Tooth extraction is a dental surgery recommended when a tooth cannot be saved because of severe tooth decay or significant structural damage. It may be needed when a tooth breaks, cracks, or splits in the crown or down into the root.
After a tooth extraction, it is very common to have bleeding, facial swelling, and pain at the site. Simple steps like biting on gauze, using cold compresses on the face, and taking dentist-recommended medications can help reduce discomfort.
Tooth extraction, also known as exodontia, is performed by a dentist in the office with local anesthesia. Most people can go home right after the procedure, but should rest, lie down with the head elevated, and maintain good oral hygiene.
When it’s indicated
Tooth extraction is recommended in the following situations:
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Severe tooth decay, when the tooth cannot be restored;
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A tooth that is cracked, split, or broken in the root or crown;
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A wisdom tooth when there isn’t enough space for it to come in, it has cavities, or it is positioned incorrectly;
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Dental trauma that affects the root;
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Teeth that have had a root canal but the treatment was not successful.
In addition, tooth extraction may also be recommended to remove a baby tooth, correct dental malocclusion, or as part of orthodontic treatment (such as braces).
Preparing for the procedure
Before a tooth extraction, the dentist may request imaging tests such as a panoramic X-ray, and may also recommend taking antibiotics a few days or hours before the procedure.
It is important to tell the dentist about any health conditions or allergies you may have and whether you take any medications regularly, as it may be recommended to stop blood thinners (anticoagulants) a few days before.
How it’s done
Tooth extraction is performed by a dentist, periodontist, or oral and maxillofacial surgeon in the office, with local anesthesia.
To perform a tooth extraction, the dentist generally follows these steps:
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Applies local anesthesia to prevent pain during the extraction;
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Separates the gum tissue from the tooth, or makes a small cut in the gum;
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Loosens the tooth or sections the tooth to make extraction easier;
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Removes the affected tooth, cleans, and disinfects the tooth socket;
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Places stitches at the extraction site.
In addition, the dentist places a dressing over the area to help control bleeding and support clot formation, which is important for healing.
Recovery time
After a tooth extraction, the dentist may recommend 1 to 3 days of rest, which varies depending on the complexity of the surgery.
Post-procedure symptoms
The main symptoms following a tooth extraction are:
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Pain at the site;
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Facial swelling on the side where the tooth was removed;
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Bleeding;
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Difficulty opening the mouth;
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Bad breath.
In some cases, an infection may develop at the site, with symptoms such as fever, severe pain, and discharge or pus.
Cleaning the mouth
To clean the mouth after a tooth extraction, it is recommended to rinse the mouth with cold water without swishing, and to avoid brushing the area where the tooth was removed.
In some cases, the dentist may recommend specific mouth rinses, but these should only be used 24 to 48 hours after the tooth extraction.
Aftercare instructions
After tooth extraction, some care measures to relieve pain and reduce bleeding include:
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Placing a piece of gauze over the extraction site and biting down gently to help stop bleeding;
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Applying cold compresses to the face over the area where the tooth was removed to reduce swelling;
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Avoiding rinsing the mouth forcefully or spitting, since this can dislodge the clot;
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Not disturbing the area where the tooth was, whether with the teeth or the tongue;
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Chewing on the other side of the mouth to avoid removing the clot with food particles;
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Avoiding eating very hard or hot foods or drinking hot beverages, such as coffee or tea, because they can dissolve the clot;
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Avoiding smoking, drinking through a straw, and blowing the nose, as pressure changes can dislodge the clot;
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Doing gentle saltwater rinses (warm water and salt) 2 to 3 times per day, starting 24 hours after the surgery, to help reduce excess bacteria.
These care measures are especially important during the first 24 hours after tooth extraction, but they can be continued during the first 3 days to support better healing.
In addition, medications prescribed by the dentist should be taken to reduce pain, such as ibuprofen or acetaminophen, and antibiotics may be prescribed to help prevent bacterial growth in the mouth and reduce the risk of infection.