All of our dentists at Conway House Dental Practice are proficient at extracting teeth. However at our practice we are very fortunate to have a visiting oral surgery specialist; Mr Adrian Curtis. Adrian is a associate specialist at Stoke Mandeville Hospital performing oral surgery and oral medicine procedures.
Our dentist will extract teeth using a number of surgical tools such as elevators and forceps. Such procedures are usually carried out under a local anaesthetic, but in the cases of very nervous or anxious patients, it is possible to carry out the procedure under I.V sedation. Harry and Adrian both have post graduate experience and diplomas in I.V Sedation. Dental extractions are needed when a tooth has become loose, badly decayed or injured through trauma and can not be saved using dental restorations. In other cases, extractions are used in conjunction to orthodontic treatment, making room for other teeth to grow or move into place.
In some cases, the target teeth may be problematic to remove due to their location or angle. They may also be partially erupted or severely decayed, making conventional extraction extremely difficult. In cases such as this, a surgical extraction involving an incision into the gum may be required. Cutting into the gum allows the oral surgeon to create a flap, giving him access to the bone underneath the tooth, making the extraction much easier. Oral surgeons can also carry out a variety of minor surgical treatments including; removing tissue samples and extracting cysts.
After one or more teeth have been removed, you will want to do all the right things for the area to heal quickly and smoothly. This requires a blood clot to be formed. The blood clot covers the extraction site and allows the area to heal. A lot of the tips below help the blood clot to form properly and not become dislodged.
It is normal for the area to be tender for the first few days, and in most cases simple over-the-counter pain relief is enough to ease any discomfort. The usual painkillers of choice are ibuprofen or paracetomol. Check with your dentist or another health care provider that you can take these (for example, asthma sufferers shouldn't). If you can't, your dentist will be able to recommend an alternative. Avoid aspirin as this thins the blood and can make your mouth bleed. Check with your dentist or pharmacist if you feel you need something stronger.
Go home, take it easy for the rest of the day, and don't exercise for at least 12 to 24 hours. If you want to lie down, and for the first night following surgery, keep your head up with pillows if possible. Do not bend over or do heavy lifting for 2-3 days. Avoid sports activities for 2-3 days.
If you still feel numb 6 hours later, call the dental practice or Harry on 07957 393 008.
We will give you a gauze pack to take home with you. If you need to use it, fold the clean gauze into a pad, thick enough to bite on, then moisten it and place it directly on the extraction site. Hold the gauze firmly in place, by biting down on the pad or using finger pressure, for about 15 minutes. If this doesn't stop the bleeding than contact Harry on 07957 393 008
While you shouldn't rinse for the first 24 hours. After the first day you should gently rinse 4 times a day using warm salt water (1 teaspoon of salt in a glass of warm water). Do not spit out forcefully! Rinse after every meal and snack, making sure that the water removes any bits of food around the area where the tooth is missing.
Be careful not to dislodge the blood clot when brushing near the extraction site for 3-4 days. You can carefully wipe the area with a clean, wet gauze pad. If you can't get a toothbrush into your mouth due to swelling or discomfort (aft er wisdom tooth removal), chlorhexidine is a good mouthwash.
Stick to a liquid or soft food diet for the first day or two. Examples include soups, yoghurts, fruit milkshakes, smoothies, mashed potatoes, etc. A Vitamin C supplement may also be helpful. Avoid spicy foods, hot drinks and sodas for 3-4 days, to prevent irritation and burns. If you've been prescribed antibiotics, follow the instructions and make sure you finish the course.
Swelling and sometimes bruising can occur after surgery. The worst swelling, pain and jaw stiffness normally occurs 2 or 3 days after surgery. On the day of the surgery, apply ice packs for 15 minutes on then 15 minutes off until bedtime. This will keep swelling to a minimum. Also keep your head elevated until bedtime. Moist heat after 36 hours may help jaw soreness.
Don't be tempted to rinse the area for 24 hours after tooth removal. Avoid hot food or drinks until the numbing wears off. You cannot feel pain while you're numb and may burn your mouth. Also take care not to accidentally chew your cheek!
Don't poke at the extraction site! - keep your fingers and tongue away from this area.
Avoid sucking, spitting, and blowing your nose (unless you have to). This is because positive or negative pressure could dislodge the blood clot. If you have a cold or allergies or anything that will want you blow your nose or sneeze, take appropriate medications to treat these.
Do not smoke for as long as possible afterwards, but at the very least for the rest of the day. Smoking can interfere with the healing process, and also the sucking motion could dislodge the blood clot.
Avoid alcohol for 24 hours, as it could delay the healing process.
It usually takes gum tissue about 3-4 weeks to heal. The bone can take up to 6 months to heal completely. However, pain should be lessening by the second day. But it varies from person to person, and also depends on how easy or difficult the tooth removal was.
You may feel the sharp edge of the socket with your tongue and sometimes, little bits of bone may make their way to the surface and work their way out. This is perfectly normal and harmless. If a small bit of bone is annoying you and you don't want to wait until it comes out by itself, you can ask your dentist to remove it for you.
Pain that starts to get worse after two days is considered abnormal and you may want to see your dentist. This could be a sign of "dry socket".
A dry socket occurs when the blood clot for healing becomes dislodged or doesn't form. In that case, the bone and fine nerve endings are not protected and exposed to air, food, and liquids. Dry socket delays the healing process and can be very painful. In this case you should contact the surgery as soon as possible.
This is a common problem with dissolving stitches. You can get your dentist to remove them if they don't come out by themselves. Many people are worried about the removal of the stitches (whether dissolvable or not) but it is an entirely painless process and you don't need any numbing for it.
