Surgical tooth extraction, commonly referred to as “tooth pulling,” is a procedure involving the removal of a tooth from the alveolus.
This process, performed under local anesthesia and occasionally under sedation (especially for multiple extractions), may necessitate surgical intervention in special cases such as impacted or deeply broken teeth. Surgical instruments are employed to expose and extract the tooth from the surrounding tissues, and stitches are applied post-treatment, typically removed within 7-14 days.
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Knowing When to Remove a Tooth
Tooth extraction is a definitive solution, determined by the dentist based on various factors. Indications for extraction include significant tooth decay preventing reconstruction, unfavorable prognosis of root canal treatment due to extensive periapical changes, oblique or longitudinal tooth root fractures, orthodontic reasons like creating space for other teeth, and impacted teeth with inflammation. Contraindications include a tooth embedded in a tumor or its vicinity, systemic issues such as pregnancy, among others.
STAGES OF TREATMENT
Consultation and Treatment Planning
Before surgery, consultation with your surgeon is crucial for planning further treatment to replace the missing tooth. A panoramic picture is taken, and if necessary, 3D Computer Tomography is employed.
Surgery
The tooth extraction procedure, carried out under local anesthesia, mild inhalation sedation, and/or IV sedation. Surgical extraction may be followed by supplemental materials to minimize complications including sinus communication or nerve injury as well as to enhance healing.
Control Check-Up
Post-extraction, a check-up visit after 7-14 days is usually sufficient for stitch removal, if necessary. In cases of difficult extractions or persistent pain, a doctor visit may be necessary.
Post-Extraction Care Guidelines
To promote healing and minimize post-extraction discomfort, follow these instructions:
Bleeding
- Continue gently biting on the gauze pack over the wound for 30 minutes to encourage clotting.
- Some blood oozing is normal for several hours. If excessive bleeding occurs:
- Fold the provided cotton-gauze or a clean handkerchief and bite firmly for another 30 minutes.
- In case of prolonged bleeding, contact your surgeon or your local hospital.
Swelling and Bruising
- Swelling and bruising are common after oral surgery and typically peak within 3 days, subsiding over 10 days.
- Apply an ice pack to the affected area (20 minutes on/20 minutes off) for the first 1–2 days.
- Continue gentle talking and chewing to minimize swelling and associated jaw stiffness.
Care after Extraction/Surgery
- Avoid eating, drinking, or rinsing for the first 2 hours (exception for drinking water to take painkiller tablets).
- Rest for a few hours with your head elevated using 2 pillows (cover your pillow with a towel overnight to prevent blood stains).
- Resume normal brushing and cleaning of teeth within 12 hours of oral surgery.
- Avoid sucking or spitting for 24 hours.
- Limit excessive activity for 24 hours.
- After 24 hours, use warm salty water or an antiseptic rinse recommended by your surgeon, particularly after meals, for 14 days or until healing is complete.
Restrictions After Procedure
- Avoid hot and carbonated beverages on the day of the procedure.
- Refrain from smoking for 48 hours.
- Avoid alcohol for 5 days (until the end of antibiotic use).
- Do not eat for 2 hours after the procedure.
- Avoid hot, spicy, or pungent dishes for 2 days.
- Refrain from physical exercise for 7 days.
Safe Foods to Eat (for 7 days)
- Finely chopped meat or cheese, yogurt, soft-boiled eggs, soups, mashed potato, pasta, and porridge.
- Chew on the opposite side of your mouth to the wound.
- Avoid small hard foods like nuts, seeds, and grains.
- Avoid spicy foods and acidic foods like lemon juice.
Pain Management
- Pain is normal after extraction/surgery and can last 7-10 days. Take pain relief medication approximately 3 hours after your extraction, then every 6-8 hours on the day of treatment. Continue taking painkillers for 7-10 days if pain persists.
- If pain is mild, choose Tylenol or Ibuprofen.
- For severe pain, take Tylenol and Nurofen/Ibuprofen together rotating every other 3 hours.
- Do not take Aspirin, as it increases bleeding.
- Follow the pain relief schedule provided.
Stitches
- If stitches were placed, they will self-dissolve in 7-14 days. No need for removal.
- Brush teeth normally after 12 hours, but be gentle around stitches to avoid damage.
Numbness Duration
- Numbness from the anesthesia will last 3-4 hours.
- Avoid extreme hot or cold items during this time to prevent accidental burns.
- Be cautious not to bite soft tissues.
Wound Closure Time
- The gums take 3-4 weeks to completely close over the wound site.
- The bony cavity takes 3-4 months to fully fill in with new bone formation.
Dry Socket Awareness
- Dry socket may occur 3-5 days after surgery due to clot removal or lodged food disrupting healing.
- Minimize the risk by following instructions, and avoid smoking for the first 7 days.
To learn more about surgical extraction and find out if it’s right for you, schedule an appointment at Oral Surgery Specialists of New York by phone or online today.
Book Appointment(718) 739 1300