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Dentist performing a tooth extraction

Dental extraction means removal of a tooth. The tooth is loosened using instruments and elevated out of the socket. There are two common types of extractions: Simple Extraction and Surgical Extraction. Simple extractions are performed on teeth that are easily accessible and can be performed using local anesthesia. Surgical extractions are performed when the tooth to be extracted is not easily accessible and may require a small amount of bone removal.

Who needs a dental extraction?

If the tooth is broken down due to cavity and it cannot be restored to its former function and a pain free state, you may need a dental extraction. Sometimes teeth need to be extracted as saving them may not extend the longevity.

Do baby teeth need extractions?

Sometimes baby teeth, also known as “milk teeth”, may need to be removed by your dentist. The most common causes are: 1) dental cavities that cause pain and 2) discomfort to your child. Another reason baby teeth need to be removed is if they are interfering with the eruption of permanent teeth.

Common tooth extraction aftercare guidelines

After the dental extraction, take all the prescribed medication as directed by your dentist. Eat soft, cold and lukewarm foods. Avoid smoking, drinking through a straw and spitting for 72 hours following the extraction procedure. Avoid strenuous exercise for 72 hours following the tooth extraction. Use an ice pack if needed to reduce inflammation.

It is very important to follow the directions from your dentist after your tooth removal. Here are the Do’s and Don’ts your dentist will explain to you.

The Do’s

  • Take all the pain medication and antibiotics as recommended if they are prescribed to you by your dentist.
  • Eat soft, cold, or warm foods for 72 hours following the procedure.
  • Ice Cream is recommended if your health permits it.
  • Use cold compresses as recommended by your dentist to reduce swelling.
  • Brush your teeth but avoid brushing the extraction socket.
  • If you have sutures in the area keep the area clean.
  • Drink fluids to keep yourself hydrated.

The Don’ts

  • Do not drink through a straw or spit for 72 hours as it may dislodge the blood clot forming in the extraction socket.
  • Do not drink alcoholic beverages for 72 hours after the procedure as it may cause interaction with the medications that are prescribed to you.
  • Do not drink carbonated beverages.
  • Do not brush roughly or rinse vigorously with mouth wash for the first 72 hours following your dental extraction.
  • Do not put finger or tongue in the extraction site to check healing as this may carry bacteria which may cause infection of the extraction site.
  • Don’t eat hard, crunchy and chewy stuff and it may disrupt the healing process.
  • Don’t eat or drink very hot foods.
  • Don’t smoke for 72 hours following extraction.

Prolonged pain after tooth extraction

Pain after a dental extraction is to be expected. But the pain should start to subside after 48 hours. If the pain gets worse along with a foul taste or smell, this may indicate a dry socket, or an infection of the extraction site. If you are experiencing these symptoms then contact your dentist immediately to treat the infection.

What is a dry socket?

Dry socket occurs when the blood clot that protects the extraction gets disrupted and causes the bone and nerves to be exposed. Sucking on a straw, smoking and continuous spitting are most likely the culprits which cause loss of the protective blood clot and hence dry socket. A dry socket can be very uncomfortable.

How can I avoid getting a dry socket?

In addition to following all the directions given to you post operatively by your dentist, a socket preservation procedure significantly reduces the chance of Dry socket.

After the tooth is removed from the jaw bone, there is “a hole” in the bone where the roots of the tooth were anchored. This area has a clot initially and bone grows into it gradually for the next 3-12 months either completely or partially filling the socket. If a socket preservation procedure is performed, “the hole” in the bone is filled with a graft material that forms a matrix to help with the healing. The socket preservation procedure significantly reduces the chance of dry socket formation. This also helps the healing process and makes the area more receptive to dental implants.

Bottom molar extraction

When a tooth is being extracted, it is gently elevated out of its bony housing. Sometimes due to extensive decay, the tooth may need to be cut out of the bone using surgical instruments.

Tooth extraction healing “white stuff”

The white stuff that you see in the dental extraction site after a few days is the scab formation. It will gradually get replaced by the gum tissue. If you see greenish yellow discharge or foul smell in the site, there may be a secondary infection and you need to contact your dentist immediately.

Tooth extraction bleeding after 2 hours

A little bleeding for a few hours after the extraction is normal. Also, a little blood mixed with a lot of saliva may appear to be a lot of bleeding. However if you have bright red blood oozing from the socket, place 2 pieces of gauze on the bleeding site and bite on it for 30 minutes. If the gauze gets soaked with bright red blood, bite in a tea bag. The tannins in tea help with clotting. If you are having a continuous bright red bleed or bluish purple clots, contact your dentist and head to an emergency room as this may indicate an underlying undiagnosed health condition.

Wisdom teeth removal

Wisdom teeth removal may be recommended if these teeth are erupting sideways. The altered eruption may lead to pain and discomfort. Sometimes if the wisdom teeth are partially erupted, they may develop dental cavities. In some situations your wisdom tooth may be pushing on the second molar in front of it causing damage to its roots or a dental cavity on both wisdom tooth and second molar. In very rare cases wisdom teeth may undergo cystic transformation. This can cause extensive damage to the jaw bone so it is imperative to get your wisdom teeth .

Broken tooth

When the dental caries (tooth decay) is extensive, the crown portion of tooth starts to disintegrate leaving the roots in the jaw bone. Sometimes the crown of the tooth may be broken due to trauma or as a result of biting on something hard. Whatever the reason may be, the remaining roots now have open root canals creating a direct pathway for food and bacteria into the bone. It is very important to have the roots removed to avoid abscess and drainage.

Impacted tooth

An impacted tooth is one that is stuck in the jaw bone and has not erupted. This may be due to the fact that the tooth is coming in sideways and is being blocked by other teeth. The dental impaction may be due to the fact that the teeth are crowded and there is not enough room for the teeth to erupt. The most commonly impacted teeth are third molars commonly known as wisdom teeth followed by upper canines.

Tooth extraction complications

The most common complication of a tooth extraction is pain and swelling. The severity of pain is usually related to the difficulty of the extraction. The more infection you have before the extraction or if the tooth is broken down and needs to be removed in pieces, the more discomfort you may have. Infection of the socket is another complication. Sometimes, there can be a secondary infection in the socket and this needs to be treated with antibiotics. Dry socket is another complication that may occur after a tooth extraction. Dry socket is loss of the protective blood clot exposing bone and nerves in the extraction site.

Tooth extraction when wearing dental braces

Back in the day, 2-4 premolars were routinely extracted to straighten teeth with dental braces. With newer wires and dental expanders, the necessity to remove teeth has significantly reduced. It is very rare with the modern Orthodontic techniques to require dental extraction. It is important to consult your dentist as soon as you see the initial sign of crowded teeth in your child.

Broken tooth extraction procedure

When a tooth is broken, it may require a surgical extraction. A surgical extraction is a process where a small amount of bone needs to be removed to gain access to the broken portion of the tooth. This helps your dentist to grasp the root tip with a forceps and remove it.

Emergency tooth extractions

We all know that tooth pain is one of the worst pains an individual can experience. It is important to contact your dentist immediately when you start experiencing mild tooth pain. If you decide to wait, it may not be possible to provide you with treatment as the infection will make it very difficult for you to get numb. In some rare cases, the infection may spread to your air spaces causing difficulty in breathing.

An excessively painful tooth may indicate an infection. The pus in the area makes it difficult for you to get a nub. So your dentist may prescribe you some antibiotics, and pain medication to reduce the infection and have you return for a tooth extraction. In some severe cases your dentist may choose to prescribe you a steroid pack to control the swelling.

Cost of a tooth extraction

If you do not have dental insurance, at Carrollton Smiles we have a program to help you. With our Carrollton Smiles Advantage Program you will be able to afford the dental treatment and take care of your oral health.

If your tooth is broken at the gum line, you would need a surgical extraction. The surgical extraction is a procedure where a small portion of bone and gum may be removed to gain access to the broken portion of the tooth. The tooth is then loosened and removed. For our patients without dental insurance, at Carrollton Smiles we offer our Carrollton Smiles Advantage Program to help with the financial burden associated with your dental care.


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