Tooth extractions are one of the most common procedures that I perform as a dentist. But to many, they can bring about anxiety and fear, while conjuring images of long recovery periods. If you feel this way, you’re not alone. It’s estimated that around 36% of Americans are afraid of getting a tooth pulled, and some studies have even suggested that the percentage is even higher at 50%. But, did you know that nearly half of the U.S. population will have a tooth extraction at some point in their lives?
In my experience, having more knowledge and insight about a dental procedure will make the experience far less scary and daunting. I’m here to demystify the process to help you have a smoother journey – because getting a tooth pulled doesn’t have to be a traumatic experience. With the right information and a supportive dentist, it is a very straightforward procedure.
Here are 10 things you should know before getting an extraction, straight from the dental chair.
1. Why Extractions Are Necessary
Tooth extractions are sometimes an important part of maintaining oral health. They become necessary when a tooth is too damaged by decay, infection, gum disease, or trauma to be repaired. Extracting the problematic tooth can prevent the spread of infection to surrounding tissues which, if left untreated, can lead to serious health complications.
Another common scenario where a tooth needs to be removed is in the case of an impacted wisdom tooth. When these molars don’t have enough space to emerge properly, they can become trapped in the jawbone or gums, leading to pain, swelling, or infection. Impacted wisdom teeth can also crowd neighboring teeth, resulting in misalignment and increased risk of cavities or gum disease.
Teeth may also need to be extracted to for orthodontic treatment to create space for proper alignment and to achieve an optimal bite. In cases of overcrowding, where there isn’t enough room for all teeth to fit comfortably, removing one or more teeth can help facilitate the movement of others into their ideal positions.
2. Consultation is Key
A consultation with your dentist prior to an extraction is essential for a smooth and successful procedure. This step allows your dentist to take appropriate X-rays and thoroughly examine the problematic tooth and gums, as well as all surrounding anatomical structures. In doing so, your dentist will be able to create a personalized plan that will remove the offending tooth quickly and painlessly. For instance, a non-restorable cracked front tooth will need to be removed with a different technique than heavily decayed lower molar.
In certain complex cases, your dentist will recommend a referral to an oral surgeon during the consultation. This will allow you to have your extraction performed by a specialist who is expertly trained in specific procedures like severely impacted wisdom teeth. This determination is only made through a thorough exam with your regular dentist.
Consultations also allow your medical history to be evaluated. Certain medical conditions, medications, or previous health complications can affect how your body responds to the anesthesia that is used for the procedure, as well as the procedure itself. By understanding the specifics of your situation, your dentist can tailor the extraction to your needs by taking preventive measures to avoid complications. This ensures a safer and more predictable extraction process.
3. Anesthesia Options
When getting a tooth extracted, there are several anesthesia options to ensure a comfortable and pain-free experience.
Local anesthesia is the most common, which numbs the specific area around the tooth. This allows you to remain awake but comfortable during the procedure. The most that I tell my patients to expect to feel when choosing this option is mild pressure.
For those with dental anxiety or for more complex extractions, conscious sedation in addition to local anesthesia- such as nitrous oxide (laughing gas) or oral sedatives (Valium)- can help you relax while you are awake. I have had many anxious patients, both adults and kids, feel completely mellow using this option.
In cases where more profound sedation is needed or elected for, intravenous (IV) sedation or general anesthesia may be used. This allows you to sleep through the entire procedure, waking up only when everything is all finished. Most of the time this will need to be done at an oral surgeon’s rather than your family dentist, as it requires specialized equipment.
4. Preparation Matters
Start by following any pre-operative instructions provided by your dentist, which may include dietary restrictions, especially if sedation is involved. Arrange for someone to drive you home afterward, as you might feel groggy or disoriented. It’s also helpful to stock up on soft foods like yogurt, smoothies, and mashed potatoes, as you’ll want to ease into your diet post-extraction.
Additionally, you may need to adjust your medications before the procedure. Certain medications, such as blood thinners, can increase the risk of excessive bleeding during and after the extraction, so your dentist may recommend a temporary pause or dosage adjustment. Also, if you’re taking medications that affect your immune system or healing capability, your dentist may consider working with your physician to adjust these in order to optimize recovery. As dentists often communicate with patient’s physicians, always communicate openly with both about all your current medications and medical conditions.
5. The Procedure and Duration
First things first: your dentist will numb the tooth and the surrounding area. After ensuring that you are completely and fully numb, your dentist will carefully loosen the tooth from its socket using specialized instruments. In cases of impacted or more complex teeth, a surgical extraction may be required, which involves making a very small incision in the gum. After the tooth is removed, your dentist will clean the socket and may place stitches to aid in healing.
Most tooth extractions are relatively quick, typically taking between 20 to 30 minutes. However, the time may be shorter or longer depending on the complexity of the extraction.
6. Post-Extraction Care is Crucial: Diet Adjustments & No Smoking
Once the tooth is removed, you might experience some bleeding. Typically, a gauze pad is provided for you to bite down on in order to help form a blood clot at the extraction site. Avoid vigorous rinsing, spitting, or using a straw for 24 hours to protect this clot.
Stick to soft foods like yogurt, applesauce, mashed potatoes, and smoothies for the first few days. Stay hydrated and avoid hot, spicy, or hard foods. Gradually reintroduce more solid foods as you start to feel more comfortable, and be sure to chew on the opposite side of your mouth to protect the extraction site.
Try not to smoke for at least 72 hours. While this may seem daunting, the components of cigarette smoke cause inflammation, delay healing, and can lead to a painful condition called dry socket.
7. Managing Pain and Swelling
While a certain amount of discomfort and swelling is to be expected, there are steps you can take to manage it and make yourself more comfortable.
To minimize discomfort, your dentist will likely recommend over-the-counter pain relievers or prescribe pain medication. This will depend on your specific needs, but I’ve found the most effective pain relievers for my patients in these cases to be a combination of ibuprofen and acetaminophen. Prescription strength painkillers are usually reserved for severe pain, and only a very small percentage of my patients require these.
Applying ice packs to the outside of your cheek in 15-minute intervals during the first 24 hours can reduce swelling and numb the area, while alternating between hot and cold compresses afterward can promote circulation and healing. Additionally, keeping your head elevated while resting can further alleviate swelling.
8. Watch for Complications
While complications are rare, it’s important to be aware of potential signs just in case.
One of the more commonly known issues is dry socket, which occurs when the blood clot at the extraction site dislodges, leading to pain and delayed healing. Signs of infection such as increased swelling, persistent pain, fever, or discharge from the site should also be taken seriously. Additionally, if you notice excessive bleeding that doesn’t subside with gentle pressure after a few hours, it’s important to contact your dentist promptly.
By being aware of these potential complications and following your dentist’s post-operative care instructions, you can help ensure a successful recovery for yourself.
9. Oral Hygiene
Maintaining oral hygiene after a tooth extraction promotes healing and helps prevent complications.
24 hours after the procedure, you can begin rinsing your mouth with warm salt water to keep the area clean. You should also continue to gently brush and floss the rest of your teeth while being cautious around the extraction site to avoid irritation.
10. Follow-Up Appointments
Be sure to attend any scheduled follow-up visits to ensure your mouth is healing correctly. Your dentist will check for signs of infection and ensure the site is recovering well.
Final Thoughts
Tooth extractions are an extremely common dental procedure, and being informed will help alleviate any anxiety you may have. By understanding these key aspects of tooth extractions, you’ll be better prepared for the procedure and recovery process.
I hope this article helped to make your upcoming extraction less intimidating! As always, trust the expertise and care provided to you by your dental team and don’t be afraid to ask questions.
Have you had a tooth extraction before? Do you have any lingering questions about the procedure? What tips or experiences can you share with others facing a similar situation? We’d love to hear your thoughts and stories in the comments below.
~Dr. Lee
Disclaimer: The information provided in this blog post is for informational purposes only and does not constitute medical advice. Always consult with your healthcare professional or dentist before adjusting your medication, taking new medication, or using over-the-counter products to address dental concerns. Individual needs may vary, and your physician can provide guidance tailored to your specific situation. Always consult with your dentist or physician for any symptoms mentioned in this article.