Extraction What is it? A tooth which is very decayed, damaged or loose because of gum disease may have to be extracted (taken out of your mouth). Wisdom teeth sometimes have to be extracted if they have come through at an awkward angle and are causing problems (such as decay in adjacent teeth or, being difficult to clean, and causing infections). Teeth are sometimes taken out from children’s mouths to help other teeth which are crowded to grow straight (usually on the advice of an orthodontist). What will my dentist do? Some teeth are easier to take out than others. A local anaesthetic (an injection in your mouth) will be used to numb the tooth before it is extracted; this is the best treatment for most patients. In some cases, for children or nervous patients, or where a tooth might prove difficult to remove, sedation (something to make you relaxed) with a local anaesthetic may be used. On rare occasions a general anaesthetic may be considered. If a general anaesthetic is needed, you will have to go to hospital or a specialist treatment centre (you are likely to be able to go home the same day, but not all patients are able to do so). After working out the best way to take the tooth out, your dentist will discuss with you: How to minimise what you feel while the extraction is happening Whether you should bring someone with you if you are to have sedation or a general anaesthetic When it would be convenient for you to have the tooth removed You might also discuss other treatment you might need- for example, whether you may require a denture While the tooth is being taken out You may hear some noise and feel some pressure as the tooth is being eased out- but you should not feel the pain. Sometimes the stitches are put into the gum to minimise any post extraction bleeding, to make the area more comfortable and help it heal quickly. Afterwards You may need a day or so off work to recover, depending on how difficult the extraction was and whether sedation or a general anaesthetic was used. Most people experience very little post-operation discomfort. The dentist will ensure that bleeding has stopped before you leave the practice. You should not smoke or drink for at least 24 hours after an extraction. The dentist will give you advice on: How to look after the space where the tooth was while it is healing Which painkillers are suitable to use so you are not in any discomfort when the anaesthetic wears off How to contact the practice if there are any problems Pre Extraction Information Please make sure you have eaten something before you come to your extraction appointment. Please make sure you inform your dentist of any medication you have taken that day. It is not essential but you are advised to bring someone along to the appointment with you. Don’t plan on doing any exercise or anything that will increase your heart rate for the rest of the day. Post Extraction Advice Avoid cycling or exercising for several hours. Ideally rest by sitting in a chair and use an extra pillow for the first night. Do not drink anything alcoholic for the first 24 hours and avoid smoking Take any pain killing tablets as advised by your dentist. Follow any instructions regarding the dosage carefully. After 24hours rinse your mouth gently with warm salt solution (level a teaspoon of salt to a cup of water) and continue after meals and before bed for seven days, or advised by a dentist. You may feel a sharp edge of a socket with your tongue and occasionally small fragments of bone may work their way out. This is normal. Try not to disturb the socket with your tongue by eating food on that side or vigorous rinsing. This may delay the healing process. If excessive bleeding occurs: Use some clean linen or gauze about 1.5” (4cm) wide to make a roll of 1” thick thus forming a firm pad (a clean handkerchief may also be used). Make a few such pads if necessary. Keep sitting up and clear the mouth of loose blood clots with a clean linen square or tissue so you can find where the socket is bleeding. This is important. Place the pad across the bleeding socket from the tongue to the cheek side. If the socket is between two standing teeth, constrict the pad to fit. Bite firmly to compress the pad on the bleeding socket for 10-15 minutes. Avoid lying down. Inspect the socket and replace the pad or use another one if bleeding still appears from the socket. If your efforts are unsuccessful after an hour or two contact your dentist. It is not unusual to experience swelling or discomfort for a few days. However, if pain, swelling or bleeding persists, contact your dentist. Remember, if excessive bleeding does occur, it is important to avoid exercise, drinking alcohol or disturbing the socket.
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