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

Follow-Up

Your doctor will give you detailed guidelines on what to work on and what to expect after your surgery. If you have any questions, make certain to ask them before you leave the office.

Having a tooth removed is surgery. You can expect some soreness after even simple extractions. Usually it is light. Research has shown that taking nonsteroidal anti-inflammatory drugs (NSAIDs) can considerably decrease pain after a tooth extraction. These drugs include ibuprofen, such as 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 generally cause more pain following the procedure than simple extractions. The level of discomfort and the length of time it lasts will be dependent on how difficult it was to remove the tooth. Your dentist may suggest pain medicine for a few days then afterwards suggest an NSAID. Most pain fades away after a few days.

A cut in the mouth often tends to bleed more than a cut on the skin because it can not dry out and develop a scab. After an extraction, you’ll be asked to bite on a portion 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 lessen after that. Don’t disturb the clot that forms on the wound.

You can put ice bags on your face to decrease swelling. Commonly, they are left on for 20 minutes at a time and removed for 20 minutes. If your jaw is sore and stiff after the swelling recedes, try warm compresses.

Eat soft and cool foods for a couple of days. Then try other food as you feel comfortable.

A mild rinse with lukewarm salt water, started 24 hours after the surgery, can help to keep the area cleansed. Use one-half teaspoon of salt in a cup of water. Almost all swelling and bleeding end within a day or two after the surgery. Initial healing takes at the very least two weeks.

If you require stitches, your doctor may use the sort that dissolve by themselves. This generally takes one to two weeks. Rinsing out with warm salt water will help the stitches to dissolve. Some stitches must be removed by the dentist or surgeon.

You should not smoke, utilize a straw or spit after surgery. These practices can pull the blood clot out of the cavity 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 forms in about 3% to 4% of all extractions. This happens 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 made vulnerable to air and food. This can be very excruciating and can cause a bad odor or taste. Commonly dry sockets begin to trigger pain the third day after surgery.

Dry socket occurs as high as 30% of the time when impacted teeth are extracted. It is also more likely after troublesome extractions. Smokers and women who take birth control pills are more likely to have a dry socket. Smoking on the day of surgery further increases the risk. A dry socket must be treated with a medicated dressing to stop the pain and encourage the area to heal.

Infection can set in as a result of an extraction. However, you likely won’t get an infection if you have a healthy immune system.

Other plausible problems include:

Unexpected damage to neighboring teeth, such as fracture of fillings or teeth

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

A fractured jaw triggered 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 back tooth (molar)– A small hole usually will close up by itself in a few weeks. If not, more surgery may be required.

Discomfort in the jaw muscles and/or jaw joint– It may be challenging 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 caused 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 have fever, chills or redness
You have trouble swallowing
You develop uncontrolled bleeding in the area
The area continues to ooze or bleed after the first 24 hours
Your tongue, chin or lip seems 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 usually will prescribe antibiotics.