Our dentists make every effort to preserve your natural teeth. However, extractions are necessary when decay has made the tooth unsalvageable or when you have an advanced periodontal disease. When a tooth is malformed, damaged, impacted or ingrown, different procedures are used, but all extractions are considered surgery. Depending on which tooth is removed, we can offer you a replacement in the form of a dental implant or oral prosthetic.
What should I expect during an extraction procedure?
We will apply anaesthetic as required until you are unable to feel any pain from the procedure. Sensations of pushing and pressure will still be felt, these can only be removed with general anaesthesia.
You may also hear noises, especially for molar teeth that are close to your ear, and find some metallic tastes in your mouth.
How long is the healing process?
Healing varies from person to person and also depending on the tooth and the difficulty in removing it. Generally, soft tissues should close after four weeks and bone should have completed remodelling by eight weeks. Other factors that can affect healing include medical histories, smoking and alcohol consumption (which will slow the healing process considerably and sometimes increase post-extraction pain) and age (younger patients will often heal a lot faster than older patients).
If incisions were required, stitches will be applied which should dissolve after two weeks. Should they fail to dissolve, we can remove them with surgical scissors and tweezers, an easy process that doesn’t require anaesthetic.
What do I need to do beforehand?
Prior to an extraction, we will need to assess the following:
- The shape of your tooth’s roots and the disease affecting the tooth – this can be determined by an X-ray. This will influence the type of extraction procedure we use and the ease/difficulty of the procedure.
- Your medical history – medical conditions and medications can have effects on the procedure and your healing afterwards.
Preparation for extractions varies from patient to patient. You may need to:
- See your doctor or medical specialist for advice regarding the need to cease medication temporarily or take antibiotics before the procedure (at times we may be able to contact your doctor or specialist on your behalf)
- Discuss time off with your employer (we advise NOT doing physical work immediately after having your tooth extracted!). 1-3 days is usually sufficient, depending on your healing ablilities.
- Arrange for a relative or friend to assist in caring for you in the days after the extraction
- Prepare some soft foods and cold packs and stock up on pain relievers for the coming days
What do I need to do after the procedure?
- For the first 24 hrs, refrain from rinsing your mouth. After the first 24 hours, gentle rinses with warm saltwater can be used to aid the healing process. Do not use mouthwash.
- For the remainder of the day abstain from any hot foods or drinks and avoid strenuous exercise
- Take pain relief as required. If your extraction was a difficult one, stronger pain relief may be prescribed to you.
- Use gauze to control the bleeding – you can remove the initial gauze pad after 2 hours and replace it with some spare gauze that we will give you immediately afterwards. DO NOT USE TISSUE PAPER.
- Avoid smoking or drinking alcohol for up to 3 days (at least for the first 24 hours) as this can cause painful healing complications such as dry sockets. Pain from dry sockets is often worse than toothache and only goes away with time.
- If you have used any sedatives before the extraction, it is best to have somebody escort you home and check on you for a few hours
Do I need antibiotics after the extraction?
Antibiotics will only be prescribed if:
- A large amount of bone removal was required for the extraction
- There is a considerable amount of pus and swelling associated with the extracted tooth or other teeth that cannot be treated immediately
- You develop a fever
Antibiotics will not be prescribed for dry sockets or as an ordinary precaution. The swellings that occur after an extraction are largely due to the healing process and as such only pain relief is required. Anti-inflammatories such as Nurofen are far more effective if they can be used.
The over-prescription of antibiotics is causing a lot of concern around the world with regards to the rise in antibiotic-resistant superbugs and as such we are endeavouring to minimise their prescription when they are not absolutely necessary.
What do I do if I experience bleeding afterwards?
It is normal for a little blood to ooze out of the socket and when mixed with saliva can appear worse than it is. Applying spare gauze over the socket and applying a cold pack to the side of the face will usually take care of this.
If blood is pooling in your mouth, contact us if this occurs during our operating times, or contact your local hospital Emergency Department if this occurs after hours.
To avoid post-extraction bleeding, it is important that you disclose all medical conditions and medications to us beforehand and follow all instructions given.
Is it normal to feel pain AFTER the extraction?
Tooth extractions are not like haircuts! It is normal to feel some pain in the surrounding areas afterwards. Usually this goes away within a fortnight and decreases in intensity.
Some patients can develop a dry socket where the healing process stalls or does not occur normally. There is no magic cure for this. Pain relief and continuing with saltwater rinses until the situation resolves is all that can be done. Dry sockets can take up to 3 weeks to resolve. To minimise the risk of a dry socket, avoid smoking and alcohol for 3 days post-extraction.
In the rarest of instances, phantom pain can still be experienced well after the extraction.
Can extracting a tooth affect my other teeth?
You may experience some soreness from surrounding teeth when you bite together for up to a fortnight after the procedure. Sometimes fillings in adjacent teeth can be knocked out of place during an extraction procedure and need to be replaced in the weeks afterwards.
Long-term, extraction of a tooth and leaving a gap can cause surrounding teeth to tilt into the space and opposing teeth to erupt into the space left by your now missing tooth. Replacement options can be discussed with the dentist prior to having the tooth removed.
Additional loading on surrounding teeth can cause them to crack and chip. We can assess whether this is occurring and what can be done about it.
What if the extraction is too hard?
In situations where it appears the extraction procedure is highly difficult, the risk of medical complications is high and/or you think you may not be able to sit through such a procedure, we will refer you to an Oral Surgeon.
Oral Surgeons have had several more years of training in the art of tooth extraction and can also treat you in a hospital environment under general anaesthetic. Impacted wisdom teeth cases and patients who have multiple medical conditions are often referred to Oral Surgeons and several Oral Surgeons, both male and female, are available around the Brisbane area.