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Tooth Extraction: Procedure, Pain & Tips

by Tijana

Many patients fear the pain of tooth extraction. However, these are often unfounded. Find out here how a tooth is extracted, when pain can occur, and what you should pay attention to after an extraction.

Tooth Extraction

How is the tooth fixed in the jaw?

Teeth are not rigidly attached to the jawbone. There is an exceedingly small gap between the tooth and the jawbone. This space is called Sharpey’s fibers and they connect the tooth to the jawbone. The area of ​​the root surface determines how many fibers there are.

Why are front teeth easier to remove? Front teeth only have one root. They are not as strongly attached to the bone as molars, which have two or three roots. Therefore, extracting a molar tooth is more difficult than extracting an anterior tooth.

Risks and complications of tooth extraction

As a patient, must know exactly what complications and risks there are before tooth extraction. Your dentist should explain this to you.

There are specific and general risks, and complications associated with the tooth extraction.

Special and general risks of tooth extraction

General Risks:

  • Pain
  • Hematomas
  • Injury to blood vessels
  • Swelling
  • Inflammation
  • impaired wound healing
  • dry socket or empty socket
  • Secondary bleeding

Special risks:

  • Opening of the maxillary sinus (mouth-antrum connection) in the upper jaw. The maxillary sinus must be tightly closed with a plastic covering.
  • Damage to the mandibular nerve
  • Damage to neighboring teeth

Complications of tooth extraction

A dental operation can – like any procedure – lead to complications.

Complications are, for example:

  • The fracture of a tooth root. If a root breaks off, your dentist may need to expose it a little. Then he can remove it better.
  • Ankylosis is a rare complication. Here, the tooth has grown together with the bone and is exceedingly difficult to pull. Here, the dentist needs to remove the jawbone around the tooth root.
  • Abnormal root formations that make extraction difficult. Molars sometimes have very crooked roots. The dentist then must separate the root parts of the molar tooth. Then he can solve them individually.
  • If the tooth extraction takes longer, a dislocation (dislocation) of the temporomandibular joint can occur
  • Even if the patient is in pain, this can make the procedure more difficult for both doctor and patient.

What is the process of tooth extraction?

1st step: the anesthetic

The treatment is usually carried out under local anesthesia. This can be done with conduction anesthesia (anesthesia of the entire nerve) or with an intraligamentary anesthesia (anesthesia of the tooth holding apparatus of the affected tooth). Sometimes both procedures are used in combination so that the treatment does not hurt.

2nd step: loosening the tooth

When the surrounding tissue is numb and pain is no longer to be feared of, the gums are first removed from the tooth. Then it moves back and forth with a lever. When it is loose enough, the practitioner grabs it with special pliers and moves it further.

This will stretch the bone until the tooth loosens. Then it can be removed from the mouth. As soon as we have removed the extracted tooth from the tooth socket, it is checked for completeness.

3rd step: cleaning the wound

Now the wound just needs to be cleaned. The dentist scrapes out the tooth socket with a sharp spoon and removes any inflammatory tissue.

Specific features of tooth extraction

Unique feature: a broken tooth

A broken tooth makes removal difficult, but in most cases, it is not an exclusion criterion. Often it can be easily released with a small lever. If that does not work, there are special pliers that the dentist can use to grip the tooth.

With molars, the tooth roots still must be separated from one another. Then the individual parts can be loosened more easily. If that works neither, the dentist must remove the bone around the broken tooth and thus loosen it from its tooth socket.

Special case: extraction of a wisdom tooth

Wisdom teeth are the rearmost molars of humans. They need to be removed if they become constantly inflamed and painful.

They often associate the removal of a wisdom tooth with a minor surgical procedure. Especially if it has not broken through the gums and is still in the jawbone. During this procedure, the dentist must first expose the jawbone with a gum incision. Then he works the bone until it exposes the wisdom tooth. Once the doctor has removed enough bone, we can extract the tooth. Finally, the hole in the gum is sutured.

Surgical tooth extraction often leads to bruises, moderate-to-severe pain, and swelling. These consequences of tooth extraction disappear after about a week.

Tips: What to do after tooth extraction

Immediately after removing the tooth, the patient must bite on sterile swabs for 30 minutes. The pressure stops the bleeding.

For the first 48 hours after tooth extraction, you should never:

  • Smoke
  • Drink coffee, tea, or alcohol
  • Work hard physically
  • Rinse your mouth vigorously, otherwise, the blood clot important for wound healing will be lost in the tooth socket.

If you stick to these rules as a patient,  you should start feeling better soon.

Pain after extraction: when to go to the dentist

Note: Please do not take too many tablets if you are in pain!

Mild to moderate pain after tooth extraction surgery is normal. You can fight these easily with painkillers. You should also cool well.

In rare cases, the pain is so severe that pain medication is not enough. If the wound hurts too much, contact your dentist or go to emergency services.

Go to a dentist’s office if:

  • Pain medication no longer works
  • Pain recurs after more than a week
  • The pain did not go away after a week
  • Swellings keep getting bigger
  • An unpleasant odor is noticeable.

Severe pain can occur if:

  • The wound has become infected
  • The blood clot in the tooth socket has been lost

In both cases, patient must have the wound checked in a dental practice.

With inflammation, an antibiotic must often be prescribed after tooth extraction. If the blood clot has been lost, the extraction wound must be freshened again to create a new clot. These treatments should relieve the pain.

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