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Tooth Removal (Extraction) - Reasons, Complications, and Recommendations

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Tooth Removal (Extraction) - Reasons, Complications, and Recommendations

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Tooth removal or dental extraction is a common surgical procedure done usually under local anesthesia. This article discusses the reasons for tooth removal.

Medically reviewed by

Dr. Sneha Kannan

Published At February 29, 2020
Reviewed AtDecember 13, 2023

Introduction:

Sometimes, people need to have one or more of their teeth pulled out. This tooth extraction may be advised by the dentist for one of the following reasons:

  • Severe gum disease that makes the tooth wobbly, which cannot be fixed.

  • Severe tooth decay involves the nerve inside the tooth called the pulp. In this case, the only alternative treatment to save the tooth is root canal treatment or endodontic treatment, which is a complex and costly procedure and may not be feasible.

  • A badly broken tooth that cannot be restored with a filling or a cap.

  • Crowding or malposition is when a tooth is out of the arch or not in its correct position, it may hinder proper tooth cleaning and aid food accumulation and plaque retention. In this case, its removal is recommended for better dental health and maintenance of the rest of the teeth.

  • Braces where sometimes the orthodontist recommends the removal of certain teeth before braces to facilitate placing the remaining teeth in their proper position and achieve a proper bite.

  • Problems with a wisdom tooth also called third molar teeth, are the last adult teeth to come through (erupt) into the mouth and there are four of them, one on each side of each jaw. If there is not enough room for a wisdom tooth it may get stuck inside the jaw bone and require removal to avoid future problems. Sometimes, it cannot grow properly because of lack of space and erupts only partially in the mouth or gets stuck against the nearby tooth causing infection and swelling of the gum around it. In this situation and to avoid recurrence of the infection or further complications, it may be better to have the tooth pulled out by the dentist or an oral surgeon.

What Happens During Tooth Removal?

The procedure of tooth removal is a simple surgical procedure performed under local anesthesia. The dental practitioner may first apply a topical anesthetic gel or cream to the gum tissue to avoid pain while injecting the local anesthetic. During the local anesthetic injection itself, there may be a feeling of a small scratch after which, the tooth and surrounding tissue become numb and there should be no pain during the procedure though there may be a feeling of some pressure and pulling.

When the mouth is numb, the dentist starts loosening the tooth from the gum with a special tool and then pulls it out with forceps. The procedure usually takes from a few minutes to less than an hour, depending on the difficulty of the procedure and how many teeth are removed. After the tooth has been removed, the dentist might put stitches to close the wound or place a piece of gauze over the wound to stop the bleeding.

What Are the Risks and Complications of Extraction?

As with any medical and dental treatment, tooth extraction is associated with some risks and complications. Common risks and complications include

  1. Tooth breakage during extraction.

  2. Damage to lips and cheeks when the person bites or rubs the numbed area without realizing the damage that may occur. Children are particularly more prone to this and may need to be supervised until the numbness has worn off.

  3. Short-term minimal to moderate pain, including jaw pain, due to the irritation of the nerves and the movement of the jaw during extraction.

  4. Short-term swelling or infection are signs of post-extraction infection including pain and swelling that is worsening or not improving 48 hours after tooth removal, purulent discharge from the wound or the tooth socket (the hole where the tooth was), and cellulitis adjacent to the extraction site.

  5. A dry socket occurs when a blood clot does not form in the hole where the tooth was or the blood clot is disrupted. The bone underneath will be exposed to air and food, which can be very painful and can cause a bad taste and/or odor in the mouth. This is more likely to occur if the person smokes.

  6. Temporary numbness.

  7. Pain or difficulty opening the mouth.

Some uncommon risks and complications include:

  1. Prolonged or permanent nerve damage a small percentage of people may, despite all precautions, experience partial or total loss of feeling in the area served by the nerves near the extraction site. Irritation of these nerves during extraction can cause permanent or prolonged numbness or a tingling sensation to the lip, tongue, cheek, chin, gums, or teeth.

  2. Bone and root fragments remain in the gum.

What to Do Following Tooth Removal?

  • People will normally have a gauze swab placed over the wound and must keep pressing on it for 30 minutes. If bleeding recurs, the person can apply another piece of gauze and bite on it for another 30 minutes. The bleeding usually stops after that, unless there is a serious problem.

  • The person should not rinse the mouth for the first 24 hours after the tooth has been removed, then rinse gently with salty warm water a few times a day for a few days until the wound heals.

  • The person should avoid smoking and drinking alcohol or any strenuous activity for at least 24 hours.

  • For the first 24 hours, avoid hot drinks and food, and eat a soft diet, such as mashed potatoes and scrambled eggs, on the other side away from the wound.

  • Do not place fingers, pens, or other objects in the mouth to avoid injury and infection.

  • People can take an over-the-counter painkiller such as Paracetamol or Ibuprofen before the numbness wears off to avoid any postoperative pain.

If pain continues or increases the next day, consult a dentist online for further advice and treatment.

How Long Will It Take To Recover After Tooth Extraction?

It depends on the complications of the case. Usually, people get back to normal in very few days. The person can return to normal activities within two to three days, but it will take a long time for the jaw bone to heal.

What Should Not Be Done After Tooth Extraction?

Few activities should be avoided for a few days post-tooth extraction. These are

  • Any sort of strenuous activity should be avoided for two days. An increased heart rate can result in excessive bleeding.

  • Hard and crunchy food should be avoided in the initial days after tooth extraction.

  • Avoid using straws as they can disturb the clot formation and can result in dry sockets.

  • Vigorous mouth rinsing should be avoided.

  • The person should not smoke for 24 hours.

  • The person should not spit the saliva or blood.

  • The person should avoid intake of alcohol or alcohol-based mouthwashes.

Conclusion:

Extraction is a procedure done where the tooth is removed for various reasons like severe damage or decay. At time extraction is done to maintain the overall health. Post tooth extraction should be followed by tooth replacement which is essential to restore function, appearance, and overall oral health.

Frequently Asked Questions

1.

What Are the Causes of Tooth Extraction?

 
The common causes of tooth extraction are
- Grossly infected tooth.
- Trauma or injury.
- Orthodontic reasons.
- Poor periodontal health.
- Impacted teeth.
- Failed dental treatment.

2.

What Are the Common Complications That Occur in Tooth Extraction?

The common complications that occur after tooth extraction are
- Swelling.
- Pain.
- Trismus (difficulty in jaw opening due to muscle spasm).
- Dry socket.
- Prolonged bleeding.
- Altered sensation.
- Temporary nerve paralysis.

3.

How to Know if a Tooth Needs to Be Extracted?

Generally, a dentist determines whether a tooth needs an extraction depending on the clinical and radiographic findings. The dentist may recommend extraction if the tooth has lost more bone support and is highly infected. If the tooth can be saved, a root canal treatment  is performed to remove the dead tissues and protect the teeth.

4.

Is Tooth Extraction a Recommended Procedure?

Tooth extraction is only recommended for orthodontic purposes, where the jaw cannot accommodate the teeth, resulting in malaligned teeth. Other indications of tooth extraction include wisdom tooth impaction, which may cause pain and discomfort.

5.

What Is Recommended After Tooth Extraction?

After tooth extraction, the dentist may recommend a set of rules for better healing. Avoid spitting saliva or blood as it may cause negative pressure and dislodge the clot from the tooth socket. The clot is essential for better healing and to arrest bleeding.

6.

Is It Possible to Eat After Extraction?

Yes, it is possible to eat after extraction. Although most patients may find it uncomfortable after extraction, a soft diet is advised. Avoiding spicy and sticky food can help with healing. The dentist may also advise eating ice cream as it helps the blood clot.

7.

Is It Advisable to Undergo Extraction or Root Canal Treatment?

The dentist makes the decision to make the root canal treatment or extraction depending on factors like the extent of infection and prognosis after treatment. In case of poor prognosis, a root canal treatment is avoided, as it can be an expensive procedure. However, replacing a tooth after extraction is important for better functionality purposes.

8.

What Is the Duration Taken for a Tooth Extraction?

A tooth extraction may take five minutes to one hour, depending on the amount of tooth structure. If the teeth are more brittle, they may take a longer time to extract, as they may crumble into pieces. However, the procedure is done under local anesthesia, and the patient may not feel any pain.

9.

Should the Infected Tooth Be Extracted?

Not necessarily every infected tooth undergoes extraction. Extraction can be avoided if the infection can be minimized with antibiotics and root canal treatment. However, if the tooth is severely damaged and has very little structure, it must be extracted.

10.

What Are the Measures to Be Followed or Avoided Post-extraction?

Measures to Be Followed Post-extraction:
After extraction, the individual should follow a diet the dentist advice for better healing. It is important to take medications on time and go for a review to see if the healing is satisfactory. It is important to maintain good oral hygiene.
Measures to Be Avoided Post-extraction:
Do not smoke, as it may affect the healing. Avoid spicy food and alcohol for a few days.Do not brush aggressively on the extracted site.
Dr. Akmal Albert Asham Abdelmalek
Dr. Akmal Albert Asham Abdelmalek

Orthodontist

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tooth extractionpost extraction complicationpost extraction instructionsdry socket
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