Tooth Extraction – Everything About Tooth Removal & When to Go for It?

Tooth extraction is a procedure of having your tooth removed from its place in the mouth. The tooth is embedded in a socket in the bone, which requires a systematic procedure for removal. There are several conditions, such as tooth decay, periodontal issues, problematic wisdom teeth, etc., which require tooth extraction.

The tooth extraction procedure requires anesthesia and instruments such as elevators and forceps. Tooth extraction may be surgical or non-surgical, and the dentist will give you medications for pain relief and infection control.

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Through this article, we will read extensively about dental extractions. You will learn about leading cause of tooth extraction, pre-extraction pointers, tooth extraction procedure, post-extraction pointers, complication, etc.

Why might tooth exaction be the only solution?

There could be several reasons for tooth extraction. These reasons could be concerning the teeth itself, the bones, other structures in your mouth or even the body.

Decay

Tooth decay is the most frequent cause of tooth extraction. When there is a cavity or some discoloration in any of your teeth, the dentist will remove the decay and fill a restorative material.

If the decay is widespread, a root canal is carried out. But sometimes, the decay is so severe that the tooth has to be removed to prevent the decay from spreading.

Periapical Lesions

The periapical region is the area around the apex of your tooth root. If there is an infection in the periapices, you will have a cyst, abscess or a granuloma in that region.

Clinically it may not be distinguishable, but your dentist can see it well on a radiograph. If the lesion is large or causing much damage to the tooth and its surrounding tissues, then tooth extraction becomes the only resort for a cure.

Periodontal Problems

The periodontium is the supporting system of the tooth. It holds the tooth firmly in the socket. Due to excessive calculus or some pathology, the tooth may become loose from the socket. The dentist will advise tooth extraction if the mobility is very high.

Over-retained deciduous teeth

In some teenagers, the milk teeth do not fall off at the expected age. These teeth are over-retained, and they delay or hinder the eruption of their permanent successors.

Over- retained deciduous teeth require tooth removal so that the permanent teeth have space to erupt. This condition can also be due to some growth deficiencies or syndromes.

Orthodontic treatment

Often, people with crowded or forwardly placed teeth need to get braces. To make space to straighten these teeth, your orthodontist may advise you to have one or two of your premolars removed.

Orthodontic extractions are needed to reduce crowding in the arch.

Wisdom teeth extraction

The wisdom teeth, often called the third molars, are the last teeth to erupt on each side of the jaw. Most times these teeth are impacted, which means they are tilted or angulated because of lack of space.

They push through the gums and often cause pain, swelling, and infection. The most effective treatment to get rid of wisdom teeth problems is extraction.

Radiation therapy

Cancer patients undergoing radiation therapy for head and neck may have to go for tooth extraction if a tooth falls in the line of radiation. (1)

Organ Transplants

Patients undergoing organ transplants are under medications that suppress the immune system. These medications lead to the teeth becoming infected, and the infection can spread. For this reason, an infected tooth may have to be extracted.

Tooth Extraction

Pre-extraction pointers

Though tooth extraction is a single sitting procedure, there are many procedures and practices before actual removal of the tooth that you must keep in mind.

Medical History

You must inform your dentist about any medical conditions that you suffer from. Not just that, any history of recent hospitalization or the medicines that you’re on must be called out when you visit your dentist.

If you are taking certain drugs, the tooth extraction procedure may have to be slightly modified. (2) If you have diabetes, your dentist will check with your latest reports to ensure your sugar is under control. If not, you may be asked to get consent from your endocrinologist. (3)

Similarly, if you are taking medicines for high blood pressure, or blood thinners, written consent from your physician is needed. Female patients taking oral contraceptives should also inform the dentist about the same.

Dental history

You must also keep your dentist fully informed about any previous tooth extraction that you might have undergone. This helps your dentist assess your body’s response to the anesthesia and the tooth extraction procedure in general.

It also gives an idea about your mouth’s healing rate. If you developed an allergic reaction to the anesthesia, you must tell your dentist about that.

Allergies to drugs

Before and after the tooth extraction, the dentist will give you medicines to reduce the pain, swelling and prevent infection. These mainly include analgesics and antibiotics. You must tell your dentist beforehand if you are allergic to any particular class of drugs.

Habits

You must refrain from consuming alcohol or smoking before tooth extraction. These habits interfere with the clotting mechanism and delay wound healing.

Procedures before tooth extraction

  • When your dentist advises you a removal, he will get an x-ray of that tooth to get a better picture of the damage inside. Through the x-ray, the dentist also gets a better idea of the tissues around the tooth.
    If there are any nerves, blood vessels or other structures around the tooth, the oral surgeon will be particularly cautious about it during tooth extraction.
  • Before the day of your tooth extraction, the dentist may also prescribe you some medicines if you have an infection or severe pain.
    The antibiotics help to reduce the bacteria population in that area. This is important because if you have an abscess or some other infection, the anesthesia may not act.
  • The dentist will advise you to have a wholesome breakfast, or an appetizing meal before you come for extraction. This is because you may get dizzy or hypoglycaemic if you are administered anesthesia on an empty stomach.
    It is imperative that someone accompanies you for the procedure. In case you feel giddy or uncomfortable, you aren’t going to be able to leave for home on your own.
  • Unless asked by the dentist or physician, you must take your daily dose of medicine for conditions like diabetes and blood pressure.
    However, if you are on aspirin, your dentist may prescribe for you to discontinue it 72 hours before extraction, after consultation with your doctor. This is because aspirin is a blood thinner which could prolong your bleeding time. However, it is not always required to stop aspirin. (4)

The tooth extraction procedure

  • The procedure is usually carried out under local anesthesia. Under some special circumstances, general anesthesia may be given to a patient. If the patient is unstable, extraordinarily apprehensive or uncooperative, then general anesthesia may have to be administered by an anesthetist.
  • A test dose of the anesthesia is given on the skin of the arm to check for allergies to any contents in the injection.
  • The dentist first applies a topical numbing gel over your gums and palate near the tooth to be extracted. This helps to reduce the pain of the needle prick.
  • The anesthesia is given with a small injection, and the dentist waits until the effect sets in.
  • Depending on the area of the mouth, you will have subjective symptoms like tingling sensation over the anterior part of your tongue, or numbness and heaviness on your lower lip.
  • Once the dentist is satisfied that the anesthesia has acted, he begins by removing part of the gums around the tooth to be removed. This helps them to gain better access to the tooth, and also gives a better grip while removing it.
  • With the help of an instrument called an elevator, the dentist then loosens the tooth from its socket. The elevator works like a wedge or a wheel and axle.
  • Once the tooth is loose in the socket, the dentist or the oral surgeon takes a forceps and firmly casts his grip on the tooth from its neck. The hold of the forceps on the tooth is important because if it is not firm, the tooth can break from the middle, fracturing it.
  • With hand movements, the forceps are used to remove the tooth from the socket, where it is first rotated and then pulled out.
  • If the tooth extraction is a surgical one, which is usually the case with third molars or impacted canines, a part of the bone may have to be removed. Special instruments like chisel and mallet are needed for this procedure.
  • If you are having multiple teeth removed, or have had a traumatic extraction, the oral surgeon will give you sutures.
  • Once the tooth is out, the dentist will clean the area gently and place a small cotton gauze that you will be asked to bite on. He will advise you to keep this in the mouth for about thirty minutes to maintain pressure and control bleeding.

Post-extraction pointers

  • Some bleeding over the next twenty-four hours is normal, do not continuously spit. This will dislodge the clot that is forming over the socket, and therefore delay healing.
  • Do not eat anything over the next hour. After about an hour, plain ice cream is the best thing to control swelling and reduce pain.
  • What to eat – Over the next three days, take care of your diet. Stick to eating cold, soft and non-spicy food. This will ensure you don’t have to chew too hard.
  • Avoid eating spicy, crispy food or small grains or seeds. These can get lodged in the socket and give you pain and infection.
  • The next day, take some lukewarm water and add one to two tablespoons of salt. Rinse your mouth with saline water. This helps to reduce the inflammation and swelling.
  • Make sure you take the medicines as prescribed. Most commonly the dentist will prescribe painkillers and antibiotics.
  • Applying ice over the area outside also helps to prevent or reduce swelling.
  • Visit your dentist as advised for a follow-up and suture removal.

Complications of tooth extraction

Sometimes there may be minor inconveniences during tooth extraction, which may have implications later. Let’s look at some of them.

  • Trismus – trismus is a problem with your muscles where you experience difficulty in mouth opening and jaw movements. This may be because of the injection or prolonged and excess mouth opening during extraction. Consulting your dentist and doing mouth opening exercises is beneficial. (5)
  • Dry socket – It is also called alveolar osteitis in medical terms. Dry socket is a condition that happens when a clot fails to develop at the extraction site.
    The clot may get dislodged because of some disturbance at the extraction site. Due to the absence of the protective clot, the underlying nerves and bone are exposed, making it susceptible to infection, pain, and sensitivity.
    If the pain persists for longer than a week, you must see your dentist for management. (6)
  • Damage to the adjacent teeth or fracture of the adjacent teeth may be an unwanted consequence of tooth extraction.
  • If you are having your upper premolars or molars removed, there can be a communication between the oral cavity and your maxillary sinus, called an oro-antral communication. It may require surgical intervention if large.
  • If your inferior alveolar nerve is injured, the numbness may last longer than anticipated. But this is a rare problem.

FAQs for tooth extraction

How long does the pain last after tooth extraction?

Usually, the pain lasts for 2-3 days after the extraction, which can be managed by prescribed pain killers. However, if you experience continuous pain even after this time, consult your dentist to check for a dry socket.

How much is a tooth extraction?

Typically, the cost of tooth extraction depends on the type of tooth and whether it is impacted or fully erupted. Usually, a simple extraction costs between $75 – $200. On the other hand, the cost of extracting an impacted tooth may range between $600 – $1000.

Does tooth extraction hurt?

Generally, all tooth extractions are performed under local anesthesia. The tooth is always numb while the dentists remove the tooth. Therefore, the process of tooth extraction is painless. However, the patient might feel slight pressure, which is applied to luxate the tooth.

Does a rotten tooth extraction cost?

Rotten teeth, also known as root stumps, are grossly decayed teeth. These teeth are usually removed by surgical extraction. Moreover, it requires precise skills and technique to remove a root stump. Additionally, the cost also depends on the type of anesthetic used to numb the teeth. Therefore, the cost of rotten teeth ranges between $100 – $600.

A tooth extraction cost without insurance?

The cost of tooth extraction may be slightly expensive without insurance. It usually depends on the type of tooth and the severity of the tooth decay. Generally, a simple tooth extraction without insurance may cost between $80 – $600. Moreover, the cost of a surgical tooth extraction without insurance may range between $700 – $2000.

How long after tooth extraction can i eat?

Ideally, the best time to eat anything after a tooth extraction is when the numbness is completely gone. However, it is advised not to eat anything for at least 1-2 hours after the tooth extraction. This is to avoid unnecessary injury caused by biting on the lips and tongue when the tissues are numb.

What to do after tooth extraction?

It is essential to follow the post-extraction instructions carefully to allow proper healing of the extraction site and avoid unnecessary injuries. Given below are the critical post-extraction instructions –

  • The patient must bite on the gauze placed by the dentist for one hour after the procedure
  • After one hour take the gauze out
  • During this time, it is recommended to eat ice-cream or drink cold water or juice to bring down any swelling around the extraction site. However, do not drink fluids using a straw.
  • Take the pain medications prescribed by the dentist
  • It is advised to eat food after 1-2 hours post-extraction when the numbness is worn away
  • Do not spit saliva for 1-2 days. Rather swallow it
  • Do not touch the extraction site with your tongue
  • Use cold compress if there is a facial swelling
  • Pay attention while brushing teeth and rinse your mouth gently with warm water
  • Eat a soft, nutritious diet. Avoid spicy, hard, and crunchy food. Moreover, avoid alcohol or acidic beverages.
  • Quit smoking
  • Follow-up with the dentist after one week to check the healing of the extraction site

Can i eat bread after tooth extraction?

It is better to re-introduce bread after a few days of tooth extraction.

Usually, after tooth extraction, it is advised to drink plenty of fluids such as fresh juice and water. Moreover, a soft, nutritious diet is recommended to avoid injury to the extraction site. Additionally, it reduces the heavy biting force applied while chewing hard food.

The soft diet mainly includes yogurt, mashed potatoes, rice, milk, and cheese. Moreover, the dentist may guide the patient to chew from the opposite side until the wound heals completely.

When can I smoke after tooth extraction?

You can smoke eventually after tooth extraction when the socket has completely healed. However, smoking is strictly restricted for at least 72 hours after the tooth extraction procedure. This is because smoking increases the risk of a dry socket. Moreover, smoking delays the healing of the extraction site by dislodging the blood clot.

Can I eat rice after tooth extraction?

Yes, you can eat rice after tooth extraction. Rice is included in the soft, nutritious diet that is usually advised by the dentist. However, make sure to consume food after 2-3 hours of tooth extraction or when the numbness around the tooth, lips, and tongue is completely gone.

What food to eat after wisdom tooth extraction?

Usually, you should switch to a soft, nutritious diet rich in minerals, vitamins, and protein. Some of the food that you can eat post-extraction are listed below –

  • Blended soups such as tomato and pumpkin
  • Vegetable broth or bone broth
  • Yogurt
  • Mashed potatoes
  • Scrambled eggs
  • Applesauce
  • Bananas
  • Plain ice cream
  • Mashed avocados
  • Blended smoothies
  • Humus
  • Cottage cheese
  • Oatmeal
  • Salmon

You can re-introduce solid foods after 4-5 days of tooth extraction.

How long after tooth extraction can i smoke?

Usually, it is advised not to smoke for at least 72 hours after tooth extraction. However, you must always wait until the extraction wound is completely healed. This may take at least one to two weeks after tooth extraction.

It is always best to consult your dentist and check for the healing of the extraction site before starting to smoke.

Alcohol after tooth extraction?

It is essential to take great care of the extraction site to allow proper healing. Drinking alcohol often disturbs and dislodges the blood clot from the extraction wound. Moreover, the acidic content of the alcohol can irritate the gums and surrounding tissues leading to pain and discomfort. In severe cases, it can also lead to dry socket.

Can I drink coffee after tooth extraction?

It is advised to avoid hot beverages such as tea and coffee for the first few days after tooth extraction. This helps to prevent any complications such as dry socket and delay wound healing.

How to stop bleeding after tooth extraction?

Usually, the dentist places gauze over the extraction site and asks the patient to bite on it. The patient is asked to keep biting on the gauze for the next hour. However, if there is bleeding even after removing the gauze, you can make take some cotton or gauze, place it over the wound and bite on it gently to apply pressure.

Apply pressure for at least 45 minutes, which will arrest the bleeding from the extraction site.

Smoking weed after tooth extraction?

Usually, you can smoke weed within 3-4 hours of tooth extraction. However, it is best to wau=it for a day or two to allow proper wound healing. Often smoking can irritate the wound and cause dislodgment of the blood clot. Therefore, wait at least 6-9 hours or a few days after tooth extraction.

What to drink after tooth extraction?

Some of the beverages that you can drink after tooth extraction are listed below –

  • Water
  • Freshly blended juice
  • Milk
  • Blended smoothies

Food not to eat after tooth extraction?

Always avoid hard and crunchy food such as hard candy, ice, chips, biscuits, meat, and raw vegetables such as carrot and cucumber.

Tooth extraction recovery time?

Usually, it takes around 7-10 days for the extraction site to heal completely. However, the recovery time depends on the aftercare of the patient.

Do I sleep with gauze after tooth extraction?

Never make the mistake of sleeping with the gauze inside your mouth. Doing so may lead to accidental choking, which will not only harm your health but also dislodge the blood clot leading to delayed wound healing.

Can I brush my teeth after tooth extraction?

Yes, you can brush your teeth regularly after tooth extraction. However, pay attention while cleaning around the extraction site. Do not disturb the wound. Rinse your mouth gently with warm water.

Can I drink soda after tooth extraction?

No, aerated and acidic beverages often irritate the healing wound. Moreover, they can cause a dry socket and unnecessary pain and discomfort to the patient. Therefore, avoid drinks like soda after tooth extraction.

How long to keep gauze in after tooth extraction?

Usually, bleeding stops within 45-50 minutes of tooth extraction. Therefore, the dentist advises to firmly bite on the gauze for at least one hour after tooth extraction.

Mouthwash after tooth extraction

usually, you can start using non-alcohol mouthwash after 24 hours of the tooth extraction. It is best to talk to your dentist about the best mouthwash suitable for use after tooth extraction. You can use it 3-4 times a day or after every meal to clean the extraction site.

Tooth extraction for dentures recovery time

usually, the dentist may place temporary immediate dentures after tooth extraction, which will aid in the healing of the gum tissue. It usually takes six to eight weeks for the bone and the gums to completely heal and become ready for dentures.

The dentist then fabricates the final dentures and places them over the healed gums.

Can I eat ice cream after tooth extraction?

Yes, it is usually advised to eat ice cream after one to two hours of tooth extraction. This helps to soothe the extraction wound and control swelling around the wound.

Sore throat after tooth extraction

swollen muscles usually cause sore throat after tooth extraction of an impacted tooth. This subsides on its own after two to three days. Moreover, the patient may also feel stiffness around the jaw, which will gradually heal on its own.

What are the signs of infection after tooth extraction?

Some of the typical signs of infection after tooth extraction includes –

  • Pain and discomfort
  • Pus discharge
  • a bad taste in the mouth
  • High fever
  • Tenderness around the gums
  • Swelling in the jaw and gums
  • Swollen lymph nodes
  • Exposed raw bone

Bad taste in mouth after tooth extraction but no pain

Usually, patients experience a bad taste in the mouth after tooth extraction. This occurs more often during the removal of lower teeth as compared to upper teeth. However, bad taste associated with pain and discomfort can be a sign of infection or post-extraction complication.

When does the blood clot go away after tooth extraction?

Usually, it takes one to two weeks for the gums to completely heal and cover the extraction site. This is when you will notice that the extraction site does not have a blood clot. Instead, it gets covered with the surrounding gum tissue.

Will tooth extraction cure periodontal disease?

No, tooth extraction does not cure periodontal disease. The dentist will require to perform deep cleaning and tissue repair to treat periodontal disease. Moreover, the patient will have to maintain proper oral health and hygiene to reduce periodontal disease.

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Can you use mouthwash after tooth extraction?

Usually, mouthwash, especially those with alcohol, is not advised after tooth extraction. The use of mouthwash increases the risk of blood clot dislodgement. Moreover, it irritated the open wound in the mouth. However, prescribed mouthwash can be used after 24 hours of tooth extraction.

You can also use warm salt water rinse. Salt water is well known for its cleansing property. Additionally, it soothes the gum tissue and helps in the rapid healing of the extraction site.

Does laughing gas help with tooth extraction

laughing gas or nitrous oxide can be used in anxious or nervous patients to aid in tooth extraction. However, the patient might be able to sense the pressure applied while luxating the tooth.

How soon after tooth extraction can you have an implant?

Immediate dental implants can be placed in the jaw bone right after tooth extraction. Additionally, dental implants can also be positioned within two weeks of tooth extraction.

How to brush teeth after wisdom tooth extraction?

You can continue to brush and floss as usual after tooth extraction. However, take care that you do not disturb the site of removal as it may lead to the dislodgement of the blood clot.

Usually, during the first-day post-extraction, patients can rinse with warm salt water to flush away food particles from the extraction site. Moreover, it helps to heal the surrounding gum tissue. To make a warm salt water mouth rinse, add half a teaspoon of salt in one cup of lukewarm water.

Over to you on tooth extraction

We all know someone or are someone who has had a fear of tooth extraction. But getting it done at the right time and following your dentist’s advice will make it a simple procedure without any harrowing experiences.

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