tooth extractions / oral surgery / dental surgery

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. As a part of this examination they will need to take an x-ray (radiograph) of the tooth in question. This x-ray will allow your dentist to evaluate the internal aspects of the tooth as well as the tooth's root portion and the bone surrounding it.

The information that your dentist obtains from their clinical examination and the x-ray will help them formulate a diagnosis as to why the tooth should, or should not, be extracted. If a determination is made that an extraction is indicated, depending on the anticipated difficulty of the procedure, your dentist might offer to perform the extraction for you or else suggest that an oral surgeon should perform the treatment.

Taking your medical history.

During your pre-extraction examination your dentist will collect relevant medical information from you. Even if your dentist doesn't ask, make sure to report if you have had any problems with any 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.

Make sure your dentist is aware of all of the medicines and supplements that you take (prescription, over-the-counter, and herbal). Some common medications can cause complications with tooth extractions. 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 to develop "dry sockets" after a tooth extraction than those who don't. People who have taken bisphosphonate drugs (such as Fossmax®) can be at greater risk for complications associated with tooth extractions.

If infection is present your dentist may have you take antibiotics before your tooth extraction is performed.

If during the examination a significant level of active infection is found to be present (primarily evidenced by the presence of swelling) your dentist may decide that you need to take an antibiotic for several days before the tooth extraction procedure is performed. Doing so will make it less likely that complications, either during the extraction procedure or the subsequent healing process, will occur.

Any antibiotics that are prescribed for you should always be taken as directed. Failure to do so can lead to the development of bacterial resistance to the antibiotic. If you have any problems associated with taking your antibiotics (including the development of a generalized rash or itching) you should report them to your dentist or physician immediately.

Other reasons why it might be necessary for you to take antibiotics before a tooth extraction.

Tooth extractions (as well as many other types of dental procedures) can place some dental patients that have certain medical conditions at risk for developing a bacterial infection subsequent to having received dental treatment. In these cases it is mandatory that the dental patient take antibiotics before the dental procedure is performed so to reduce the risk of this event occurring. Some of the types of medical situations that may require that a dental patient take "prophylactic" antibiotics include:

• Various cardiac conditions.
• Prosthetic joints.
• Patients on renal dialysis.

Of course our list is not all-inclusive and is purposely vague. Studies, as well as the opinions of doctors and organizations that reference these studies when formulating recommendations and guidelines for patients, are constantly evolving. An important part of your dentist's examination is to collect that information concerning your medical history which can help them make a determination about what precautions (if any) are needed for your precise situation. In some instances your dentist may feel that they need to consult with your physician before they can determine exactly what precautions are appropriate.

Communicate with your dentist.

Be up front with your dentist during your exam regarding any concerns or fears you have related to the tooth extraction procedure. Knowing as much as possible about not just your tooth but also you personally will help your dentist know how to treat you more effectively. The goal is to have as many considerations dealt with and out of the way before that time when the extraction is performed. This way your dentist can focus more of their attention on performing the actual work of the extraction process and less on managing you as a patient.