To prepare for a tooth removal extraction we will numb the tooth, the jaw bone and the surrounding gum tissue with local anesthetic. We may also offer sedation or general anesthesia to make the procedure more comfortable.

A surgical extraction is used for teeth that are impacted, broken or in very poor condition. We will provide special instructions for care after the procedure.

Preparation

The person will be given a local anesthetic to numb the area around the tooth. They may also be given sedatives to help them relax during the procedure. People who need sedation should not eat or drink anything for 12 hours before their appointment, unless they have been instructed otherwise by the dentist.

After the procedure, the dentist or oral surgeon will place a piece of gauze on the extraction site and ask you to bite down with firm and steady pressure. This helps slow bleeding and allows a blood clot to form in the socket, which promotes healing and reduces the risk of complications such as dry socket.

You should not rinse vigorously, suck on straws or smoke for the first 24 hours after the procedure, as this can dislodge the clot and lead to infection. Instead, you can gently rinse your mouth with warm salt water several times a day to help keep the area clean.

Anesthesia

Anesthesia ensures minimal to no pain during a tooth extraction, enhancing comfort and reducing distress. It also alleviates anxiety, promoting a more positive patient experience.

Local anesthesia is injected close to the site of the extraction, numbing it completely. The person can still feel pressure, but not pain. Depending on the amount of anesthesia used, patients can drive home afterward.

Sedation is also available for patients with anxiety or a low pain tolerance. Nitrous oxide, commonly known as laughing gas, is an inhaled sedative that reduces anxiety and produces a relaxing effect.

Although rare, some people have allergic reactions to local anesthetics. These can range from mild (itching, rash) to severe (difficulty breathing, anaphylaxis). Patients should disclose any allergies to their dentist prior to treatment. Avoid rinsing, smoking or drinking through a straw at the extraction site. This can delay healing and increase the risk of complications. Your dentist will give you specific instructions on post-treatment care.

Removal

Once the area is numb, the dentist will use extraction forceps to grasp and remove the tooth. The empty tooth socket will be checked for bone fragments and spurs, which can often cause pain or need to be removed at a subsequent appointment. The empty socket will then be cleaned and sealed.

Surgical extractions are more complicated treatments performed on impacted or severely damaged teeth that have not fully erupted from their sockets and require incisions and removal of gum tissue for access. They are usually performed by oral surgeons and necessitate sutures to close the extraction site.

After the procedure, patients should keep the site clean and follow their dental professional’s aftercare instructions to minimize discomfort and avoid complications like dry socket. Adherence to these instructions can reduce recovery time and increase healing. Patients should also call their dentist immediately if they experience severe pain, pus, or excessive bleeding during the recovery process. They may need to see an oral and maxillofacial surgeon (OMS) for treatment.

Post-operative care

Some blood will ooze from the tooth socket for several hours after your surgery; this is normal. Bite firmly but gently on the gauze pad that your dentist or oral surgeon provides to reduce bleeding and allow a blood clot to form in the tooth socket. Change the gauze pad if it becomes soaked in blood.

Avoid spitting or aggressive rinsing; this can dislodge the blood clot and prolong healing time. Rinse your mouth gently with salt water (half a teaspoon of table salt in 8 oz of warm water) three times per day beginning tomorrow to maintain oral hygiene and kill bacteria that may cause infection.

Take pain medication as directed; however, be careful when driving or operating machinery since some pain medications can make you drowsy. Follow the course of antibiotics as prescribed to prevent infection, even if you start feeling better before they are finished. Avoid smoking and alcohol, which delay healing.