Tooth Extraction At The Emergency Dentist

There are many reasons for needing to have a tooth removed (dental extraction), in fact it’s one of the most common reasons to see an emergency dentist.

Normally having a tooth removed is an option that patients elect for when a tooth is beyond repair, or when previous attempts at repair have been unsuccessful.

Occasionally you may elect to have teeth extracted because of other reasons, and these may include time, personal finances or if you are unwilling to go through extensive treatments to restore the tooth. It can sometimes be a fine line between choosing to save a tooth or to remove it, but your dentist will be able to guide you about chances of treatment being successful and alternative replacements should you take the tooth out.

Why dental extraction?

•  Decay of a tooth such that it is beyond repair
• Persistent infection-for example impacted wisdom teeth, failed root canal treatments
• Orthodontics-removal of teeth to allow space for orthodontic treatment
• Gum disease
• Trauma

The procedure of having your tooth removed

Your dentist will have a discussion with you about the pros and cons of a dental extraction. You may be asked to a sign a consent form.

A thorough assessment will be made, and this will normally include x-rays. If your extraction looks like it may be difficult, or if it carries certain risks, then you may be referred to an oral surgeon for the procedure.

Most dental extractions are carried out with local anaesthetic, however, you may ask to be referred for sedation if you are particularly nervous or anxious.

• Application of topical gel to numb the injection site.
• After a few minutes, the dentist will inject the area around the tooth in order to anesthetize the tooth and surrounding areas.
• It normally takes 10-15 minutes to allow the effect of the anaesthesia to become effective.
• The dentist will check if you are sufficiently numb
• Using special tools, the dentist will initially gently loosen the tooth. You may feel pressure during this time.
• Once the tooth has been loosened, the dentist will use special forceps to help wiggle the tooth out. Again you may feel pressure and movement of the tooth on it’s way to being delivered.
• Occasionally you may hear some sounds-creaks and cracks. This is nothing to worry about-remember there is a reason why the tooth is being removed and it already may be very weak and fragile.
• Sometimes the dentist may make incisions in the gum to allow better access for the procedure. Sutures may be placed and these may be resorbable.
• The dentist will wait to see a good blood clot form prior to discharging you, and will provide you with instructions on how to take care of the wound.

What you should expect after a dental extraction?

• Soreness and discomfort is to be expected.
• You may develop a localized swelling-this is nothing to worry about and is entirely normal. It should resolve within 3 days, but may get worse before it improves.
• A mild taste of blood in the mouth is normal. If you have any heavy bleeding, place a clean cotton pad over the wound and hold firm pressure by biting or with your fingers for 10-15 minutes.
• Do not smoke for FIVE days after the procedure.
• Gently bathe the area with warm salty water the following day. Do this 5 or so times a day for a week.
• Avoid alcohol for 24 hours.
• Do not use aspirin.
• You can use anti-inflammatories and ice-packs to help reduce swelling and discomfort.
• Avoid hard,hot and spicy foods for a few days.

Most wounds heal uneventfully. If you are unlucky, you may develop dry socket, but this is more likely if you have had a very difficult extraction, have smoked or are prone to delayed healing and infections.

Following a dental extraction you may find little shards of bone making their way through the socket. These are called sequelae, and are nothing to really worry about. You may find many small fragments coming through. Normally they fall out or are dislodged themselves. Occasionally, especially with larger fragments, you may need to see the dentist to remove these.