Wisdom Tooth Extraction

Tooth extraction or dental extraction is one of the most common and feared procedure of the dentist. It normally precedes a very badly decayed tooth or a painful tooth. The dentist nowadays will try as much as possible to save the tooth in question first before opting to remove it. Sometimes however due to costs or inability to restore the tooth, there is no choice but to extract the tooth.

How does the dentist carry out a tooth extraction?

Tooth extraction can be a painless procedure. Before extracting a tooth, the dentist will give a local anaesthesia via injection with a syringe. The local anaesthetic most commonly used is lignocaine ( xylocaine) containing adrenaline. In patients with hypertension or even diabetes, prilocaine may instead be used as adrenaline is not recommended for such patients.

The dentist will then carry out the tooth extraction after the local anaesthetic has taken effect. He normally uses tooth forceps to carry out the tooth extraction. Tooth elevators such as the couplands and warwick james may also be used.

After the tooth has been successfully extracted, the dentist will put a gauze on the extraction sit and ask the patient to bite down on it to act as a compression to help in blood clot formation and haemostasis.

How should I prepare myself before a tooth extraction?

If you are a healthy individual, there is normally nothing to worry regarding the tooth extraction. Your dentist will inform you of the procedure and risks involved and he would also have had your medical information obtained from you or his records before hand to determine your fitness for the extraction.

You may like to have a good meal before you go for your tooth extraction though as you will probably be taking soft diet for one to a few days after the procedure!

If you have any medical problems, you should discuss it with your dentist to see if you are fit for the tooth extraction.

What should I expect during the tooth extraction?

The extraction site should be numb during the tooth extraction. There shouldn’t be any sharp pain but you might experience some dull sensation much like a pressure sensation. You should also not be alarmed if you can feel movements as the local anaesthetic only removes the pain sensation and your other sensations are intact.

Just relax and cooperate with your dentist and the procedure will be over very quickly.

And most importantly do not struggle or push your dentist’s hands away! Remember that there are sharp instruments being used and if you do any of the above you are not only endangering yourself but the dentist and his assistant too.

Sometimes complications might occur during the tooth extraction such as a fractured tooth root. When such an incident occurs, do not panic. Your dentist might have already foreseen this in some cases due to the nature of the tooth or your bone and he is very well equipped to deal with such scenarios.

However he might need to do a minor surgical procedure if he thinks it is warranted.

Other complications that might occur are the dislodgement of the root into your maxillary sinus for your upper premolars and molar and accidental swallowing of your tooth.

These occurrences though not rare are uncommon though and you should not worry at all. If in doubt do ask your dentist as he is the best person to reassure you.

What should I expect after a tooth extraction? Is post extraction pain normal?

After the tooth extraction, you will normally be discharged with minimal medications. A simple tooth extraction normally does not require antibiotics unless you have underlying medical conditions or if the dentist thinks it is necessary.

Pain is also normally not an issue though some patients do experience some dull throbbing pain after the local anaesthesia has worn off.

Again do not panic. Paracetamol (acetaminophen) or aspirin will suffice to stop the pain. If the dentist has not prescribed any for you, you can easily get it at any pharmacy.

If the pain still does not go away after one week or it gets worse or it becomes very sharp, please do consult your dentist. You might have a condition called “dry socket”.

Will I bleed after a tooth extraction?

Bleeding is another concern that patients might have after a tooth extraction. On off oozing or bleeding from the socket might be experienced on the day of the tooth extraction and sometimes a few days after. This is normal and if you do not have any underlying medical conditions such as a bleeding diathesis, simple application of a gauze on the tooth extraction site with firm pressure by biting will stop the bleeding.

Avoid excessive gargling/rinsing of your mouth and also avoid spitting out the saliva and blood in your mouth. It is uncomfortable but by doing so you might actually promote bleeding and prolong it. Just swallow your saliva and the blood in your mouth and before you know it you wont even realize you just had a tooth extraction!

When should I be worried about bleeding?

You should start to worry if you have underlying medical conditions such as a bleeding diathesis eg factor VII deficiency or if you are on blood thinning products such as aspirin or warfarin. Normally the dentist would have taken the necessary steps and precautions but if you realize you are bleeding non stop and you have huge patches of jelly like blood clots all over your mouth despite your attempts to stop the bleeding by applying pressure with gauze, please seek medical help immediately.

This article is written and contributed by an oral surgeon and any duplication, reproduction or plagiarism in any form is strictly prohibited without the author’s permission.