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Extractions/Total Extractions

If the tooth has poor prognosis (unlikely to recover), and root canal or any other treatment is not an option beyond what is reasonable to save, the tooth may have to be extracted. Although it sounds complicated, a tooth extraction is a routine procedure that carries a very low risk of long-term complications. The procedure itself is painless and is usually done under local anaesthetic.

The charges for extraction may range from $60 to $190 per tooth depending on the nature of the procedure. 

 A dentist may also recommend extraction for impacted teeth, malfunctioning teeth or teeth that are hard to clean, such as the wisdom teeth. Removal of wisdom teeth can prevent crowding and may also be more prone to causing inflammation or infection if they do not fully emerge.

How Is The Treatment For Surgical Extractions done?

Although there are exceptions, most tooth extractions are uneventful procedures that last only a few minutes. Usually, the dentist or surgeon will have already taken x-rays of the teeth prior to the procedure. The tooth, gum and bone will then be anesthetized using a local numbing agent for a patient who will be awake for the extraction. Once the extraction begins, patients should feel only pressure – not pain. In most cases, the dentist can remove the tooth using only applied pressure to the socket and dental forceps, rather than surgical intervention.

In some cases, a dentist or oral surgeon will recommend full sedation – especially if there will be more than one tooth extracted during the procedure. In this case, the patient is instead given anesthesia intravenously to prevent pain throughout the entire body. Patients who undergo a sedated tooth extraction will have no memory of the procedure.

 

Post-Operative Instructions Following Tooth Extraction 

Our goal is for your healing process after an extraction to be as comfortable as possible. the removal of teeth is a surgical procedure, and post-operative care is imperative. Please follow all instructions carefully to avoid any unnecessary pain and possible infection.

If you have any difficulties or concerns following your surgery, please do not hesitate to call us or return to our clinic for a follow-up exam.

Immediately Following Surgery

Keep the gauze pad placed over the surgical area with pressure applied by biting down until the bleeding stops which is approx 20-30 minutes.

You may take pain killers such as  Panadol, Panadeine, Maxigesic or Neurofen plus as soon as you begin to feel discomfort.

Do not suck on a straw, spit, rinse, or smoke on the day of extraction.

Restrict your activities the day of surgery, and resume normal activity when you feel comfortable.

For mild discomfort, you may take the above mentioned pain killers. DO NOT take more than 6-8 in 24 hrs. Please avoid taking these medications if you are allergic to any of them.

Vigorous mouth rinsing or touching the affected area following surgery should be avoided. This may initiate bleeding caused by dislodging the blood clot that has formed. Do not rinse your mouth for the first post-operative day or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and after meals to flush out particles of food and debris that may lodge in the area.

Restrict your diet to liquids and soft food which are comfortable for you to eat.

Bleeding – A certain amount of bleeding is to be expected following surgical extractions. Slight bleeding, oozing, or redness in the saliva is not uncommon. Bleeding is best controlled by the use of pressure. Excessive bleeding may be controlled by placing a gauze pad over the area and biting firmly for 30 minutes. Repeat if necessary. If bleeding has not decreased in 3-4 hours, bite on a dampened tea bag placed directly over the surgical site. The tannic acid in the tea helps the blood to clot. If the bleeding persists, please contact us or the nearest medical health provider.

Swelling – The amount of swelling that is normally expected after an extraction depends on the type of surgery. Swelling around the mouth, cheek, eyes, and side of the face is not uncommon. The swelling sometimes may not appear immediately, and it may occur up to 2-3 days post-surgery. You can help to minimize the swelling by applying ice packs to the affected area. For the first 3 hrs, apply ice packs directly to the area, alternating on for 20 mins then off for 20 mins. Applying ice after 24 hrs has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm, if the swelling is significant, you may use a moist heat compresses to help suppress it.

Pain – Post operative pain will be the most severe the first day after surgery. It is beneficial to take your pain medication before your numbness wears off. For moderate pain, pain killers may be taken every 4-6 hrs. For severe pain, contact us. DO NOT take the pain medication on an empty stomach as nausea may result. DO NOT drive an automobile or operate machinery, and AVOID alcoholic beverages. Pain or discomfort following surgery should subside more and more each day. If pain persists, it may require attention, and you should contact our office.

Antibiotics – If you have been placed on antibiotics, take the medicine as directed. Antibiotics may be prescribed to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavourable reaction. PLEASE NOTE: If you are currently taking birth control pills, they will be inactivated by the antibiotic.

Nausea and Vomiting – In the event of nausea and/or vomiting following surgery, DO NOT take anything by mouth for at least an hour, including the prescribed medication. You should then sip on water, tea, or juice. Sip slowly over a 15 min period. When the nausea subsides, you can begin taking solid foods and the prescribed medication.

Sutures – If any sutures were required, it will be necessary to return to our office for sutures to be removed which will be 7-10 days after extraction.

Activity – Over-exertion may start or intensify your pain. AVOID excessive work or play. It is not necessary to stay indoors following uncomplicated surgery. However, rest and minimal activity will help to minimize pain, swelling, and bleeding. Normal activity may be resumed the following day as tolerated.

Cleaning – Do not rinse or spit vigorously for the first 24 hrs following surgery. You can brush your teeth the night of the surgery, but rinse gently. The day after surgery, you should begin rinsing 4 times a day and after eating. Do this gently as to not dislodge the blood clot. To rinse, mix a teaspoon of salt and a cup of warm water. DO NOT use a non-prescription rinse for 24 hrs after surgery. Clean the rest of your mouth as usual.

Diet – It is advisable to eat only soft, non-spicy food for the first few days following surgery. AVOID hot food or liquid that could agitate the already inflamed area. AVOID rice, grits, and foods that are very small that may become lodged in the area.

Special Considerations – Trismus (stiffness) in the face muscles may cause difficulty in opening your mouth for a period of days. Moist heat compresses can minimize this condition. You may experience aching from other teeth. This discomfort is caused by referred pain and is a temporary condition. It is not unusual to develop bruising in the area of the extraction. There may be a slight elevation in temperature for 24-48 hrs. If the fever persists, please contact our office.

Dry Socket – A “dry socket” is the loss of the blood clot in the socket. This condition creates a delayed healing at the extraction site and presents symptoms such as pain in the ear, chin, adjacent teeth, and jaw. The discomfort usually begins about the third or fourth day after the surgery and can last for many days. The cause of a dry socket is unknown, but it can be attributed to the difficulty of the surgery, increased age, medications (such as birth control pills), and smoking. Treatment is for the symptoms only.

 

For Total Extractions and Denture Inserts Please Follow the Instructions Below

For the first 24 hours your immediate denture is not to be removed from your mouth. If the denture is removed, swelling may occur that will make it difficult or impossible to replace the denture.

• After extractions, do not rinse, spit, smoke or suck on a straw. Do not rinse your mouth vigorously. Do not drink any hot beverages or carbonated beverages.

 Your immediate denture not only replaces your missing teeth, but it is acting to protect the surgical site, control swelling, and control bleeding. The denture

needs to be in place to be effective.

• The fit of your immediate denture will change as your mouth heals from the extraction of your teeth. As healing occurs, the dental ridges change shape – and

they generally shrink in size. An immediate denture is often only a temporary denture which will require replacement or reline after final healing of the mouth.

• The immediate denture will need to be adjusted and/or relined to compensate for the changes that will take place in your mouth as the gums heal. You will be

instructed by your dentist to return for periodic appointments to monitor your mouth for changes that will require denture adjustments.

• After the dental extraction sockets have healed over (two to six weeks) you may find a denture adhesive paste or powder to help stabilize your denture.

• Dental extraction sockets take at least 6 months to heal and fill in with new jaw bone. At that time, your dentist will speak to you about replacing your immediate

denture with a permanent denture or making a permanent reline.

Do not hesitate to contact our clinic if we can be of assistance during your recovery period.

 

 

Precautions To Be Taken Following Extractions

On the day of surgery

  • Avoid: hot drinks, food, alcohol, vigorous physical effort, playing with the wound, and rinsing your mouth.
  • Drink plenty of cold or warm fluid, and eat soft food.
  • Avoid smoking as this delays healing.
  • Use Paracetamol or prescribed tablets for pain relief. It is recommended that you start this before the local anaesthetic wears off.
  • Slight oozing of blood is normal. If significant bleeding occurs, place a gauze or cotton pad over the bleeding site and apply pressure by biting down firmly for 15-30 mins. This may need to be repeated.
  • If bleeding is excessive and uncontrolled by pressure, contact us.
  • To minimize swelling, an ice pack (small bag of frozen peas) may be held on the side of the face. Apply 10-15 mins every hour on the day of surgery. 

Depending on the type of tooth extraction performed, the dentist or oral surgeon may also prescribe medication to help relieve pain for the first few days following the procedure. So long as the extraction site is kept clean and patients follow the instructions for care, the gums should heal in a matter of weeks without complication or infection. Furthermore, if necessary and once the extraction site heals, the dentist can replace one or more missing teeth with a bridge, a denture or a permanent dental implant for both functional and aesthetic purposes.

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