Dental Extractions

A tooth extraction is, as the name implies, the removal of a tooth from your mouth, or more technically, the removal of the tooth from the socket and jaw bone. This procedure is relatively common and in most cases the procedure itself will be relatively pain free.

Why would you need to have a tooth removed?

Despite the fact we always try to preserve any of your natural teeth, even if that means performing procedures such as a root canal treatment, there are unfortunately, instances where we need to remove a tooth. Some of the more common reasons for removal of a tooth include:

• Severe gum disease, such as advanced periodontal disease, which affects the surrounding gums and possibly even the structure of the bone itself.
• Tooth decay or an infection in the socket or surrounding area, possibly even an abscess at the root of the tooth.
• Physical trauma to the tooth, possibly from a fall or a sporting accident.
• For an orthodontic reason, possibly too many teeth or not enough space to allow the other teeth to be repositioned correctly via braces or similar.
• Removal of a tooth to allow effective radiation treatment for cancer in the head and/or neck area. A tooth may affect the ability for targeted treatment.
• Organ transplant recipients sometimes require a tooth, which has a higher risk of infection, to be removed prior to the transplant, as the medication they will be on may suppress the immune system causing a real risk of a serious dental issue.

Naturally of course there are other reasons that a tooth may need to be removed, however, by and large, the most common are gum disease and tooth decay.

I need a tooth removed. What is the process?

Unlike in the movies where a string is tied to a tooth and a door handle or even back of a Ferrari, we like to employ a safer and gentler method when removing a tooth.

The first step of almost all tooth removals is to have an x-ray of the tooth to allow our team to know in which direction the root of the tooth is implanted and whether there are any cracks or issues in the tooth below the surface. This may have already been done at a previous appointment and therefore, will not be required again on the day of the extraction.

Once the x-ray has been examined and the actual procedure can commence, the process will always begin by numbing the area using a fast acting local anaesthetic injection. In rare cases, such as when the tooth extraction is more complicated, a general anaesthetic may be needed, however, this is definitely the exception rather than the rule.

After a few minutes the anaesthetic injection will have taken effect and the tooth removal procedure can begin and be pain free. The process is relatively straight forward. A special tool, called an elevator, is gently used to loosen the tooth in the socket. You may feel pressure generally on your jaw during this process, however, as the area is numb you won't experience any pain.

Once the tooth is loosened in the socket, a pair of forceps is used to lift out the tooth gently. In some cases, we may need to cut back the gum slightly to allow us to wobble the tooth out, however, this is generally relatively minor.

Depending on the reason why a tooth is being removed, it may break or splinter during the removal. Usually this will happen when the tooth decay is more severe. Sometimes, this will make the removal process easier, as smaller parts can be removed more easily. In other more uncommon cases, a simple extraction may become a slightly more complex surgical extraction. Unfortunately, given the nature of the tooth extraction process this is impossible to predict accurately on every occasion, however, rest assured our team is extremely experienced to handle these cases if they were to arise you will be informed every step of the way.

What happens after the tooth is removed?

Unfortunately, one thing that will not happen is us giving you the tooth to place under your pillow for the tooth fairy. Despite this, there are still several important things that need to happen after the tooth has been taken out.

Depending on the way in which the tooth was removed, it may be that the socket itself will need to be gently cleaned out. This is to ensure nothing is caught in the tooth socket and will ensure the healing process can progress faster.

Given the nature of the treatment, there will undoubtedly be some bleeding from the socket. To help stop this, our team will get you to bite down on a small piece of gauze. This will help stop the bleeding and allow a small blood clot to form. If your gum has been cut during the process of the tooth extraction, we may sometimes place some stitches in your mouth to close the cut. These stitches may also be used to actually close the extraction site itself and their use will be on a case by case basis. Don't worry, the stitches will naturally fall out or dissolve in a few days and will not require you to come back to have them removed.

Generally at this point you will be able to leave. Our team may write you a prescription for pain relief or recommend over the counter medicine for any discomfort you may have once the anaesthetic wears off and a post extraction sheet will also be given to follow.

How long does a tooth extraction take to heal?

Generally, it will take 1 or 2 weeks for the area to heal fully, however, only a few days for you to feel relatively normal again. During this time we recommend the following:

• Avoid rinsing or spitting on the day of the extraction as this may cause the blood clot which would have started to form in the socket to potentially dislodge, causing the bleeding to start again and thus delay the healing process.
• Smoking should be avoided for several days after the tooth extraction. Smoking may cause the blood clot to be lost and the socket drying out. This is known as a 'dry socket' and can be painful and would require you to come back for further treatment.
• Avoid chewing on that side for a few days, particularly crunchier foods or meats. A 'softer' diet is recommended to help ensure the area has time to start healing and close, reducing the risk of the blot clot being lost. We also recommend avoiding foods that are too hot or too cold.
• Avoid brushing the area for a period of time to help prevent any infections from forming. Continue to brush the rest of your teeth and tongue as per your normal oral hygiene routine.
• In some instances we may ask you to rinse your mouth with warm salty water several time a day for up to a week. This can aid in preventing infections in the area.
• Avoiding participating in marathons, iron man competitions and more generally any physical sports for the rest of the day and possibly 1 or 2 days following the procedure.

As the anaesthetic wears off, you may also experience some level of discomfort. Generally taking a Panadol or Nurofen will assist with this. Additionally, there may be some additional bleeding for 24 hours after the extraction. We will provide you with another gauze to use if the bleeding starts again. Be sure to have clean hands and gently put it in the area and bite down for 30 minutes to help stop the bleeding.

Are there any risks associated with having a tooth extracted?

As with any medical procedure, there will always be some level of inherent risks. The most common complication that may arise, albeit rarely, is that of the blood clot being dislodged and a condition known as 'dry socket' developing. If this occurs you will experience discomfort in the area and will need to come back so we can apply a sedative dressing over the area to allow a new blood clot to form.

Other possible risks or complications may include bleeding for more than 12 hours, excessive swelling of the area, an infection forming, nausea or vomiting or more generally a fever and a feeling of being unwell. If any of these occurs you should call us and come in for a follow up check. All of these conditions can be easily managed and resolved if promptly addressed.

What happens after a tooth extraction area has healed?

Depending on the reason why the tooth required removal, it maybe that you now have a 'gap' between your teeth. This may be addressed via orthodontics, possibly if an extra tooth had come through, or via an implant, dental bridge or even a denture.

Whilst you may grow accustomed to the gap in your teeth, we strongly recommend you speak to one of our team to help assess how best to fill the gap. Without follow up treatment, such as an implant or dental crown, the underlying bone structure may change which may cause further dental health issues down the track.