Tooth Extraction

Removal of a tooth

Parts of the Body Involved

Teeth, gums, bones in jaw

Reasons for Procedure

Although many teeth can be saved with modern dental techniques, some must be removed. Tooth extraction may be necessary in the following situations:
  • The tooth is too badly damaged or decayed to be saved by root canal
  • The tooth's nerve is infected
  • The tooth is impeding normal tooth growth
  • The tooth is loose from advanced periodontal disease
  • There is a loss of supporting bone, gums, or tissue

Risk Factors for Complications during the Procedure

  • Smoking
  • Heart or blood disease
  • High blood pressure
  • Alcoholism
  • Poor nutrition
  • Use of some prescription and non-prescription drugs; inform your doctor of any drugs, medications, or supplements you are using or have used in the last month

What to Expect

Prior to Procedure - X-rays of the mouth; blood and urine tests

During Procedure - Anesthesia

Anesthesia - General or local

Description of the Procedure - If the tooth is impacted, the dentist will remove the overlying gum and bone tissue to expose the tooth. Using forceps, the dentist will grasp the tooth and gently rock it back and forth. This action loosens the tooth from the alveolar (jaw) bone and breaks the ligaments that hold the tooth in place. The tooth is pulled and a blood clot usually forms in the empty socket. The dentist packs a gauze sponge into the socket. Occasionally the dentist will place a few stitches to close the gum edges.

After Procedure - Removed tissue, bone, and blood is analyzed

How Long Will It Take? About 20 minutes, longer for impacted teeth

Will It Hurt? Anesthesia prevents pain during the procedure, but you may feel some pain in your jaw once the anesthesia wears off.

Possible Complications:
  • Infection
  • Excessive bleeding from tooth socket
Average Hospital Stay - None

Postoperative Care:
  • Bite firmly but gently on the gauze pad placed by your dentist. This will help reduce bleeding and permit a clot to form in the tooth socket.
  • If rapid bleeding continues, replace with a fresh folded gauze pad every 20-30 minutes. Otherwise, leave the gauze in place for 3 to 4 hours.
  • It is important not to dislodge the blood clot that forms in the wound. Do not spit or rinse forcefully in the first 24 hours.
  • Do not smoke.
  • Do not allow food particles to pack into the socket.
  • Do not use drinking straws in the first 24 hours.
  • To minimize swelling, apply an ice bag immediately after the procedure to the affected area. Apply for 10 minutes at a time.
  • Begin rinsing your mouth 24 hours after surgery. Use a solution made of 1/2 teaspoon salt and 8 ounces warm water.
  • Continue to brush and floss other teeth; this will help prevent infection in the extraction site.
  • Eat a soft or liquid diet for the first 24 hours.
  • Avoid activity for the first 24 hours following surgery. For the next 1-2 days, engage in only limited activity.

Outcome

In the first 24 hours after the extraction, expect some swelling and residual bleeding. The initial healing period usually takes about 1-2 weeks. New bone and gum tissue will grow into the gap.

Having a missing tooth can lead to shifting teeth, improper bite, or difficulty chewing. Your dentist may attempt to restore the area with an implant, fixed bridge, or denture.

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Nausea or vomiting
  • Excessive bleeding continuing for more than 4 hours after surgery
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the affected area
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting