Extractions

A tooth may need to be extracted (removed) for any one of a number of reasons:

  • Your tooth is decayed or has become infected.
  • A tooth is broken or fractured beyond repair.
  • You have severe gum disease, affecting the supporting bone structure and tissues.
  • Teeth may be growing in crooked because there is not enough space in your mouth. Tooth extraction allows room for the rest of the teeth to grow straight and proper.
  • You do not have enough space for your wisdom teeth at the back of your mouth.

Antibiotics may offer temporary relief from symptoms (like pain and swelling), but having teeth removed or surgically addressed often is the only solution for permanently relieving your symptoms.

 

Why should I see an oral surgeon?

Tooth extraction is an operation. Drs. Gulley and Gomez perform thousands of these operations each year. They are well trained in anesthesia and tooth removal. We have special qualifications and training that make the process comfortable and safe.

 

Tooth Extraction – Preparation

Prior to an extraction, our dentists and qualified staff will take your medical history to assess the risk of anesthesia, noting any allergies you have and prescription medications you are currently taking. A dental history will also be taken, with particular attention to reactions to anesthetics. Antibiotics may be prescribed to help fight the possibility of infection. The face is then x-rayed to determine the tooth’s full shape and position, especially if it is impacted.

If deep anesthesia is needed, patients should not eat or drink anything for at least eight hours prior to tooth extraction. You should wear loose clothing with sleeves that are easily rolled up to allow for an intravenous line. Arrangements should be made for a friend or relative to drive you home after the surgery.

 

The Procedure

The first step in the procedure is to administer a safe, gentle anesthetic to make sure you are comfortable and pain-free during the procedure. During a simple extraction, instruments called elevators will loosen the tooth, after which it will be removed using forceps. You may feel some pressure but you should not feel any pain.

If your tooth is severely damaged, a surgical extraction may be required. Sometimes there is not enough tooth to grab with the forceps or it may crumble during the extraction. After the anesthetic is administered, several small incisions will be made in your gum, exposing the tooth’s roots. Some surrounding bone can be removed with a drill, allowing the tooth to be removed. The incisions, depending on size, are closed with stitches which usually dissolve in about a week’s time.

 

Tooth Extraction – Aftercare

The primary goals of aftercare are to encourage a clot to form at the extraction site and to prevent infection. You should put pressure on the area by biting gently on a gauze pack until bleeding stops. Once the clot is formed, it should not be disturbed. You should not rinse, spit, drink with a straw, or smoke for at least 24 hours after the extraction and preferably longer.

For the first two days after the procedure, you should drink liquids without using a straw and eat mostly soft foods. Any chewing should be done on the side opposite the extraction site. Hard or sticky foods should be avoided. Facial swelling is a normal part of the healing process. Ice packs can be applied to reduce swelling.

Medications may be prescribed to relieve postoperative pain. The mouth may be gently cleaned with a toothbrush, but the extraction area should not be scrubbed. Typically we recommend periodic salt water rinses afterwards.

 

Socket Preservation

Often the bone that holds the tooth in place is damaged by disease or infection. The surrounding bone and gums can shrink or recede, resulting in unsightly defects which can cause major problems. If immediate implants are not an option, these deformities can be prevented and repaired by a procedure called socket preservation.

Socket preservation improves your smile’s appearance and increases the chances that future treatments such as dental implants, fixed bridges, removable dentures, or gum line reshaping will be successful. If you are advised to have a tooth extracted, be sure to ask if socket preservation is necessary to help you achieve your treatment goals and set the foundation for dental implants or other restorations.

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