Extractions General Dentistry

Tooth extraction is the removal of a tooth from its socket in the bone. It is a generally quick outpatient treatment that can be performed under local, general, intravenous, or combination anesthetics.

If you require an extraction, your dentist will determine if they will perform it or refer you to an oral surgeon. You will be given a local anaesthetic injection to keep the area around the damaged tooth numb during the extraction. There are times when general anesthesia is required. However, this is not common for simple extractions.

While tooth extraction is commonly referred to as “having a tooth pulled,” it is actually a combination of rocking and pulling, known as luxation. The movement gradually expands the space in the bone where the tooth is located and breaks the tiny fibres that attach the tooth to the bone.

Dental professionals perform tooth extractions when the damaged tooth, adjacent teeth, and gums may be compromised due to the condition of the damaged tooth. It is also necessary if other dental restorations will not be able to save the tooth or if a wisdom tooth is impacted.

A dentist or oral surgeon will determine which type is suitable to treat the affected tooth:

Simple extractions are procedures performed without the need for an incision or any other special tooth removal techniques. Although most dentists perform simple extractions, some simple extraction cases are referred to as oral surgeons.

Most uncomplicated extractions require only a local anaesthetic to numb the area surrounding the problematic tooth, including the gum tissue, jaw bone, and teeth. The procedure is not painful, but you will experience a great deal of pressure during the removal process.

A surgical extraction is a more invasive procedure that is performed for a tooth that has broken off at the gum line or has not yet emerged in the mouth. Oral surgeons often perform surgical extractions, and general dentists can also perform them. The surgeon will cut a small incision into your gum and extract the underlying tooth during a surgical extraction. This procedure will take longer and may necessitate the use of general anesthesia.

The principles of tooth extraction are generally the same, whether the extraction is simple or surgical.

Numbing the area

An anaesthesia injection is administered to the tooth, gum, and bone tissue around it before extraction.

The amount of pain you feel from the needle’s bite is determined mainly by the type of tissue the anaesthesia is injected.

Your dentist may use strong general anaesthesia in some more complex cases. This will prevent you from feeling pain as well as put you to sleep during the operation.

Extracting the tooth

When a tooth is extracted, the tooth is pulled out of its socket (in the jawbone). Usually, the tooth is fully encased in the socket and held in place by a ligament. To extract the tooth, the doctor first expands the socket to detach the tooth from the ligament and then pulls it out of the socket.

The bone that surrounds the tooth’s root is relatively porous. As a result of rocking the tooth back and forth against the socket walls, the bone contracts. There would finally be enough space, and the tooth would be dislodged from the ligament.

If the tooth is located beneath gum tissue or bone, the dentist may need to cut the gums or remove the obstructing area of bone. 

During the procedure

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

It’s important to be honest with how you feel throughout the procedure. But be cautious. Pressure should not be confused with pain. This would cause your dentist to give you needless amounts of anaesthesia. As a result, you may be at risk of medical complications.

Pressure during tooth extraction

The rocking of the tooth causes pressure. In contrast to pain, you feel this because the anaesthetic has little effect on the nerves that transmit the sensation of pressure.

Closing the empty tooth socket

Stitches or other measures to control the bleeding may be required following the extraction. The dentist or surgeon will apply a thick layer of gauze to the extraction site and ask the patient to bite on it to absorb the blood and begin the clotting process. Typically, the dentist may scrape the socket walls to remove any infected or pathologic tissue.

In the case of the upper back tooth, the dentist will also smooth any rough bone edges and examine the socket for any sinus complications.

The Risks of Tooth Extraction

Tooth extractions are a common dental procedure that is generally done safely and smoothly. However, like with any medical procedure, there are risks.

The most prevalent risk of tooth extraction is a dry socket. A dry socket occurs when the blood clot at the tooth extraction area fails to form or when it dislodges or dissolves before the lesion has healed. It can result in excruciating, throbbing pain that usually begins a few days after the treatment. It can also result in bad breath. If you are in severe pain 2–3 days after surgery, contact your dentist.Though a dry socket can be painful, if treated promptly, it is rarely dangerous.

It would help if you observed any signs of the following risks:

  • Infection can develop when bacteria infect the gumline in and around the socket after 1–2 days of surgery.
  • Excessive bleeding that lasts longer than 12 hours.
  • Severe fever and chills can be an indication of an infection.
  • Nausea or vomiting
  • Coughing
  • Chest pain
  • Shortness of breath
  • Persistent swelling and redness or pus at the surgical site.

The following are some of the most severe risks linked with tooth extraction:

  • Jaw fracture
  • Nearby teeth around the extracted tooth may be damaged.
  • If the extracted tooth is in the upper back of the mouth, this will cause a sinus hole.
  • It is possible for the numbness to be permanent in very rare cases.

Aftercare of The Extraction Site

Change the gauze pad

After an extraction, the dentist or dental surgeon will apply a thick layer of gauze to the extraction site. Biting down on the gauze with gentle but firm pressure will aid in bleeding control.

The gauze must be left on for at least 20–30 minutes. When the gauze becomes covered with blood, the patient must replace it.

Mild bleeding may occur during the first and second days following an extraction. This will subside once a blood clot forms.

Pain relievers

The numbness caused by the local anaesthetic should only persist a few hours after the extraction. If the numbness persists, consult your dentist.

Following an extraction, you might experience some pain and discomfort. Take any prescription pain medications according to your dentist’s instructions. These medications can help you recover without causing pain, but they do have some risks. Before taking prescribed pain medication, discuss the risks and benefits with your dentist.

Reduce inflammation

Mild swelling is expected. To minimise swelling, apply cold packs to your face for fifteen minutes at a time for the first twenty-four hours after tooth extraction. After that, you can control pain using heat therapy in the form of warm washcloths.

Eat healthily

Drink plenty of water and consume soft, healthy foods after tooth extraction. It is best to avoid chewy or crunchy foods in the meantime.

When chewing becomes more comfortable, gradually reintroduce solid foods. The dentist will advise you to chew on the opposite side of the extraction site until the area has healed completely. Opt for soft foods such as mashed potatoes, soft vegetables, blended soups, yogurt, scrambled eggs, mashed bananas, applesauce, and avocado during the healing process.

Maintaining good oral hygiene

After twelve to twenty-four hours, you can continue your oral hygiene routine together with gently rinsing your mouth with warm saltwater. But avoid brushing and flossing the extraction site.

Avoid damaging the extraction site

It is essential to do the following during the first twenty-four to forty-eight hours after the extraction:

  • Get plenty of rest. Avoid doing any strenuous activity that may dislodge the blood clot.
  • Avoid rinsing. Use the recommended mouthwash or warm salt water after twenty-four hours following the surgery.
  • Avoid drinking from straws. The air pressure can dislodge and harm the extraction site.
  • Be careful not to spit. Any pressure on the extraction site may damage or interrupt the formation of the blood clot.
  • Avoid sucking on anything.
  • Keep your head elevated.
  • Keep your nose from blowing and sneezing.
  • Avoid smoking.

FAQs About Tooth Extractions

The cost of tooth extraction

Patients pay less for dental insurance-covered tooth extractions. The majority of medically required extractions will be covered. The cost is determined by your insurance plan and the cost of the extraction.

Several factors identify the cost of tooth extraction. According to the Australian Dental Association, the average cost of simple extraction in Victoria, Australia, may range from \$187.69 to \$300. Surgical removal, such as wisdom tooth removal, can cost between \$284.67 to \$2,300.

You can arrange a payment plan if you don’t have insurance coverage, but you’ll need to pay the whole amount out of pocket. It is always necessary to administer a local anaesthetic (numbing medication) during the extraction. The procedure may also require general anesthesia. Separate charges apply for this medication.

How long does a tooth extraction take?

There are different procedures that may be employed in the process of tooth extraction. The process may vary depending on the patient’s specific needs.

If you only need one tooth extracted, the procedure can be done in 20-40 minutes. However, if you need multiple teeth removed, you can expect to spend a little more time in the dental clinic. Other factors may determine how long the process will take, such as whether the extraction is simple or surgical, closing the empty socket, and numbing the area.

In addition, if you will undergo surgical tooth extraction, it is recommended to have a company that will drive you home for safety, as the numbing agent may still have side effects after the surgery.

What happens if your face gets swollen after extraction?

Swelling following oral surgery is quite normal. In fact, it is a natural part of the body’s healing process. When tissues in the body are damaged, fluid and blood cells rush the area, causing it to swell. Because tooth extraction involves stress on the gums and surrounding tissues, inflammation is to be expected.

Holding an ice pack or a plastic bag of frozen peas or corn that conforms to the face and cheek shape can reduce swelling significantly. For the first eighteen hours, ice therapy can be administered. A cold pack should be applied to the cheek for twenty-five minutes and then removed for five minutes. If the swelling persists or worsens after three days, or if the discomfort is significant, there is a risk of infection that may have formed, and you should see a dentist.

Factors that affect the healing of tooth extraction sites

A dry socket might occur if no blood clot develops over your tooth hole or if it becomes dislodged or dissolves before the lesion has healed.

Dry socket is a potential complication following tooth extraction treatment that interferes with new bone and soft tissue formation over the clot.

You are more likely to develop a dry socket if you:

  • Have an infection in your tooth hole.
  • Have an injury or any damage to the extraction area from the procedure.
  • Prior to the recent extraction, you had a dry socket.
  • Smoke, chew or use vaping nicotine or tobacco products.
  • Take oral contraceptives.
  • Don’t keep the area clean of bacteria and food debris.

When it comes to managing your expectations of the healing time, your dentist will be your best guide, but 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 procedure. 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. One of the most critical factors is your current health status; prior to the procedure, the dentist thoroughly evaluates your medical and dental history.
  • 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.

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.

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