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Tooth Extraction

Tooth extraction is the removal of a tooth from its socket in the bone.

Reasons for Pulling Teeth

Although permanent teeth were meant to last a lifetime, there are a number of reasons why tooth extraction may be needed. A very common reason involves a tooth that is too badly damaged, from trauma or decay, to be repaired.

Other reasons include:

A crowded mouth.
Sometimes dentists pull teeth to prepare the mouth for orthodontic treatment.
Likewise, if a tooth cannot break through the gum (erupt) because there is not room in the mouth for it, your dentist may recommend pulling it.

If tooth decay or damage extends to the pulp -- the center of the tooth containing nerves and blood vessels -- bacteria in the mouth can enter the pulp, leading to infection. Often this can be corrected with root canal treatment (RCT), but if the infection is so severe that antibiotics or RCT do not cure it, extraction may be needed to prevent the spread of infection.

Risk of infection.
If your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant), even the risk of infection in a particular tooth may be reason enough to pull the tooth.


What to Expect With Tooth Extraction

Dentists and oral surgeons perform tooth extractions. Before pulling the tooth, your dentist will give you an injection of a local anesthetic to numb the area where the tooth will be removed. During a tooth extraction, you can expect to feel pressure, but no pain. If you feel any pain or pinching, tell your doctor.

The dentist will then apply forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces.

Once the tooth has been pulled, a blood clot usually forms in the socket. The dentist will pack a gauze pad into the socket and have you bite down on it to help stop the bleeding. Sometimes the dentist will place a few stitches (usually self-dissolving) to close the gum edges over the extraction site.

After the extraction, your dentist will advise you of what post extraction regimen to follow.
In most cases a small amount of bleeding is normal. Your mouth will slowly fill in the bone where the tooth root was through the formation of a blood clot.

Here are some tips to follow to make recovery easier:

  •  Avoid anything that might prevent normal healing.

  •  Relax for at least 24 hours after the extraction. Limit activity for the next day or two.

  • Don’t smoke or rinse your mouth vigorously. This might cause the blood clot in the socket to break loose, exposing the bone in the socket. This is a painful condition called Dry Socket. If this happens, your dentist will likely place a sedative dressing over the socket for a few days to protect it as a new clot forms.

  • Avoid drinking through a straw for 24 hours.

  • After 24 hours, rinse with your mouth with a solution made of 1 teaspoon of salt to 1 cup of warm water.

  • Eat soft foods, such as soup, omelette, pudding, yogurt, or applesauce the day after the extraction. Gradually add solid foods to your diet as the extraction site heals.

  • When lying down, prop your head with pillows. Lying flat may prolong bleeding.

  • Continue to brush and floss your teeth, and brush your tongue, but be sure to avoid the extraction site. Doing so will help prevent infection.

Remember, when having an extraction, today's modern procedures and follow up care (as recommended by your dentist) are there for your benefit and comfort.


When to Call the Dentist  in Auckland

It is normal to feel some pain after the anesthesia wears off. For 24 hours after having a tooth pulled, you should also expect some swelling and residual bleeding. However, if either bleeding or pain is still severe more than four hours after your tooth is pulled, you should call your dentist.

You should also call your dentist if you experience any of the following:

  • Signs of infection, including fever and chills

  • Nausea or vomiting

  • Redness, swelling, or excessive discharge from the affected area

  • Cough, shortness of breath, chest pain, or severe nausea or vomiting

The initial healing period usually takes about one to two weeks. New bone and gum tissue will grow into the gap. Over time, however, having a tooth (or teeth) missing can cause the remaining teeth to shift, affecting your bite and making it difficult to chew. For that reason, your dentist may advise replacing the missing tooth or teeth withan implant, fixed bridge, or denture.


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