Tooth Extractions In Marietta, GA

What Is A Tooth Extraction?

Tooth extraction is the removal of a tooth from its socket in the bone.

When Are Tooth Extractions Performed?

In the event that a tooth has been fractured or destroyed by decay, your dentist will aim to fix it with a filling, crown or other treatment option. Sometimes, though, there’s far too much damage for the tooth to be repaired. In this specific scenario, the tooth should be extracted. A notably loose tooth also will require extraction if it can’t be preserved, even with bone replacement surgery (bone graft).

Here are other good reasons:
  • Some people have extra teeth that obstruct other teeth from coming in.
  • Sometimes baby teeth never fall out in time to enable the permanent teeth to come in.
  • People acquiring braces may need teeth pulled out to create room for the teeth that are being moved into place.
  • People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
  • Individuals receiving cancer prescriptions may develop infected teeth given that these drugs weaken the immune system. Infected teeth may need to be extracted.
  • Some teeth may need to be extracted if they could become a source of infection after an organ transplant. Individuals with organ transplants have a high risk of infection because they must take drugs that diminish or suppress the immune system.

Wisdom teeth, also called third molars, are often extracted either before or after they come in. They commonly appear during the late teens or early 20s. They need to be removed if they are rotted, cause soreness or have a cyst or infection. These teeth often get stuck in the jaw (impacted) and do not come in. This can aggravate the gum, causing discomfort and swelling. For this case, the tooth must be removed. If you need all four wisdom teeth removed, they are usually removed at the same time.

If you expect to have treatment with intravenous drugs called bisphosphonates for a medical condition, be sure to see your dentist first. If any teeth must be extracted, this should be done just before your drug treatment begins. Having a tooth extraction after bisphosphonate treatment increases the risk of osteonecrosis (death of bone) in the jaw.

Tooth Extraction Preparation

Your dentist or oral surgeon will take an X-ray of the area to help plan the best way to remove the tooth. Make sure to supply your full medical and dental history and a list of all medicines you utilize. This should include both prescription and otc drugs, vitamins and supplements.

If you are getting wisdom teeth removed, you could have a panoramic X-ray. This X-ray takes an image of all of your teeth at once. It can show several things that help to direct an extraction:

  • The relationship of your wisdom teeth to your other teeth
  • The upper teeth’s connection to your sinuses
  • The lower teeth’s connection to a nerve in the jawbone that gives feeling to your lower jaw, lower teeth, lower lip and chin. This nerve is called the inferior alveolar nerve.
  • Any infections, tumors or bone disease that may be present

Some doctors prescribe prescription antibiotics to be taken before and following surgery. This practice varies by the dentist or oral surgeon. Antibiotics are more likely to be given if:

  • You come with infection at the time of surgery
  • You have a weakened immune system
  • You will have a lengthy surgery
  • You have specific medical conditions

You may have intravenous (IV) anesthesia, which can vary from conscious sedation to general anesthesia. If so, your doctor will have give you directions to follow. You should wear clothing with short sleeves or sleeves that could be rolled up effortlessly. This allows access for an IV line to be placed in a vein. Don’t ever eat or drink anything for six to eight hours before the operation.

If you have a cough, stuffy nose or cold up to and including a week a week before the surgery, get in touch with your doctor. He or she may need to avoid anesthesia until you are over the cold. If you had nausea and vomiting the night before the procedure, call the doctor’s office first thing in the morning. You may need a change in the planned anesthesia or the extraction may need to be rescheduled.

Do not smoke on the day of surgery. This can increase the risk of a very painful problem called dry socket.

After the extraction, someone will need to drive you home and stay there with you. You will be given post-surgery guidelines. It is vital that you follow them.

How Tooth Extractions Are Performed

There are two forms of extractions:

Simple Extractions

Simple extractions are performed on a tooth that can be seen in the mouth. General dentists commonly do simple extractions. In a simple extraction, the dentist loosens the tooth with an instrument called an elevator. Then the dentist uses a tool called a forceps to remove the tooth.

Surgical Extractions

This is a more complex procedure. It is used if a tooth may have broken off at the gum line or has not come into the mouth yet. Surgical extractions typically are done by oral surgeons. However, they are also done by general dentists. The doctor makes a miniature incision (cut) into your gum. Sometimes it’s required to remove some of the bone around the tooth or to cut the tooth in half just to extract it.

Most simple extractions are done using just an injection (a local anesthetic). You may or may not receive drugs that can help you relax. For a surgical extraction, you will receive a local anesthetic, and you may also have anesthesia via a vein (intravenous). Some people may need to have general anesthesia. They include patients with specific medical or behavioral conditions and young children.

If you are being given conscious sedation, you may be given steroids in addition to other medicines in your IV line. The steroids help to reduce swelling and keep you pain-free following the procedure.

During a tooth extraction, you can expect to feel pressure, but no pain. If you feel any pain or pinching, advise your doctor.

Extraction Follow-Up

Your doctor will give you detailed information on what to work on and what to expect after your surgery. If you have any questions, make certain to ask them prior to you leave the facility.

Having a tooth extracted is surgery. You can expect some discomfort after even simple extractions. Usually it is mild. Research has shown that taking nonsteroidal anti-inflammatory drugs (NSAIDs) can greatly lessen pain after a tooth extraction. These drugs include ibuprofen, such as Advil, Motrin and others. Take the dose your doctor recommends, 3 to 4 times a day. Take the first pills before the local anesthesia wears off. Continue taking them for 3 days. Ask your doctor for complete information.

Surgical extractions generally cause more pain after the procedure than simple extractions. The amount of discomfort and the length of time it lasts will be dependent on how tough it was to remove the tooth. Your dentist may prescribe pain medicine for a few days and afterwards suggest an NSAID. Most pain goes away after a few days.

A cut in the mouth often tends to bleed more than a cut on the skin given that it can not dry out and develop a scab. After an extraction, you’ll be asked to bite on a piece of gauze for 20 to 30 minutes. This high pressure will allow the blood to clot. You will still have a small amount of bleeding for the next 24 hours or so. It should taper off thereafter. Don’t disturb the clot that forms on the wound.

You can put ice packs on your face to minimize swelling. Generally, they are left on for 20 minutes at a time and removed for 20 minutes. If your jaw is aching and stiff after the swelling disappears, try warm compresses.

Eat delicate and cold foods for a couple of days. Then try other food as you feel confident.

A gentle rinse with warm salt water, started 24 hours following the surgical procedure, can help to keep the area clean. Use one-half teaspoon of salt in a cup of water. Almost all swelling and bleeding end within a day or two after the surgery. Initial healing takes approximately two weeks.

If you require stitches, your doctor may use the kind that diffuse by themselves. This generally takes one to two weeks. Rinsing with warm saline will help the stitches to dissolve. Some stitches must be removed by the dentist or surgeon.

You must not smoke, use a straw or spit after surgery. These practices can dislodge the blood clot out of the gap where the tooth was. Do not smoke on the day of surgery. Do not smoke for 24 to 72 hours after having a tooth extracted.

Risks

A problem called a dry socket forms in about 3% to 4% of all extractions. This occurs when a blood clot doesn’t form in the hole or the blood clot breaks off or degrades too early.

In a dry socket, the underlying bone is subjected to air and food. This can be very excruciating and can cause a bad odor or taste. Usually dry sockets begin to induce pain the third day after surgery.

Dry socket occurs as much as 30% of the time when impacted teeth are removed. It is also more likely after challenging extractions. Smokers and women who take birth control pills are more likely to have a dry socket. Smoking on the day of surgery further increases the risk. A dry socket requires to be treated with a medicated bandaging to stop the pain and promote the area to heal.

Infection can arise following an extraction. However, you most likely won’t get an infection if you have a healthy immune system.

Other plausible problems include:

Accidental damage to surrounding teeth, such as fracture of fillings or teeth

An incomplete extraction, in which a tooth root remains in the jaw– Your dentist typically removes the root to avoid infection, but occasionally it is less risky to leave a small root tip in place.

A fractured jaw caused by the pressure put on the jaw during extraction– This occurs more often in older people with osteoporosis (thinning) of the jaw bone.

A hole in the sinus during removal of an upper back tooth (molar)– A small hole usually will close by itself in a few weeks. If not, more surgery may be required.

Discomfort in the jaw muscles and/or jaw joint– It may be challenging for you to open your mouth wide. This can happen because of the injections, keeping your mouth open and/or lots of pushing on your jaw.

Long-lasting numbness in the lower lip and chin– This is an uncommon problem. It is caused by injury to the inferior alveolar nerve in your lower jaw. Complete healing may take three to six months. In rare cases, the numbness may be permanent.

When To Call Your Dentist

Call your dentist or oral surgeon if:

  • The swelling gets worse instead of better.
  • You develop fever, chills or redness
  • You have trouble swallowing
  • You develop uncontrolled bleeding in the area
  • The area continues to ooze or bleed after the first 24 hours
  • Your tongue, chin or lip seems numb more than 3 to 4 hours after the procedure
  • The extraction site becomes very painful– This may be a sign that you have developed a dry socket.

If you have a complication, your Marietta dentist, typically, will prescribe antibiotics.