Tooth Removal/Extraction

Why would you need extractions and what it is like?

Your tooth might not be restorable if it is grossly decayed, fractured or has periodontal problems, in which case, your dentist will need to remove your tooth  through a procedure called dental extraction.

Dr. Mahi has extensive experience in dental extractions. She will put some topical gel on your gum and deliver local anesthesia for the tooth to be extracted. You will not feel any pain during the procedure. You may feel pressure in the area but no pain.  Dr. Mahi recommends socket preservation techniques, also known as bone grafting, for most extraction sites to make sure that the healing process will not end with bone resorption. Bone height or width loss can happen after extraction which in turn leads to unfavorable movement of the adjacent teeth and unaesthetic results. Socket preservation is also necessary for future implant placement.

You may need sutures after dental extraction which can be resorbable or non-resorbable. Dr. Mahi will check the area in 7 to 10 days to make sure the healing process is within the range of normal and remove the sutures if necessary. You may need antibiotic therapy after your extraction.

Contact Dr. Mahi if you have additional questions about your recent extraction.

 

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Post-Op instruction after the extraction

After your extraction, your mouth will remain numb for a few hours. Make sure, you do not bite your cheek, tongue or lips while being numb. Do not eat any food that requires chewing to prevent biting on your tongue, cheek and lips while numb. Contact us if your numbness does not wear off after a few hours.

Bleeding:  

We will place a gauze on the extraction site to insure that the bleeding will stop. Bite gently on the gauze for about 30 to 45 minutes to give your body enough time to form a blood clot. Do not chew the gauze. You might experience light bleeding or oozing which is normal and may be noticed the rest of the day after the procedure. If there is still active bleeding after removing the gauze, dampen a piece of gauze (that is given to you after the extraction) with clean, warm water and put it on the extraction socket. Apply pressure by closing your teeth for another 30 to 45 minutes. Repeat this step as needed. You do not need to replace the gauze if there is no bleeding.

You need to call us if you experience active, heavy bleeding.

  • Do not disturb the blood clot that is formed in the socket. Do not play with it with your tongue and do not touch it with your fingernail.
  • Do not rinse vigorously; do not use a Waterpik®.
  • Avoid anything that would suck the blood clot out of the socket such as smoking, drinking from a straw or spitting.
  • Smoking should be stopped for at least 3 days following surgery. Healing and success of the surgery will be substantially reduced by the chemicals released in your body after smoking.
  • Rest and avoid strenuous activities for the remainder of the day.
  • You can also place a tea bag on the socket and apply pressure for 15 minutes to half an hour, that will help to stop the bleeding. The tannic acid in the tea bag helps to form a clot by constricting the blood vessels.
  • Sometimes the blood clot will not form properly during first few days after the extraction, or it forms but breaks down or it is sucked out of the socket as the result of smoking for example. That will result in dry socket which can be very painful. Call us if you experience pain starting after a few days after your extraction. A dressing may be placed in the socket to protect it until the socket heals and will also help to reduce the pain.

 

Eating and drinking

Eat cold, soft foods on the first day after the extraction. Maintain a good, balanced, nutritious diet. Drink plenty of water. Avoid alcohol for 48 hours. Avoid hard, crunchy food for a few days.  Avoid drinking and eating hot liquid and food and also avoid alcohol. Do not drink out of a straw. Eat on the opposite side of the few first days. Go back to solid, nutritious food as soon as you can.

Pain

Moderate discomfort may be noticed when the anesthetic first wears off, and may continue for a few days. Take over the counter Tylenol, Advil, or similar non-aspirin pain reliever every 4 to 6 hours as needed. Do not exceed the recommended dose on the bottle. We may prescribe pain relievers in which case you need to follow our instruction. Take the first tablet before the anesthesia wears off. Don’t exceed the dose prescribed. Take those with food or milk to help reduce upset stomach. Avoid driving when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications. Nausea may be caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with food, and taking the pill with a large glass of water.

Swelling

Some swelling and discoloration of the lip and/or cheek may occur and may last for a few days. Applying an ice bag to the face over the operated area will minimize swelling. Place paper towel between the ice bag and your skin. Apply for 15 minutes, then remove for 15 minutes. Continue this for the first day.

Sensation

There may be a temporary loss of feeling in the gums and face in the operated area. The teeth may also feel loose. The teeth may be sensitive to hot and cold temperatures.

How to maintain oral hygiene

Brush all of your teeth after each meal. Avoid the operated area for the first day. Take care to avoid pulling the sutures.
You may rinse your mouth with warm saltwater solution (half a teaspoon salt + 8 ounces warm water) after each meal to prevent infection. Consult with your physician about this if you have high blood pressure.
Brush your tongue to reduce the number of bacteria in your mouth and prevent unpleasant  taste and bad breath.

Other things to have in mind

  • You should avoid blowing your nose or playing a wind musical instrument for one week especially If your sinus was involved in the procedure.
  • Use of decongestant medications might be recommended.
  • Avoid lifting the lip with your fingers to look at the area. It is possible to accidentally tear the sutures, open the incision, and delay healing.
  • If you were given antibiotic prescription, take all of them as directed until they are gone.
  • Some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.
  • You may be instructed to use a prescription antimicrobial mouthrinse such as Chlorhexidine Gluconate.
  • Return to your dentists office for removal of the sutures or follow-up checks as directed.

When to call us?

  • Uncontrollable pain
  • Excessive or severe bleeding, pain or swelling that gets worse with time instead of getting better.
  • White secretions (pus) coming out of the socket
  • Fever, nausea, vomitting
  • Excessive warm swelling occurring a few days after the procedure which could be due to  allergic reactions to the medications, especially rash, itching, or breathing problems.

Go to the hospital emergency room if you cannot reach us.

Following these instructions very closely will help your comfort and promote uneventful healing of the area. You might have significantly more discomfort, and the success of the procedure may be affected if you do not follow the instruction.