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Many teeth can be saved with modern dental
techniques, some must be removed. There are a number of
reasons why you may need to have a tooth removed (a tooth
extraction). A surgeon who specializes in surgeries of the
mouth (oral and maxillofacial surgeon) or your dentist can
remove a tooth.
Many patients like to have sedation dentistry
for tooth extraction appointments. Whether or not this is
recommended depends on the patient. If you have no anxiety
about the dental appointment at all, this isn’t necessary.
The extraction of teeth is a commonly
performed and generally safe procedure. For most people, the
benefits – treatment of pain, decay and infection - are
greater than any disadvantages. However, in order to make a
well-informed decision and give your consent, you need to be
aware of the possible side-effects and the risk of
complications.
Why Have a Tooth Extraction?
There are several reasons why your dentist
may recommend that you have a tooth taken out.
• Tooth has decay or is infected. This can be
very painful and an abscess may form.
• Break or fracture a tooth by accident.
• Having severe gum disease which may affect the supporting
tissues and bone structures of teeth.
• In preparation for orthodontic treatment (braces)
• Teeth are crooked because there is not enough space in
mouth. One or more teeth can be extracted to make room for
the rest. This can help to straighten children’s teeth as
the teeth have more room to grow.
• Not having enough space for wisdom teeth at the back of
your mouth (impacted wisdom teeth).
Before you have your tooth extraction
procedure it’s important to consult with your dentist how it
might be replaced.
Dental Examination before Tooth Removal
Your dentist will need to examine your mouth
and teeth before a determination can be made that a tooth
extraction is warranted. As a part of this examination a
X-Ray (radiograph) will be taken of the tooth in question.
This X-Ray will allow your dentist to evaluate the internal
aspects of the tooth as well as the tooth’s root portion and
the bone surrounding it.
During the examination your dentist will
collect relevant medical information from you. Even if your
dentist doesn’t ask, make sure to report if you have had any
problems with any previous tooth extractions, or if you have
any bleeding problems or medical conditions in general.
Do no hesitate, be up front with your dentist
during your exam regarding any concerns or fears you have
related to the tooth extraction procedure. Knowing as much
as possible about not just your tooth but also you
personally will help your dentist know how to treat you more
effectively.
What to Do after Tooth Extraction?
Most people have teeth removed under local
anesthesia by a general dentist or oral surgeon. This means
that they are awake, but the area around the tooth is
completely numb. Sedative drugs can be given with local
anesthesia to help you relax during the procedure.
It will be necessary to rest for a while
after general anesthesia or sedation. After any method of
extraction using local or general anesthetic the jaw may
feel stiff and sore, but painkillers will help to relieve
discomfort.
Immediate post-operative advice for tooth
extractions (while you are still in the dental office):
• Sit still for a few minutes immediately
after the appointment. You want to be sure that a blood clot
has formed before you get up and around, because you could
provoke bleeding. The amount of time you need to sit still
varies with the type. If this was a baby tooth that was
close to coming out on its own, you may only need one or two
minutes of sitting still. For the simple removal of an adult
tooth, you may need to sit for about ten minutes. For a
surgical extraction in which stitches were necessary, it
could be half an hour or longer. This amount of time could
be longer if you tend to bleed longer than most people.
• You will be biting on gauze while you are
waiting. This keeps pressure on the site and assists in
stopping the bleeding.
Advices on what to do after you leave the
dental office:
• After you leave the office, you should be
somewhat still, without strenuous activity, for about two
hours. Don’t suck or spit, as this will inhibit the
formation of a blood clot.
• Some persistent bleeding is normal. Expect
your saliva to be tinged with blood for several hours.
• However, if you notice thick bleeding with
dark red blood clots, you need to apply more pressure to the
site. Most dental offices give you a pack of gauze in case
this occurs. If you don’t have gauze, use a paper towel. Wad
it up so it puts pressure directly on the site, and bite on
it for a good forty-five minutes. If the bleeding still
hasn’t stopped, repeat this. If it still doesn’t stop, call
the dentist or go to the hospital emergency room.
• For pain, after a simple extraction, you
should be able to just ask your dentist what you can take.
Are There Alternatives for Tooth Extraction?
Antibiotics and painkillers can temporarily
relieve symptoms which show you need tooth extraction, such
as swelling and tooth pain (toothache), but they are not
long-term solutions. Having teeth removed may be the only
way to permanently relieve your symptoms.
If the nerve at the centre of your tooth is
painful or infected, or the fracture of the tooth is not too
severe, your tooth may be saved by having root canal
treatment followed in appropriate circumstances by crowning.
This removes infected and damaged blood vessels and nerves
from a tooth.
If your teeth are crooked, you may choose to
leave them the way they are, rather than having teeth
extracted. Your dentist or orthodontist (a specialist in
straightening teeth), will be able to advise you
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