The simplified guide to tooth extractions

Updated: Sep 10, 2020

The summarized guideline to navigating and thriving in a fear-inducing procedure. Don't worry, that dental gal is here to the rescue.


Before

Continue to take any medication that has been prescribed and complete your entire treatment. Medication is not always needed but may be a part of the treatment sequence for a severely infected tooth.


Try not to eat any solid foods after midnight the night before your appointment. Drink apple or orange juice in the morning. This may vary depending on your medical situation (ex: diabetes), so follow protocol that will ensure you are not lightheaded, nauseous or uncomfortable.

Make arrangements for post-surgical transportation.


During

The dentist will extract the tooth with a series of instruments. In complex cases a surgical extraction may be needed if the tooth anatomy is complex or fragile. In this case, the site will be sutured.


After

Keep the gauze in the area for 20 to 30 minutes. Apply some light pressure, which can be achieved by simply biting down softly and holding the gauze in place. This will help create a clot in the area and expedite healing. It will also stop the bleeding.

Apply ice continuously on the outside of your face and take any prescribed medication. This is typically a combination of ibuprofen and Tylenol but may vary depending on medical history. Speak to your medical provider before taking any medication.

Try not to eat anything while you are numb, as you may inadvertently bit your lip or cheek. You won’t be able to feel your soft tissues and may end up chewing them and causing trauma (this is especially important for children).

Have something cold and soft for your first meal. A milkshake, smoothie or green juice is a great option. Don’t chew anything. Do not use a straw as this can disrupt the pressure in your mouth and tear the clot. A straw can also hurt the tender, healing tissues.



After this, continue to have soft meals for a couple of days. Think ice cream or soup.


After each meal, put some water in your mouth and drop it out into the sink. No water swishing as this may lead to a pressure change in the oral cavity and disrupt or dislodge the delicate healing tissues.

Use mouthwash on the first night of your surgery and then brush your teeth softly for the next couple of days.

For a surgical extraction site, be very gentle, as you do not want to disrupt the sutures.


You may have a little drool with some blood the night after your surgery. Don’t be alarmed, this happens and as long as it is not excessive, it shouldn’t be an issue.

Don’t engage in physical activity for the first couple days after surgery and re-start with low-impact exercises for the upcoming week. Again, this maintains a normal pressure in the mouth and prevents clot dislodgement and subsequent dry socket (more on this below).

Start cleaning the area gently a few days after the extraction (consult your dentist for the detailed post-operative timeline, toothpaste, mouthwash and toothbrush recommendations).

Complications

If inflammation and pain in the area have not subsided within a week, it’s prudent to visit the dentist.

A site may become infected if not cleaned and managed, so be mindful of the area and listen to your dentist’s post-op instruction.


Dry Socket: If a clot is dislodged a few days after extraction, it leaves the site vulnerable. The bone and nerve supply are exposed to liquid, air and other contaminants, which can create a painful infection in the area. This situation would warrant a dental visit. You may be prescribed medications and the dentist may place materials in the tooth socket to promote healing.

To prevent dry socket, be gentle with the area post-op. You want the clot to form remain in place. Smoking is a big risk factor for dry socket. Its just detrimental for your health across many parameters. Speak to your dentist about a smoking cessation program; your body and teeth will thank you.

If you have sutures, be gentle, but also remember to start opening and closing your mouth normally on day 2 or 3. Some patients develop trismus and are unable to open their mouth due to anxiety around disrupting sutures. Tension can build up in the muscles, so try some mouth exercises and stretches. Keep the muscles relaxed. Massage your cheeks and the side of your face if you feel tension building up.


Final thoughts


Dental anesthesia has come a long way and there are a plethora of methods to make this process comfortable. I hope this post gives you insight into the process and gives you a sense of control. I hope your extraction is smooth and comfortable. Be on the look out for future posts related to dental anxiety.


Fear only hinders our lives. Conquer it with your courage. Don't let fear hurt you in any way (including your oral health).


Stay safe and keep smiling.

Sources:

  1. https://www.sciencedirect.com/science/article/pii/S0002817718302022

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4437177/

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598935/

  4. https://www.medicalnewstoday.com/articles/321300

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