Dental Extractions

Dental extractions can be done for a variety of reasons. 

• The tooth has decay into the nerve, and you do not want to keep the tooth by root filling it.
• Impacted wisdom teeth (these are referred to another dental practitioner)
• Broken at or below the gum line - not fixable
• Only a third of people that have orthodontic treatment require tooth removal
• Wobbly teeth due to gum disease
• Fractured through the root of the tooth

Having a tooth removed due to decay is not something anyone would want every time they see a dentist, but some people put off having their teeth checked and then end up with this as the only option. Prevention is key to losing multiple teeth, see our dental prevention page for some top tips. 

We refer impacted wisdom teeth to be removed under IV sedation with several practitioners in Tauranga, for example Tauranga OMS. We also refer broken-down root-filled teeth to be removed as they are very brittle and likely to become a surgical procedure.

DENTAL EXTRACTION PROCEDURE

Local anaesthetic is placed after a numbing gel, to freeze the tooth and either side of the gum. The gum and tooth are checked and re-checked to ensure the tooth and surrounding structures are fully numb prior to tooth removal. If at any time there is any pain, we stop, check, re-apply more anaesthetic, check for numbness again and continue.

Funny noises can be heard sometimes when we remove teeth, and if the tooth is broken down or has gross decay, bits of the tooth can break off. This is very normal. 

Until we start removing the tooth, we do not know how long it will take. Some people's bone that holds their teeth in place is very tough, and some is not. Plenty of time is booked for an extraction therefore it is not a rushed job, as slow and steady wins the race. 

Gauze is placed onto the tooth socket and the patient bites hard onto this to achieve a blood clot. Written instructions are given to all patients - see below.

AFTERCARE FOLLOWING A DENTAL EXTRACTION

The following steps will help prevent bleeding and relieve soreness:

REST: Rest for a few hours following treatment and avoid strenuous exercise.

SALT WATER: Do not rinse your mouth on the day of surgery. The next day, you may bathe your mouth gently with warm salt water after meals and before bed.  Dissolve 1/2 teaspoon of salt in a glass of warm water. Hold the solution in your mouth for several minutes, discard and repeat 2-3 times, particularly after eating. It is normal for you to have blood-stained saliva. Do not rinse vigorously as this may make the socket bleed and inhibit healing.

FOOD: In the first 24 hours, avoid hot fluids, alcohol, hard or chewy foods.  Choose cool drinks and soft or minced foods, such as luke-warm soup, banana, soft bread, pasta, scrambled eggs. Avoid sucking at or interfering with the wound. 

BLEEDING: Should bleeding occur sit upright with head and shoulders raised.  Apply pressure using a small pad of gauze or clean linen clamped very firmly between your teeth for 15 minutes - repeat if necessary. Call us immediately if this is unsuccessful.

PAIN: For the next five days, please take 2 Paracetamol (500mg x2) every 6 hours if necessary (maximum 8 tablets per day) and 2 Ibuprofen (200mg x2) every 8 hours (maximum 6 tablets per day). These are best bought as a “home-brand” or “value” pack from a supermarket as they are the same medicine as the branded packaging.

INJECTIONS: While the numbness lasts, great care must be taken not to bite the cheek or lip, otherwise these will become very sore.

ANTIBIOTICS: These are occasionally prescribed, but generally they are not needed. If antibiotics have been prescribed please continue the whole course of the tablets until they are finished.

SMOKING: Please avoid smoking for 48 hours as this greatly affects the healing process following extraction. You can suffer from “dry socket” which is when the blood clot has been lost usually due to smoking, causing significant pain; this pain can be worse than your original toothache. Sometimes you can get a dry socket even if you are a non-smoker.

AFTER 24 HOURS: For several days following treatment bathe your mouth gently with warm salt water after meals and before bed. Savacol can be used as an alternative mouth rinse. Hold the solution in your mouth for several minutes, discard and repeat 2-3 times.

Your teeth can and should be brushed carefully.
    
A clean and healthy mouth aids healing.

If excessive bleeding, undue pain or other symptoms occur contact your Dentist 
(Gardens Dental Dr Fiona Paterson 075712861) for advice without delay.
If this occurs after hours, please go to Tauranga Hospital on Cameron Road