The most common reasons are due to gum disease, decay or fracture of the tooth. Other reasons may be to make space to straighten other teeth, extra teeth or malformed teeth. It may be chosen as a cheaper option than treatment to keep a tooth.
The dentist may take an x-ray of the tooth, He will need a full current medical status and list of prescribed and over the counter medicines tablets and supplements
The dentist will numb the tooth with a local anaesthetic. He will then check that it is fully numb. The tooth is loosened with instruments called luxators and elevators. The dentist then uses forceps to extract the tooth.
Take it easy for the rest of the day. Take as little exercise as you can, and rest as much as you can. Keep your head up to avoid any bleeding.
Avoid hot or very cold food or drinks till the clot has fully formed. Also be careful not to chew or bite any parts of your mouth while they are numb If you do rest, try to keep your head higher for the first night using an extra pillow if possible. It is also a good idea to use an old pillowcase, or put a towel on the pillow, in case you bleed a little.
Do not be tempted to rinse the area till the following day. It is important to allow the socket to heal, and you must be careful not to damage the blood clot by eating on that side or letting your tongue disturb it. This can allow infection into the socket and affect healing.
Avoid alcohol for at least 24 hours, as this can encourage bleeding and delay healing. Eat and drink lukewarm food as normal but avoid chewing on that area of your mouth.
It is just as important, if not more so, to keep your mouth clean after an extraction. However, you do need to be careful around the extraction site.
The first thing to remember is that there may be some slight bleeding for the first day or so. Many people are concerned about the amount of bleeding. This is due to the fact that a small amount of blood is mixed with a larger amount of saliva, which looks more dramatic than it is. If you do notice bleeding, do not rinse out, but apply pressure to the socket. Bite firmly on a folded piece of clean cotton material such as a handkerchief (not a tissue) for at least 15 minutes. Make sure this is placed directly over the extraction site and that the pad is replaced if necessary. If the bleeding has not stopped after an hour or two, contact your dentist.
We recommend that you avoid smoking for as long as you can after an extraction, ideally for 48 hours, but certainly for four hours.
Different people heal at different speeds after an extraction. It is important to keep your mouth and the extraction site as clean as possible, making sure that the socket is kept clear of all food and debris. Don’t rinse for the first 24 hours, as this will help your mouth to start healing. After this time use a salt-water mouthwash, which helps to heal the socket. A teaspoon of salt in a glass of hot water gently rinsed around the socket. This should be done as often as possible to begin with, every hour or two, and certainly after any meals. Keep this up at least twice a day for a week or for as long as your dentist tells you. It is important to keep to a healthy diet, which will help your mouth to heal.
There will usually be some tenderness in the area for the first few days, and in most cases some simple pain relief is enough to ease the discomfort. What you would normally take for a headache should be enough. However, always follow the manufacturer’s instructions and if in doubt check with your doctor first. Do not take aspirin, as this will make your mouth bleed.
As we have said, it is important not to use anything containing aspirin as this can cause further bleeding. This happens because aspirin can thin the blood slightly. Asthma sufferers should avoid Ibuprofen-based pain relief. Again check with your chemist or dentist if you are worried or feel you need something stronger.
Sometimes an infection can get in the socket, which can be very painful. This is where there is little or no blood clot in the tooth socket and the bony socket walls are exposed and become infected. This is called a dry socket and in some cases is worse than the original toothache! In this case, it is important to see your dentist, who may place a dressing in the socket and prescribe a course of antibiotics to help relieve the infection. You may also feel the sharp edge of the socket with your tongue and sometimes small pieces of bone may work their way to the surface of the socket. This is perfectly normal.
If it has been a particularly difficult extraction, the dentist will give you a follow-up appointment. This could be to remove any stitches that were needed, or simply to check the area is healing well. Your dentist will also want to discuss the options available to you for replacing your lost tooth.