Tooth Extraction

Kids have always loved extracting their own wobbly baby teeth. After all, the tooth fairy pays. But Dr. Tosto usually tries everything he can to keep a permanent tooth in the patient’s mouth. Sometimes, however, extraction can be necessary when a tooth has too much decay to save it or when it’s necessary to make room for other teeth in the patient’s mouth.

Tooth extraction is a common, simple procedure that Dr. Tosto performs in our Savannah offices.

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When would it be necessary to have a tooth extracted?

Dr. Tosto does everything possible to save a tooth, but there are instances where the tooth cannot be saved. A root canal is the usual treatment used to save a tooth where the infection has invaded the tooth interior, but it cannot always save the tooth.

The usual line between extraction and not is a matter of degree. For instance, a tooth with a crack can usually be saved with a crown. But a tooth with a deep crack may be too compromised, as it won’t provide the underlying base needed to place the crown. The same is true with a chip. A small chip can be covered with bonding, a porcelain veneer, or a crown. But a large chip may expose too much of the tooth interior to be able to be saved. Large chips also expose the tooth interior to infection.

Does Tooth Extraction Require Anesthesia?

Before pulling the tooth, Dr. Tosto injects a local anesthetic to numb the area of the tooth. If you’re having more than one tooth removed, general anesthesia may be used.

What is the procedure for getting a tooth extracted?

If the tooth is impacted or is failing to descend, Dr. Tosto will cut away gum and bone tissue that cover the tooth. Next, he grasps the tooth with a pair of forceps, and then he gently rocks the tooth back and forth to loosen it from the jawbone and connecting ligaments that hold it in place. Although rarely necessary with regular teeth, if the tooth is very hard to pull, it may be broken and then removed in pieces. This is often true with wisdom teeth extraction.

When the tooth is out of the socket a blood clot usually forms in the socket. It’s important to try to maintain the clot in place. Dr. Tosto will pack a gauze pad into the socket and will have you bite down on it to stop the bleeding. If the gums were opened, they may be closed with a few self-dissolving stitches.

How painful is tooth extraction?

When Dr. Tosto numbs the area, this ensures you won’t feel anything during the actual extraction. Once the anesthesia wears off, any pain you have will depend upon the type of tooth pulled and its location, along with other variables.

Extracting a regular permanent tooth typically doesn’t involve much residual pain. Any pain you experience should be easily handled with over-the-counter pain medication. You’ll have some swelling and possible slight bleeding. This is all normal. If you experience more pain or swelling than that, you need to call us.

Wisdom teeth are the exception. Because most wisdom teeth are impacted, meaning they are coming in sideways and are blocked by your molars, this involves more work to get the teeth out. They often need to be broken and removed in pieces. Sometimes they have wrapped around the roots of the normal molars. Removing wisdom teeth will usually create a good deal of pain for the next two to three days after the procedure.

Dr. Tosto does not perform wisdom tooth extraction, but he can refer you to an oral surgeon.

What risks are involved with tooth extraction?

The main risk with a tooth extraction is what is known as “dry socket.” This occurs when a blood clot doesn’t form in the hole or the blood clot breaks off or breaks down too early. This happens in about 3-4 percent of all extractions, although the occurrence is higher after difficult extractions, particularly with impacted wisdom teeth.

Dry socket is a problem because without the blood clot, the underlying bone is exposed to air and food. This is usually very painful, and it will likely create a bad odor and a bad taste in your mouth.

Beyond dry socket, there is also a risk of infection after extraction. This is rare in patients with healthy immune systems. There are slight risks of damage to other adjacent teeth, a fractured jaw caused by pressure during extraction (usually only possible with patients with osteoporosis), and a hole in the sinus when an upper back molar is extracted.

Generally, the main risk/complication after extraction is soreness in the jaw muscles and jaw joint. This is due to your anesthetic injections and having your mouth open for a long period of time.

What should I do after having a tooth extracted?

The goal after having Dr. Tosto extract a tooth is to have the site heal as quickly as possible. Toward that end, there are a few dos and don’ts. The obvious things you can do to help with healing are to control your bleeding, to keep the blood clot in place in the tooth socket, to take pain medication as prescribed, and to reduce swelling with ice. When lying down or sleeping keep your head slightly elevated.

These are other things you can do to help healing:

  • Eat a diet of soft, healthy foods and snacks.
  • Drink plenty of liquids.
  • Brush your teeth, but without toothpaste. Rinsing toothpaste from your mouth can dislodge the blood clot. Avoid the extraction site.
  • Keep the extraction site clean.
  • Lightly rinse with saltwater solution after 24 hours.

What should I Not Do after having a tooth extracted?

  • Don’t drink with a straw. Sucking on a straw may dislodge the blood clot.
  • No hot liquids. Hot liquids can increase your swelling.
  • Limit your alcohol. This can slow your healing if you drink in excess.
  • No smoking. Smoking can break down the blood clot.

How long will it take to recover after having a tooth extracted?

As mentioned above, you’ll probably have some soreness after your extraction. Anti-inflammatory over-the-counter medications such as Advil or Motrin are usually sufficient for dealing with it. You’ll take these for three days.

If Dr. Tosto had to cut your gums to access the tooth, obviously there will be pain, swelling, and recovery time. To minimize your swelling, ice packs on your cheek should be used for 20 minutes on and then 20 minutes off.

When you hit 24 hours after your extraction, you will gently rinse your mouth with warm saltwater, but the key is “gently.” You don’t want to break loose the blood clot in the tooth socket. This rinse helps keep the area clean. Most swelling and bleeding will end within two days.

You continue to brush and floss normally on the rest of your mouth, but you avoid the extraction site. Don’t use toothpaste initially, as rinsing it aggressively from your mouth can break loose the blood clot.

The site will heal fully in one to two weeks, although the socket takes longer. But you should move ahead and replace the tooth with a dental implant or bridge anyway.

When can I eat normally after having a tooth extracted?

It’s not a long time before you can eat normally, but it’s wise not to run out and order anything with hot Carolina barbecue sauce on it initially. For the first 24 hours, you’ll only eat soft foods such as yogurt and liquids. You can’t eat anything hot or spicy for at least 3 days. Generally, you’ll want to eat soft foods for 3-5 days. These are things such as macaroni and cheese, mashed potatoes, oatmeal, applesauce, yogurt, and pastas. Let hot foods cool.

You can eat some foods that require chewing, but you need to stay completely on the opposite side away from the extraction location. It’s a better idea to stay with soft foods.

After 3 to 5 days, depending on the person, you can get back to your normal diet. This is completely up to you. Until the gums have fully healed, you should avoid any sharp foods, such as pretzels or chips.

What Dental procedures options do I have after a tooth extraction?

Now that the heavily decayed or damaged tooth has been removed, your danger of infection is gone. At this point, some patients opt to leave the gap in their teeth. This is a bad idea. First, your teeth stay in place due to pressure placed on them by the adjacent teeth. When a tooth is missing the teeth on each side tend to slide over into the gap messing up your overall alignment. Also, who wants a gap in their smile? If the tooth is a molar, you’ll have issues eating certain foods on that spot.

If possible, it’s always best to replace an extracted tooth with a dental implant. Dr. Tosto is a big fan of dental implants because they become a part of the jaw, and they look, feel, and function just like a natural tooth. Plus, in most cases an implant will last the remainder of the patient’s life. Dr. Tosto has extensive training and experience placing dental implants.

If you’re having a few teeth pulled, a bridge or an implant-supported partial denture would be a good option.

All of these tooth replacements keep your other teeth in place, so they don’t migrate and affect your overall bite. Plus, replacing the extracted tooth allows you to eat normal foods, and it prevents possible whistling sounds when speaking. And your smile is complete once again.

Schedule a Consultation Today!

To learn more about our Tooth Extraction procedures, call us today at (912) 351-0081 to schedule a consultation.  Ronald A. Tosto, DDS is proud to serve Savannah, GA and the surrounding areas.

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