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Extractions

The most common extraction procedure performed on patients is on wisdom teeth.  They often cause pain and problems for patients as the teeth are trying to protrude through the gums. When a wisdom tooth is coming in at an angle and not straight through the gum line, it is referred to as “impacted.”  Such an impacted wisdom tooth can cause not only pain, but the tooth can come in unevenly or may only emerge partially.

Sometimes wisdom teeth only emerge partially.  When this happens, sometimes flap of skin (called an operculum) can form over the tooth, which makes it difficult to clean and pieces of food may be caught underneath.  Such side effects of an operculum make your mouth more prone to infection, called pericoronitis.  Eventually, after it causes swelling and pain in the area, it should go away on its own.

Impacted teeth and wisdom teeth should be removed to avoid the chance of infection.  Wisdom tooth extractions can range from a single tooth, to removing all four wisdom teeth at once.  Based on the preference of the patient and recommendation by the dentist, a local anesthetic can be used to numb the areas where the teeth will be extracted.  Some dental professionals will opt for their patients to go under a general anesthetic, so that the patient will be sedated during the entire procedure.

During this type of tooth extraction, the gum tissue around the wisdom tooth is cut open to reveal the tooth.  The dentist then loosens the tooth by gripping it tightly and wiggling it back and forth until it can be easily lifted out of the gums.  Sometimes, a tooth may be impacted so tightly that it cannot be simply lifted out of the gums with ease.  In cases like this, the tooth will need to be broken up into smaller pieces before being removed.  Depending on the incision and extraction site, sutures may be needed to close the area once the wisdom tooth is removed.  Soluble sutures, ones that dissolve on their own, are the best option for patients.

After wisdom tooth extraction surgery, the patient will need to get plenty of rest.  Due to the anesthesia, the patient will need to be driven home by a friend or family member.  Bleeding of the gums near the extraction site is to be expected for a little while after the surgery.  Gauze will be applied at the completion of the surgery, and should continue to be used for the first 24 hours after surgery.  The gauze pads will need to be changed whenever they become soaked.  If bleeding continues for longer than 24 hours, the patient’s dentist should be contacted.  While resting after the surgery, it is important to not lie completely flat while resting.  This could prolong the bleeding and healing process.  Instead, the patient should prop their head up on a pillow when lying down.

For pain management, dentists will prescribe pain medication for tooth extraction patients.  These should be taken as directed as pain progresses during the healing process.  Ice packs can also gently be used on the outside of the patient’s mouth for pain relief.  Your dentist might also provide you with a cleaning solution to help keep the extraction site clean.

There will be some food restrictions for the first few days after surgery.  Some recommended foods are:

  • Jell-O
  • Pudding
  • Yogurt
  • Mashed Potatoes
  • Ice Cream
  • Thin Broth Soups
  • Other foods you can eat without chewing.

While drinking, it is important to remember not to use a straw because the sucking motion could loosen the sutures and slow the clotting process.  The same goes for smoking – it should be avoided while in the healing process after a tooth extraction.  If a patient experiences prolonged pain, bleeding, irritation, or does not feel that the extraction site is healing properly, it is important to call your dentist for a follow up right away.

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