Tooth Extraction: Causes, Preparation, Procedure, Follow-up and Complications

Tooth extraction is also known as tooth removal, it involves removing tooth from its socket in the bone.

Reason for Tooth Extraction (Causes)

When tooth had decayed or damaged, dentist has to fix it with a crown and other methods. There is need for the tooth to be extracted. Bone graft also involves tooth extraction for a loose tooth that can’t be saved any longer. Tooth extraction is also done for people with extra teeth that obstruct other teeth from growing.  In cases whereby wisdom teeth causes pain or has been affected by infection, tooth removal can be done. Wisdom tooth is sometimes called the third molar tooth. Tooth removal can be done before it grows up of after and it’s common in teenagers and adolescents. People with weak immune system (like in cancer patient) that have their teeth affected with weak teeth can undergo tooth extraction. People that have undergone organ transplant may have their immune system suppressed because of their medications and have weak teeth which are needed to be extracted. In cases whereby wisdom teeth is needed to be removed in thirties, forties and beyond, there is higher complication rate with prolong post-operative course. There is high chance of exposure to infection than when tooth removal is done in young ones. Also, treating these complications may be a bit difficult.

 

Preparation for Tooth Extraction

Do not eat or drink anything for about 6-8 hours before the surgery and wear a short sleeve cloth. Dairy product such as yogurt, cheese, milkshakes and ice-cream  on day of surgery may cause nausea and vomiting with analgesics and anesthesia. Avoid smoking on the day of tooth extraction to prevent dry socket that is painful.

Notify your doctor in case you have cough, cold or stuffy nose some days to the surgery. The doctor may like to avoid giving anesthesia until you are free from cold. Also ensure you have someone to drive you home after surgery.

The X-ray of the area of tooth removal is taken in order to give a clear view of the teeth.  Panoramic X-ray is taken if you want to remove wisdom tooth. This will provide information about the connection between the wisdom teeth and other teeth and also the relationship to the nerve in the jaw bone called the inferior alveolar nerve, this nerve supplies the chin, lower lip, lower teeth and jaw. It also shows the presence of any disease or tumor to the bone.

Some dentist will prescribe antibiotics before the surgery or after in order to reduce the incidence of infection during tooth extraction surgery. Antibiotics are also given in case the surgery will be take time. Patient with specific condition and weak immune system are also given antibiotics.

Intravenous anesthesia may also be administered. 

Procedure

There is simple extraction and surgical tooth extraction. Simple extraction involves using an instrument called elevator to loosen the tooth and then forceps is used to remove it.

Surgical tooth removal is a complex one mostly use for broken tooth and it is carried out by oral surgeons. Small incisions are made in the gum. Some bones around the tooth may be removed or even tooth may be cut into half before removal.

Anesthesia is given in both surgical and simple extraction. Steroids may be given to a patient on conscious sedation. This is to reduce swelling and reduce pain.

Pressure might be felt during the procedure but not pain. Notify your doctor if you feel any pain.

Follow Up

Your dentist will give you necessary instruction on what to do after surgery and also what to expect. It is not unusual to feel some discomfort after surgery. Surgical tooth extraction produces more pain than the simple one. Your doctor will give you analgesics to relief pains associated with the surgery. Pain disappears mostly after 3days.

Eat soft foods for the first week and avoid hot food or drink. You can rinse your mouth with warm salt water a day after the surgery. In case of swelling, use ice packs on the area. Swelling mostly end about 2 days after the tooth extraction surgery.

In case of bleeding, bite gauze for about 30minutes to provide pressure and allow blood clotting. 

Complications of Tooth Extraction

Dry socket occurs in 3-4% of all extraction. It is common in smokers and women on contraceptive pills. Dry socket occurs when blood clot is pull out of the tooth hole. This result in the exposure of the underlying bone to food and air and thus pain is felt. The pain is mostly felt in day 3 of the surgeryand it can produce bad breath or taste. Medicated dressing is required to encourage the healing and alleviate pain.

Other potential problem associated with tooth extraction includes:

• Sore in the jaw muscle and joint with difficulty in wide opening of mouth also. This is mainly because of the presence of infection.
• Numbness in the lower jaw, lip and chin. This is as a result of injury to the inferior alveolar nerve. This numbness may take up to 5momths to heal and might be permanent.
• Fracture of nearby teeth
• Fracture of jaw
• Hole in the sinus which may close naturally after some weeks. In case it does not close, contact your doctor.

When to See Your Doctor

Contact your doctor if you have chills, fever and trouble in swallowing. Also in case of worsen uncontrollable bleeding and swelling, see your doctor.