What Is A Tooth Extraction (Pulling a Tooth )

What to know about tooth extraction (a complete guide)

Have you ever wondered what a tooth extraction is and why the dentist asked you to have one. Here is a complete guide for you to know about tooth pulling.

Causes:

While many teens and some adults get their wisdom teeth removed, there are other reasons why tooth extraction may be necessary for adulthood.

Cavities are holes that develop on teeth due to excessive tooth decay, and Tooth decay occurs from a buildup of dental plaque in the mouth. It can damage the tooth structure over time. Tooth infection and crowding require a tooth extraction. 

Periodontal (gum) disease. An infection of the tissues and bones surrounding and supporting the teeth has caused loosening of the teeth. It may be necessary to pull the tooth or teeth.

Those who get braces may need one or two teeth removed to provide room for their other teeth as they shift into place. Additionally, those undergoing chemotherapy or are about to have an organ transplant may need compromised teeth removed to keep their mouth healthy.

Tooth extraction is performed by a dentist or oral surgeon and is a relatively quick outpatient procedure with either local, general, intravenous anesthesia, or a combination. Removing visible teeth is a simple extraction. Teeth that are broken, below the surface, or impacted require a more involved procedure.

How much does a tooth extraction cost?

The cost for tooth extraction varies widely depending on whether the tooth is impacted. Simple extraction usually costs between $75 and $200 per tooth and maybe more, depending on the patient’s type of anesthesia.

The cost to remove impacted teeth is significantly higher and can land anywhere between $800 and $4,000. Where you live can also impact how much you pay for the procedure, as many services are tailored to an area’s cost of living.

How to prepare for a tooth extraction

Before scheduling the procedure, your dentist will take an X-ray of your tooth. Be sure to tell your dentist about any medications you take and vitaminssupplements, and over-the-counter drugs.

Inform your dentist of your other medical condition with an intravenous bisphosphonate drug. The extraction should be done before the drug treatment, or your jaw could be at risk for osteonecrosis (bone death).

Also, tell your dentist you suffer from any of the following medical conditions:

  • a congenital heart defect
  • diabetes
  • liver disease
  • thyroid disease
  • renal disease
  • hypertension
  • an artificial joint
  • damaged heart valves
  • adrenal disease
  • an impaired immune system
  • history of bacterial endocarditis

Your dentist will want to make sure all conditions are stable or treated before undergoing the tooth extraction. You might be prescribed antibiotics in the days leading up to the procedure if

  • your surgery is expected to be lengthy
  • you have an infection or a weak immune system
  • you have a specific medical condition

It is helpful to keep the following in mind for the day of the tooth extraction to ensure quality treatment:

  • If you will be receiving intravenous (IV) anesthesia, wear a short-sleeved shirt or loose-fitted clothing and do not eat or drink for six to eight hours before your appointment.
  • Do not smoke beforehand.
  • Tell your dentist if you have a cold, as you may need to reschedule.
  • Tell your dentist if you had nausea or vomiting the night before, which may require different anaesthesia or rescheduling.
  • If you are receiving general anaesthesia, have someone with you to drive you home.

Anesthesia during surgery

The person will receive a local anesthetic injection close to the extraction site. It will numb the area so that the person will not feel any pain. The numbness will continue for a few hours after the surgery.

A person can request additional anaesthetic or sedative medication to minimize anxiety during the procedure. The dentist or surgeon may offer:

  • Nitrous oxide is also known as a laughing gas. Known as “laughing gas,” nitrous oxide is a gas you inhale through a mask or nosepiece. It is a good option for people who need light level sedation. People who choose nitrous oxide can drive themselves to and from their appointments.
  • An oral sedative medication This type of sedation is given by mouth, usually in pill form, about an hour before your dental appointment. Common medications used for this purpose include diazepam, midazolam, triazolam and lorazepam. Oral conscious sedation can be used independently or in combination with nitrous oxide or intravenous sedation. Dosages are adjusted according to your specific needs. People who choose oral conscious sedation will need a friend or family member to drive them to and from their appointment.
  • Intravenous, or IV, sedation is recommended for people with significant dental anxiety or those undergoing lengthy procedures. Sedative and pain medications — such as midazolam and meperidine — are delivered directly to your bloodstream using an IV line. IV sedation is the highest level of sedation obtained in a dental office setting. People who choose IV sedation will need to make arrangements for a driver on the day of their procedure.
  • General anesthesia This option is usually reserved for complex cases, such as facial reconstruction or corrective jaw surgery.

A person who receives a general anesthetic will be completely asleep during the procedure.

Some dentists do not have the options above at their offices. If a person requires any of these, they should let their dentist know during the consultation, and the dentist may refer them to an oral surgeon.

What is the procedure for a tooth extraction?

Your tooth extraction will either be simple or surgical, depending on whether your tooth is visible or impacted.

Simple extraction

You will receive a local anaesthetic, which numbs the area around your tooth to feel only pressure, not pain, during the procedure. The dentist then uses an elevator instrument to loosen the tooth and forceps to remove it.

Surgical extraction

You will likely receive both local anesthesia and intravenous anesthesia, which will make you calm and relaxed. You may also receive general anesthesia, depending on any medical conditions. With general anesthesia, you will remain unconscious during the procedure.

The general dentist or oral surgeon will cut your gum with a small incision. They may need to remove bone around your tooth or cut it before the tooth can be extracted.

Once The Procedure Is Complete

When the procedure is complete, your dentist will place a piece of gauze over the extraction site and ask you to close down with firm, steady pressure.

It helps slow bleeding so a blood clot can form. (Clotting is a normal aspect of recovery. It promotes healing and reduces the risk of dry sockets.) You will take the gauze out once the bleeding has slowed enough. You may continue to have light bleeding throughout the first 24 hours.

How long does it take to recover from a tooth extraction?

Recovery depends on the complexity of the case. However, most people feel back to normal in just a few days. While you will be able to return to routine activities within 48 to 72 hours, it usually takes the jawbone several weeks to heal completely. Therefore, if you plan to replace the tooth with a dental implant, you will probably need to wait a few months to allow for a full recovery.

Tooth extraction aftercare

After your extraction, your dentist will give you a detailed list of post-surgical instructions. Here are some general guidelines for a speedy recovery:

  • Keep the extraction site clean. Gently rinse the area with an antimicrobial mouthwash two to three times daily. Avoid brushing directly over your extraction site until your dentist tells you it is safe to do so. Brush and floss all other areas normally.
  • Take all medications as directed. Your dentist may prescribe antibiotics and pain relievers. It is important to take all of these medications exactly as directed. You can also take over-the-counter pain relievers, such as acetaminophen and ibuprofen.
  • Avoid strenuous activity for at least two days. An elevated heart rate can cause increased postoperative bleeding and discomfort. Skip the gym for the first 48 to 72 hours. Ask your dentist when it is safe to resume normal routines.

People should therefore avoid:

  • sucking on the extraction site
  • touching it with their tongue
  • using a straw
  • spitting
  • eating solid — especially crunchy — foods
  • rinsing the mouth vigorously
  • drinking alcoholic beverages or using mouthwash that contains alcohol
  • smoking

What can you eat after a tooth extraction?

Avoid hard and crunchy foods for the first few days. Stock your fridge and pantry with soft foods like rice, pasta, eggs, yoghurt and applesauce. You will also want to avoid drinking through straws, which can dislodge blood clots and cause dry sockets.

When can I go back to work or school after a tooth extraction?

Most people can return to work or school within a day or two. If you have a job that requires a lot of lifting or physical labour, you may need to take a few more days off work.

Brushing and flossing

Continue to brush and floss as usual after a tooth extraction, but avoid disturbing the blood clotting.

Starting the day after surgery, people can rinse every few hours with warm saltwater. To make this, add half a teaspoon of salt to 1 cup of water.

Complications after tooth extraction

One complication of tooth extraction is a dry socket. It is not an infection. It involves the exposure of bone in the extraction area, either because the blood has not clotted or because the clot has become dislodged.

A dry socket can cause intense, radiating pain that usually starts a few days after the procedure. It can also cause bad breath. If a person has severe pain that starts 2–3 days after the surgery, they should speak to their dentist.

Treatment will involve rinsing the area and placing medicinal paste on the exposed bone to protect it.

People can usually prevent dry sockets by following their dentist’s aftercare instructions — especially by not smoking after surgery.

Infection is another complication, and it can occur when bacteria infect the gumline in and around the socket within 1–2 days after surgery.

A person with any of the following symptoms of infection should contact their dentist:

  • persistent swelling
  • pus and redness in or around the site
  • a fever
  • swollen glands in the neck

If a person has experienced no complications during recovery, they may not need to follow up with their dentist. Stitches usually dissolve and do not need removal.

A dentist or oral surgeon may schedule a 1-week follow-up appointment to check how the extraction site is healing.

Conclusion

Before having a tooth extracted, a person will visit their dentist or oral surgeon to discuss the procedure.

During this consultation, the doctor will take a full medical history. They will ask about past and ongoing health issues and treatments to ensure that the right safety measures are in place. The person should ask about costs and raise any concerns about additional sedation.

Before extracting the tooth, the dentist or oral surgeon will numb the area with a local anesthetic. Although the procedure is not painful, it may cause discomfort.

A person can do several things to help speed their recovery. Ultimately, it is crucial to avoid disturbing or irritating the extraction site. It will help the blood clot and the wound to heal.

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