The Most Traumatic Appointment in Dental Surgery – Tooth Extraction
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.
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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 anaesthesia 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 anaesthesia to help you relax during the procedure.
It will be necessary to rest for a while after general anaesthesia or sedation. After any method of extraction using local or general anaesthetic 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.
Categories: Dentists, Teeth
Topics: Tags: after effects of tooth extraction, alternative to tooth extraction, antibiotics, blood, braces, broken tooth extraction, cracked tooth, dental surgery, dentist, emergency tooth extraction
I had a permanent tooth removed by and oral surgeon about a week ago. The tooth had a previous root canal and was brittle and ended up breaking. The dentist was very good and it was out before I knew it.
I have a recommendation, you might want to try. The dentist will give you gauze to bite down on and when I got home, I took a tea bag (green tea) and got it wet and put it in the gauze. I heard it helps the healing process. It worked really well and the gum is healing very nicely. Try it I think you will agree it really help in the healing process. Good Luck!
I had a tooth extracted,today, due to an infection / abscess. The infection had been treated but had not fully gone.
The anasethetic, therefore, did not fully work.
I can tell you that it was the most agonisingly traumatic experience of my life. I have quite a decent pain threshold but I burst into tears as soon as I got home and still can’t believe that I could be allowed to writhe about, on the chair, in muted agony, for 30 minutes.
Make sure any infection is fully cleared up before going ahead with an extraction…
Wow….that must have been terrible for you. I told the dentist to give me plenty of shots. I was also thinking how awful it would have been to live back in the days before they could numb your mouth. I had a dentist in Hawaii, that must have been a sadist….it was on the same tooth, too. He told me that the nerve was dead, so he wouldn’t need to use any numbing before drilling…I was appalled, but like a dummmy I let him do it. I could feel the heat of the drill and feel the pressure and Bingo he hit the nerve and I almost went through the roof….so I really do feel sorry for you….toothaches are the worse.
Lucky for me I didn’t have any abscess or infection, so everything went fine with my extraction and I’m glad to be rid of the broken tooth, once and for all. Good luck, hope you don’t devellop a fear of dentist, because of your experience. Most dentist are very good….but the few bad ones sure give the rest a bad name….
i’ll have 4 teeth extracted due to braces on the 11th dec 08 and 26 dec 08. i’m so scared
Had four permanent teeth pulled today. I had an infection in all of them but only one really gave me any problems. The first tooth he pulled he had to break it and then pull the pieces of roots that were left. It wasn’t very painful until he had to pull out the infected roots, then I thought I was going to fly up out of the chair and run to the car. My dentist said it was because of the infection even showing me the roots. The other three were infected but he pulled them in one piece. I couldn’t believe the difference, only pressure with no pain. Hopefully, won’t have to go through that again anytime soon.
These posts just scare people. Makes me very angry to read this rubbish.
Please stop doing it! There is no pain in modern dentistry. Do not be misled by these people, please!!
im 25 and went in for 2 surgical extractions about 48 hrs ago, with an oral surgeon. i have had my wisdom teeth done before, so i was a bit anxious, but not too bad, when i went in for consultation.the surgeon i met saw my nervousness, and also said he recommended i be put to sleep while they remove the 2 teeth. he said the exrays showed irritation of nerve,gum and all the way up my jaw. he said it was also infected on one side, so he sent me home with amoxicillan (anti-biotics) and percocet since the pain was throbbingly bad, and i had waited a year to come in and see whats wrong (no insurance, and i knew there was decay on tooth)
well i left feeling ok, happy i was to be out while the surgery was done in 1.5 weeks.
came back for surgery with ?’2 i had thought of along the way, that i didnt ask that day. unfortunatly i was working with another surgeon that day, who had looked at my xrays and knew i had a consult already. well i felt so weird when i was in the room, and they were hooking me up to monitors…and i had all these questions, but was asking young assistants =/ so i waited till the unmet surgeon came in, then asked some. i told him i was a big girl, i also had 7 years of smoking marijuana daily (i had just quit 45 days prior) because i WANTED him to know, incase it affects anesthesia. well he came in thinking i was a different patient =/ who was getting novacaine. i got very nervous then, and said no! no! i am getting put to sleep. he said ok, looked at my files, and said ok. i asked him if anyone had ever woken up during surgery? like those horror stories i have seen on tv….he said “well yes, and no…i mean some patients get (lighter) but they feel no pain”
i was very nervous/anxious. he put in my IV laid me back and i was all hooked up to monitors and strapped down to chair. very very nervous.what i didnt know, is what was about to happen. this was not at all going to be like when i had my wisdom teeth taken out. that time i laid back, he put in IV, and said count back from 10, i only made it to 7 =) and awoke not knowing a thing, it was great.
well this time?? i never went to sleep. i laid back….i felt slightly tired, but i remember looking with my eyes wide open, scared, at the dental assistants, thinking “hey! im awake” but they then began working in my mouth. i could not see what they did, as i was laid back so far, and my nose was covered with an oxygen mask (is what the assistant said, i HOPED it was gas….lol)
they got to work, i lay there worried, how could they start when im awake?? but, it didnt hurt. they MUST have given me a local. well it didnt hurt at that moment anyway….lol.
so on they go, i was really tense and worried, i wanted to be knocked out sooo bad. why wasnt i??? was i not getting the full affect of anesthesia? was it the smoking pot? was it bc my tooth infection was not fully cleared up? i was on anti-biotics still? i was on percocet the night before? who knows! i sure didnt =/
i wished the surgeon had been more specific with what was going to be done with me. about the fact i might be awake, maybe given me something else to help, adivan, or gas…anything. i was so uncompfortable…bc i had EXPECTED to sleep.
well as the surgery went on, he pulled out a DRILL,and when he used it, it did in fact HURT. i whimpered, i went “gahhhwwhhh” and “ohhwwcchhhwww” to TRY and tell them i could feel pain. i couldnt move my hands to signal. im not sure how loud my sounds actually came out, w the drill and all…
then i heard them say “20 cc’s” or something, probably adding to my IV. i may have went to sleep at this point? im not sure. i do remember opening my eyes, but it was what seemed like a minute later, and surgery was still on. in fact, they were switching sides now (i had both back molars on my upper taken out that day, so 2 teeth, one on each side of my mouth)
i remember them switching. more noises i made. then i remember them saying “ok lets clean up, were done” and removing my IV. i remeber sitting up. and they immidatly brough a wheelchair to me and rolled me out to the truck.
my husband went inside and got their aftercare paper. i was talked to none, and about nothing. my husband came back to truck, i was in TEARS. he said whats the matter? i said “babe, i never went to sleep…i was awake the whole time (i think) and i felt pain…this was horrible experience…nothing like my wisdom teeth!” and i whined on. he took me home. but i never forgot. its now 48 hrs post op, and i have more dental anxiety than i ever have. its not so much how the surgery went, but the fact that i wasnt informed enugh about it. i EXPECTED to go to sleep.
as i read up online when im at home now, i see there is a huge difference between general anesthesia, and iv sedation. i think that they always intended to conciouslly sedate me. but why when i asked about”patients waking up?” wouldnt he say, they are awake the entire time???
and why is there usually gas or shots or other calming drugs/numbing drugs involved in these councious sedation stories that im not sure if i had??
i feel lost, and traumatized by this…
For the person who said there is no pain in modern dentistry, that’s not true at all. Granted the local anesthetic helps immensely, however due to other health problems I have severe tooth decay and infection in a lot of teeth. I think I’ve had to have 13 out at this point. The pain of the local anesthetic is horrible, not to mention the worse your infection is, the harder it is to numb the entire area, because of severe infection despite the fact my dentist is a great one, and continues to give me the local anesthetic if I feel ANYTHING it’s still not painless. With that said, I’ve still had some severe pain when a tooth is being pulled and half that side of my entire mouth is numb. I have horrible issues after, however. Often dry-sockets. Muscle spams.. etc. However, in the long run (even though instead of how most people actually heal and have pain post-extraction only for a week, it takes me about 3) It is STILL worth having the work done in the long run.
I need teeth out and i am very timid and scared.
On my orthadontist appointment he mentioned tooth extraction i couldn’t hear anything i went numb and burst into tears i have so many questions like,
Will they strap me down?
What will they do?
What is the procedure?
What tools will they use?
Does the needle hurt?
I know its alot but im very timid thanks