Extractions General Dentistry

Tooth extractions may appear to be a daunting process, yet they are common surgery performed by dentists and oral surgeons. Understanding what to expect minimises the stress of the experience.

Like any other medical procedure, tooth extractions have possible complications, such as the risk of infection, dry socket, and persistent swelling. Yet, if these risks can be appropriately treated, it can minimise the chance of further complications.

Here we’ll discuss the complications following a tooth extraction.

Tooth extraction is the removal of a single tooth or several teeth from a tooth socket. There are various indications that a person may require tooth extraction. Although most dental professionals aim to save the original tooth as much as possible, some cases, such as dental caries that have already reached the tooth pulp (which contains nerves and blood vessels), may not be able to be restored through root canal therapy (or other dental treatments).

Tooth decay, infection, and crowding can all necessarily require extraction. People who wear braces may need one or two teeth removed to make room for their new alignment. Those undergoing chemotherapy or about to receive an organ transplant may also need compromised teeth removed to maintain oral health.

Some people have insufficient space to accommodate wisdom teeth. They may experience pain from an impacted wisdom tooth that requires removal.

The dental professional will determine if the patient will undergo simple extraction or surgical extraction. A dentist or an oral surgeon can perform both.

A simple extraction involves rocking and pulling (luxation) of a tooth visible in the gumline. Typically, this is a less invasive procedure for tooth removal and requires only local anaesthesia.

Surgical extractions take longer and may require a general anesthetic. This procedure may involve removing gum tissue and or bone to expose the affected tooth.

Learn More: Simple Extraction vs. Surgical Tooth Extraction: What’s The Difference

Possible Complications Following a Tooth Extraction

Tooth extractions are a common dental procedure without serious complications. But, like any other medical procedure, there are risks to look out for.

Bleeding

Following surgery, a certain amount of bleeding is expected. It is not uncommon for minor bleeding, oozing, or redness in the saliva to occur.

Localised postextraction bleeding might result from soft tissue or bone bleeding. Soft tissue bleeding can occur due to trauma from extraction, resulting in blood vessel injury (arterial, venous or capillary). The nutrient canals or the central vessels can both cause bone or osseous bleeding.

Swelling and inflammation

Swelling is expected following a tooth extraction. It is a normal body response and part of natural healing. A simple tooth extraction will cause minor swelling, whereas a complex tooth extraction such as impacted wisdom tooth removal or extraction of multiple teeth may cause significant swelling.

Typically, a patient may experience swelling around the mouth, cheeks, eyes, and sides of the face. The swelling will not be noticeable until the day after surgery.

If the swelling or inflammation at the extraction site persists with intense pain, it may be helpful to contact your dentist. There is a risk of infection in some cases, and the symptoms include a high temperature, a yellow or white discharge from the extraction site, and persistent pain and swelling.

Alveolar osteitis (dry socket) 

A blood clot forms, typically in the area of tooth extraction. This blood clot acts as a shield for the underlying bone and nerves in the empty tooth socket. The clot also serves as a foundation for forming new bone and soft tissue over the clot.

A dry socket, also known as alveolar osteitis, is a painful dental problem that can occur after a permanent adult tooth is extracted. A dry socket happens when a blood clot at the tooth extraction site fails to form or when it dislodges or dissolves before the lesion has healed.

When the underlying bone and nerves are exposed, it causes intense pain in the socket and along the nerves extending to the side of your face. The socket becomes inflamed and may become clogged with food debris, aggravating the pain. The pain usually starts one to three days after your tooth is extracted when you have a dry socket.

Pain

Once the numbing agent (anaesthesia) has subsided, you will feel pain, especially in the extracted tooth area.

Pain from complex procedures may last longer and must be managed with analgesics regularly. If the discomfort persists or worsens, the patient should contact the dentist to have an examination for pathologic condition.

Home Management of Complications 

Many of the home remedies listed below help reduce inflammation in the mouth, remove harmful bacteria, or provide a numbing agent for minor problems. If you have severe pain or any of the issues after tooth extraction, you should seek immediate treatment. 

In cases of excessive bleeding

Excessive bleeding can be stopped by first rinsing or wiping away any old clots in your mouth, then applying a gauze pad to the area and biting firmly for thirty minutes. If necessary, repeat. If the bleeding persists, bite down on a cold tea bag for ten to fifteen minutes—the tannic acid in the tea bag aids in forming a clot by contracting blood vessels. To prevent further bleeding, remain calm, sit upright, and avoid strenuous activity. If the bleeding does not stop, contact your doctor for further instructions.

For swelling & dry socket

To minimise swelling, apply cold packs to your face where the surgery was performed for fifteen minutes at a time for the first twenty-four hours following a tooth extraction. After that, you can control pain using heat in the form of warm washcloths.

Heat is likely to be the most effective at relieving pain caused by dry sockets. However, a cold can help numb your nerves more effectively. Try them all and find which one works best for you. Always use warm rather than hot, and press it against the painful cheek.

Rinsing your mouth with salt water can help you with two things. The rinsing might aid in the removal of debris lodged between your teeth. Also, since salt is a natural disinfectant, it can help in the treatment of any infection by reducing inflammation. Gargle a teaspoon of salt with warm water like a mouthwash.

Alleviate pain

For pain medication, the dentist will prescribe pain relievers to alleviate the pain. It is necessary to discuss any allergies, medications, and health conditions with the doctor to prevent allergic reactions or medical complications.

Take the prescribed tablets as directed for severe pain. You will become drowsy as a result of the pain medication you have been prescribed. While taking this medication, do not drive or operate machinery, and avoid alcoholic beverages.

Other home remedies that can help to manage oral problems are the following:

  • Blacck tea bags. Tannic acid, found in black tea, serves as a natural antibacterial agent while relieving swelling and pain. 
  • Honey. Honey is an anti-inflammatory and analgesic. According to a 2014 study, honey dressings for dry sockets reduced inflammation, swelling, pain, and discomfort significantly. Additionally, it prevented infections from spreading. 
  • Clove oil. It contains eugenol, which has analgesic, anti-inflammatory, and antibacterial properties. It can relieve pain and prevent infections from growing or progressing. As a result, clove oil is often used in professional dry socket pastes. Clove oil may cause adverse effects, thus consult your dentist or oral surgeon before taking it as a home cure.
  • Guava leaves. It offers anti-inflammatory and anti-microbial qualities that can help relieve dental pain. You can create a tea out of the leaves and let it cool before using it as a rinse to receive some comfort.
  • Oregano oil. It has antibacterial properties and may be beneficial against some drug-resistant forms of bacteria. This also applies to any bacterial infections that may be causing or developing in your dry socket.Apply oregano oil straight to the affected area, or apply it to sterile gauze and place it over your dry socket many times a day. 

When to Call Your Doctor?

It is common to experience some discomfort once the anaesthesia wears off. You may also expect some swelling and residual bleeding for the first twenty-four hours after having a tooth extracted. However, if the bleeding or pain persists more than four hours after your tooth has been removed, you should contact your dentist.

If you experience any signs of serious complications, you should contact the dental office immediately. Here’s a list of severe risks following tooth extractions:

Factors that Increase Your Chances of Tooth Extraction Complications

Nicotine use and smoking

Tobacco products contain chemicals that can inhibit or slow healing and contaminate wound sites. Sucking on a cigarette may dislodge the blood clot prematurely.

Oral contraceptives

Taking oral contraceptives may increase the risk of dry socket by causing high estrogen levels in the body.

Improper at-home care.

The risk of developing a dry socket and infections increases if home-care instructions are not followed, and poor oral hygiene is not maintained. Also, it is necessary to avoid drinking using a straw. The pressure from sucking can damage the blood clot or slow your healing.

Dry sockets in the past

You are more likely to develop a dry socket after another extraction if you’ve ever experienced it in the past. Discuss any previous oral complications with your dentist to determine prevention measures.

Gum or tooth infection

A dry socket and the risk of complications can occur when an extraction site is infected.

Your dentist will be your best guide when it comes to managing your expectations of the healing time. However, some factors will influence everyone’s healing period. These may include:

  • The size of the wound. If the lesion is more significant, deeper or wider, the longer it takes for the socket to heal.
  • Your recovery period. Everyone’s healing process is unique. Some people may heal faster than others.
  • Your lifestyle. Your habits play a significant role in your healing time. If you use tobacco products or smoke, it can affect the proper formation of the blood clot.
  • Your health status. One of the most critical factors is your current health status; the dentist thoroughly evaluates your medical and dental history before the procedure.
  • Your Age. Younger patients tend to heal faster from this surgery with less bruising, minor swelling, and fewer dental complications than older patients.
  • The tooth that was extracted. The health of the tooth that was extracted can cause a delay in the healing process. If the tooth is infected, there is a chance of gum disease or infection in the gum, which might cause healing to be delayed.

FAQ's About Tooth extractions

Are antibiotics after tooth extraction necessary?

Every patient has oral bacteria that, if it reaches their bloodstream, can cause an infection. Most healthy individuals are protected against such an incident by their immune systems, and antibiotics are only prescribed after dental surgery if an infection develops as a result.

On the other hand, an infection occurs due to failure to administer antibiotics following tooth extraction.

What to expect during a tooth extraction?

Before pulling the tooth, your dentist will provide a local anaesthetic injection to numb the area where the tooth will be extracted. Your dentist may use strong general anesthesia in some more complex cases. This will prevent you from feeling pain during the tooth extraction procedure and put you to sleep during the operation.

You should not experience pain, but you may feel pressure against the tooth. They may also hear bone or tooth grinding and cracking. Some individuals find the experience distressing.

If you experience pain, they should inform the dentist or oral surgeon right away. But, be careful not to confuse firm pressure with pain to avoid inducing unnecessary anaesthesia.

When a tooth is extracted, a blood clot typically forms in the socket. The dentist will insert a gauze pad into the socket and advise you to bite down on it to stop the bleeding. To close the gum lines over the extraction site, the dentist may place a few stitches, which usually are self-dissolving.

The cost of tooth extraction

According to the Australian Dental Association, the average cost of a simple extraction in Victoria, Australia, can range from $187.69 to $300. Surgical removal, such as removal of wisdom teeth, may vary from $284.67 to $2,300.

Separate charges may apply for the required anaesthesia before tooth extraction. In addition, affordable payment options are available in our dental clinic.

Medications that affect tooth extraction 

Most doctors recommend avoiding blood-thinning medications before oral surgery or tooth extraction. Tooth extraction or gum surgery, for example, is an invasive operation that has the potential to cause bleeding. Because the blood may not form a clot normally during such procedures, it may be difficult to control the bleeding. The following are examples of blood-thinning medications:

Post-operative bleeding can occur as a result of taking NSAIDs (nonsteroidal anti-inflammatory drugs). As a result, most doctors recommend that you refrain from consuming them for around one week before your treatment. Examples include the following:

Dental Restrictions Officially Lifted As of 22/10/21

As advised by Victoria's Chief Health Officer and Premier Daniel Andrews, it is expected that from 11.59 pm Thursday, October 21, 2021, the current COVID-19 restrictions will be lifted for Greater Melbourne.

Lockdown restrictions have now been lifted across Victoria. The Authorised Worker list no longer applies which means that dental practices can return to pre-lockdown settings with no restrictions on patient access to care.

Learn More