Tooth extraction is a necessary procedure to treat severe decay, gum disease, or infected teeth. It may also be needed to remove wisdom teeth or prevent recurrent infections. As with any dental procedure, there are potential complications from tooth extraction including infection and excessive bleeding. Fortunately, these risks can be avoided by following the dentist’s pre-extraction guidelines and aftercare instructions.

We provide a variety of sedation options for patients who need comfort during tooth removal. A successful recovery depends on proper care of the extraction site.

Preparation

Whether you need a tooth removed due to trauma, gum disease, alignment issues or impacted wisdom teeth, preparing for your appointment will help ensure a smooth recovery. It’s important to take any prescribed medications as instructed and to arrange transportation to and from the procedure. It’s also advisable to stay away from food for about 12 hours prior to the surgery, to avoid nausea and vomiting.

Applying an ice pack to the extraction site can reduce pain and swelling. It’s also a good idea to drink plenty of cold fluids, but it’s important to avoid hot liquids because they can dissolve blood clots and prolong healing time. Avoid rinsing, spitting or chewing directly on the affected area, to prevent dislodging or disturbing the blood clot that forms in the empty tooth socket. Gently rinsing the mouth with warm salt water several times a day can also decrease pain and keep bacteria at bay. If pain or swelling increase, contact the dentist for further guidance.

Anesthesia

During a simple extraction, local anesthesia is used to numb the area around the tooth so you do not feel pain. For surgical extractions or impacted wisdom teeth, we may use deeper anesthesia. This is administered through intravenous (IV) sedation, which can range from conscious sedation to general anesthesia. The dentist or oral surgeon monitors your heart rate, blood pressure and breathing throughout the procedure to ensure your safety.

Sedation also reduces anxiety and discomfort during the procedure. It is often combined with local anesthesia for greater calming effects. Before the sedation is given, the dentist takes a detailed medical history, including any medications you are taking. Some medications such as aspirin or other blood thinners can cause more bleeding during surgery and may need to be stopped in the days before the extraction. This is a good time to discuss any concerns or fears with the dentist as well.

Removal

The removal of a tooth is usually completed in the dental office, with anesthesia to ensure comfort. For a simple extraction (tooth that is visible and easily accessible), the dentist uses an instrument called an elevator to loosen the tooth from its socket, and then firmly grasps the tooth with forceps and pulls it out.

After the procedure, the doctor will apply pressure to stop bleeding or oozing. This is known as hemostatic response. Various types of gauze are used as well as hemostatic packing materials, such as oxidized cellulose or collagen sponges. The doctor may also prescribe pain relievers and/or antibiotics to prevent infection of the surgical site.

During the recovery process, be sure to drink plenty of fluids and eat soft foods. Avoid hot or cold foods that could irritate the surgical site and don’t use a drinking straw. It is important to eat slowly and chew thoroughly to promote healing. Rinse your mouth two or three times a day with an antimicrobial mouthwash, and gently brush the rest of your teeth as usual.

Post-Extraction Care

The dentist will provide painkillers for post-extraction discomfort. Some patients require only acetaminophen, while others may need stronger prescription painkillers. Ice packs can be applied to the face in ten-minute increments to help reduce swelling and bruising. Avoid drinking through a straw and smoking, as these activities can dislodge blood clots and delay healing.

It is important to follow a soft foods diet for the first day or two, and to rinse with warm salt water three times a day to clean the area. The dentist will recommend resting and taking it easy to avoid aggravating the extraction site. Most patients return to their normal routine within 10 to 14 days. However, it may take up to two months for the extraction site to heal completely.