Oral surgery: Tooth extractions
From experience, we know that the more a dental patient knows about what takes place during the tooth extraction procedure the less eventful the experience of having their tooth out, and the healing process that follows, will be.
That's because having this information can help them to be more relaxed, more cooperative and more likely to understand the importance of following their dentist's postoperative instructions.
To round our coverage out, our pages also discuss ...
- How much does it cost to have a tooth pulled?
- Postoperative considerations such as: Healing times, aftercare instructions for both the first 24 hours and beyond, and post-extraction complications (bleeding, swelling, dry sockets).
- Surgical tooth extractions and medical issues as they apply to extracting teeth.
Planning a tooth extraction -
A) The pre-extraction dental examination.
Your dentist will need to examine your teeth and mouth before a determination can be made that a tooth extraction is warranted.
1) An x-ray will be required.
As a part of this examination, your dentist will need to take an x-ray (radiograph). It will allow them to evaluate changes within the tooth as well as its root(s) and the bone that surrounds it.
The information that your dentist obtains from their clinical examination and the x-ray will help them formulate an opinion as to why the tooth should, or should not, be extracted.
If a determination is made that an extraction is needed, depending on the anticipated degree of difficulty of the procedure, your dentist might offer to perform the extraction for you, or else suggest that an oral surgeon should perform your work.
2) If infection is present, you may need to take antibiotics before your extraction can be performed.
If a significant level of active infection is observed during your pre-extraction examination (usually evidenced by the presence of swelling), your dentist may decide that you need to take a course of antibiotics (starting several days before your surgery is performed).
Doing so will make it less likely that complications, either during the extraction procedure or its subsequent healing process, will occur.
Any antibiotics that are prescribed should be taken as directed. If you have any problems with taking them (including the development of a generalized rash or itching), you should report them to your dentist or physician immediately.
B) Taking the patient's medical history.
During your pre-extraction examination, your dentist will need to collect your relevant medical information.
Even if they don't ask, make sure to report if you have had any problems with previous tooth extractions, if you have any bleeding problems, and identify any and all medical conditions you have, both treated and untreated, just to make sure nothing is overlooked.
1) Your current-medications list.
Make sure your dentist is aware of all of the medications, including supplements, that you take (prescription, over-the-counter, and herbal) because some can cause complications with the extraction procedure or its healing process. As examples:
- Aspirin retards the blood clotting process (ibuprofen, ginko biloba, and ginseng can have an effect on clotting too).
- Women who take oral contraceptives seem to be at greater risk for developing "dry sockets" after tooth extractions than those who don't.
- Persons (usually women) who have a history of taking bisphosphonate drugs (such as Fossmax®) can be at greater risk for complications associated bone healing.
2) You may need to "pre-medicate" with an antibiotic before your extraction.
Some medical conditions place patients at risk for developing a bacterial infection after having any type of dental procedure that involves bleeding.
In these cases, it's mandatory that the patient take "prophylactic" antibiotics before their dental surgery is performed. Doing so helps to minimize this risk. Some of the medical situations where antibiotic pre-medication may be required include: