Extraction & impacted tooth removal
What is a tooth extraction?
The term refers to the painless removal of a tooth or tooth roots with minimum trauma to the surrounding tissues so that the extraction socket wound heals uneventfully and without any post-operative complications. Whenever any surgery takes place the first thing we want is to let it heal properly, quickly and smoothly. As a common practice, most of the dental surgeons have standard post-surgery instructions printed which are handed over to the patient. One must follow these instructions given by the dentist. Following all the post-operative instructions after tooth extraction reduces the incidence of infection and chances of dry socket. If aftercare instructions are not followed then it can cause complications, which can further lead to delayed healing.
Postoperative instructions after a tooth extraction
- Keep gauzes in the mouth for an hour or two by maintaining a firm pressure and replace them every half-hour, as needed.
- Always keep your head elevated.
- Apply ice on the cheek at regular intervals (20 minutes every hour).
- If you are bleeding, bite into a gauze or a humidified teabag for 20 minutes.
The Do’s and Don’ts after a Tooth Extraction
Here are some of the do’s and don’ts after a tooth extraction.
Do’s:
- Rest: Try to get some rest after Tooth Extraction. You may feel great but don’t exercise or do too much activity for at least 24 hours. When resting, keep your head in a slightly upright position on the pillow.
- Let it clot: Let the clot be formed on the tooth extraction site, which covers it and allows it to heal. After the procedure, your dentist will give you a piece of gauze to bite on near the extraction site. Try to bite down and keep it in place for at least an hour afterward. This will put pressure over the wound and help it to stop bleeding. However, make sure you don’t chew on gauze piece. If you can keep it in place longer that’s best, but make sure to change the gauze after roughly every half hour, depending on the amount of bleeding. If once the clot forms it becomes dislodge the nerve endings then become exposed. The nerves and capillaries spasm and constrict, limiting essential blood supply, which causes a delay in healing. If the bleeding persists for a few hours after the procedure then try putting a wet tea bag on the site. The tannic acid present in black tea helps to aid in the clotting process.
- Ice Packs: Apply an ice pack on the side of your face where surgery was performed. This is done to reduce swelling. While on simple extractions swelling isn’t accompanied, in cases requiring severe cheek retractions swelling can occur after the operation. The swelling after an extraction may not occur immediately but can continue to swell for a few days, reaching a maximum at the 2nd or 3rd day. Application of the ice pack is most effective during the day of extraction as after 24 hours there is no significant beneficial effect. Ice packs should be applied 15 minutes on and 15 minutes off for 1-2 hour time periods.
Dont’s:
- Don’t smoke: For at least 48 hours after tooth extraction do not smoke. The chemicals in the smoke can affect the clot and hence the chances of developing dry socket 3-4 days after tooth extraction increases.
- Don’t eat solids immediately after: While you still have numbness it’s best not to eat solids. When you start feeling your jaws you can start taking solids. After tooth extraction, take soft and liquid foods like soups, mashed potatoes, yogurts, milkshakes, smoothies etc.
- Warm saline rinses: The main aim of rinsing is to clean the area of extraction as it is not possible to brush the socket. We mix salt to make the solution isotonic and similar to natural tissue fluid and thus it is less irritating than water. Rinsing is usually advised 12 hours after extraction. So, warm saline rinses help in cleaning and maintaining the hygiene of that area.
- Take your medicines as prescribed by your dentist: Don’t skip medicines. If antibiotics are given they should be taken regularly. Painkillers and anti-inflammatory drugs are to be taken after tooth extraction. It helps in reducing the pain and swelling. If the pain continues even after two days of tooth extraction and bleeding starts then you should call your dentist.
- Avoid Aspirin: Don’t ever take aspirin (Can take ibuprofen). Aspiring being a blood thinner will delay in clot formation thereby will prevent healing. Take the medications as prescribed by the physician and consult your dentist before taking any medicine.
- Avoid Sucking of any type: SMOKING, SIPPING, EATING HARD VEGETABLES are to be avoided after tooth extraction. Try taking soft and liquid food options such as soups, mashed potatoes, yogurts, milkshakes, smoothies etc. after tooth extraction. Avoid hot drinks, spicy foods, sodas, etc.
- Don’t poke into the gap created: Though for initial few days, it will feel a bit awkward to have a gap but don’t poke that area with any toothpick or tongue as it may delay healing, may provoke bleeding and can also lead to dry socket.
Impacted tooth removal
If your impacted wisdom teeth cause symptoms or dental problems, your dentist may suggest taking them out. Surgery to remove wisdom teeth is usually an outpatient procedure. You can go home the same day. A dentist or oral surgeon performs the operation, which is known as wisdom tooth extraction.
Wisdom tooth removal can be carried out by a dentist or a specialist surgeon working in a hospital.
If your dentist recommends removing your wisdom teeth, they’ll take an X-ray of your mouth to help them determine who should carry out the procedure.
Any charges and payment methods should be discussed before the procedure begins. Read more about NHS dental charges.
Anaesthesia
Before having your wisdom teeth removed, you’ll be given an injection of local anaesthetic to numb the tooth and surrounding area.
If you’re particularly anxious about the procedure, your dentist or surgeon may give you a sedative to help you relax. This will usually be an injection into your arm.
General anaesthetic is rarely needed for wisdom tooth removal. It’s only occasionally used when the procedure is carried out in hospital. However, in this case, you should still be able to go home on the same day as the procedure.
Removing the wisdom tooth
If the tooth hasn’t come through the gum, a small cut (incision) will be made in the gum to access it. A small piece of the bone covering the tooth may also need to be removed.
The tooth may be cut into smaller parts to make it easier to remove through the opening. There’s less need to make an incision if the tooth has broken through the gum.
You’ll feel some pressure just before the tooth is removed, as your dentist or oral surgeon needs to widen the tooth socket by rocking the tooth back and forth before taking it out.
You shouldn’t feel any pain as your wisdom teeth are removed because the area will be numb. However, if you do feel pain during the procedure, tell your dentist or oral surgeon so they can give you more anaesthetic.
How long it takes to remove the tooth will vary. Simple procedures can take a few minutes, but it can take longer than 20 minutes if it’s more complicated.
After surgery
If an incision has been made, dissolving stitches are used to seal the gum. Your dentist will tell you how long the stitches take to dissolve (usually 7 to 10 days).
Your dentist may place gauze over the site of the extraction and ask you to keep pressure on it by biting your jaws together for up to an hour. This is to allow a blood clot to form in the empty tooth socket. Blood clots are part of the healing process, so try not to dislodge them.
In some cases, antibiotics may be prescribed if you have an ongoing infection.
For the 24 hours after removing your wisdom tooth, you should avoid:
- rinsing your mouth out with liquid
- drinking alcohol and smoking
- drinking hot liquids such as tea or soup
- strenuous physical activity