At times, an adult’s permanent tooth may become so severely damaged from decay or infection that it will need to be extracted. At other times, a child might experience facial trauma that loosens a baby tooth prematurely, necessitating the extraction of the primary tooth to avoid damaging the developing permanent tooth below. Whatever the cause, if a dentist determines that a tooth extraction is necessary, he or she will schedule the oral surgery either in the office or with an oral surgeon. Tooth extractions are crucial to prevent the spread of infection to other areas of the mouth. Depending on the patient, the extracted tooth may be replaced with an implant, a denture, or a bridge, which is a replacement, either permanent or removable, for one or more teeth.
What to Expect During Oral Surgery
At the beginning of the appointment, the dentist will apply a local numbing agent to alleviate any discomfort during the surgery. Local anesthetic may be all that is needed, though a stronger general anesthetic may be used if several, and especially if all, teeth need to be removed. General anesthesia will put the patient to sleep during the procedure so that pain will not be an issue. Once the tooth has been extracted, stitches may be needed to close up the wound. Certain types of stitches dissolve naturally, but others need to be removed after a few days. The dentist will alert the patient to the nature of the stitches.
Because certain types of dental work can cause bacteria to enter the bloodstream and spread infection throughout the body, patients who have artificial heart valves, who were born with heart defects, or who generally struggle with infections may need to take antibiotics before and after oral surgery.
After the Extraction
Once the oral surgery is complete, the dentist will explain the post-care procedures, which generally last a few days and may include prescription painkillers. During the recovery period, patients can expect at least a small amount of bleeding, and should actively avoid activities that could dislodge the blood clot and delay healing, such as smoking, rinsing the mouth vigorously, or drinking through a straw for the first twenty-four hours. If a patient feels the urge to rinse the mouth, he or she should do so gently.
To reduce swelling, patients can apply a cold cloth or ice bag to the affected area. They can also rinse the mouth gently with warm salt water several times a day, which not only reduces swelling but also can alleviate pain. To decrease bleeding, the patient should bite down on a gauze pad inserted over the wound, being careful to change the gauze before it becomes soaked with blood. Physical activity should also be avoided, since it may stimulate bleeding. Likewise, patients should prop themselves up on pillows, since lying flat may prolong bleeding.
Post-surgery patients should feel free to brush and floss the teeth as usual, taking care to avoid cleaning the tooth next to the empty socket or touching it with the tongue. They should also choose soft foods for the first few days, such as gelatin, pudding, or thin soup, gradually building up to solid foods.