Pull it out!
Sometimes a tooth cannot be saved because it is so damaged it can no longer be restored. Sometimes patients elect to remove a tooth instead of carrying out alternative treatment such as root canal treatment.
At Central Brisbane Dental, we can remove or extract most teeth including wisdom teeth under local anaesthetic with the option of Penthrox gas sedation as well. To limit side effects and complications, we carefully assess in the mouth and on x-rays the difficulty of each extraction and the closeness of the teeth to vital structures such as the sinuses in the cheeks and the large nerves in the lower jaw. If we determine your case is very complex or requires general aesthesia, we can refer you to a recommended oral surgeon.
We have a digital x-ray system to take small dental x-rays in our surgeries but sometimes a large x-ray called an OPG is more useful for assessing teeth that need to be removed especially wisdom teeth as it shows all the teeth and jaw bones in the one x-ray. If this is required, we can give you a referral form to a nearby x-ray clinic where you can have this x-ray bulk-billed under Medicare with no out-of-pocket expense if you have a Medicare card.
Pain, swelling, jaw stiffness and bruising are common expected side effects of the tooth removal procedure. Infection, nerve damage and sinus issues are complications of the tooth removal procedure that may occur but do not usually occur with precautions taken to minimize their occurrence.
Infection of the tooth socket may occur as the mouth is full of bacteria. This is more likely if infection is present in the area prior to tooth removal and in those who drink alcohol or smoke. A dry socket can occur if the socket is left exposed and cannot heal properly because the blood clot that guides healing has been washed out. An infected socket can occur after the clot has formed when the socket is not cleaned properly while it is still healing and bacteria start a new infection.
A nerve that lies in the lower jaw that gives feeling to the lower teeth, lower lip and chin may be closely related to the tooth to be removed. This nerve may be damaged during the tooth removal procedure which may result in some numbness of the lower teeth, lower lip and chin. This is in most cases temporary but in some cases may be permanent.
Another nerve that gives feeling and taste to the side of the tongue may also be closely related to the tooth to be removed. This nerve may be damaged during the tooth removal procedure which may result in some numbness and loss of taste to the tongue. This is in most cases temporary but in some cases may be permanent.
Sinuses may also be closely related to the tooth to be removed. After tooth removal a communication between a sinus and the mouth may result. This may heal by itself or may require another procedure to close it.
Complications can be avoided by taking care of the area and following your dentist’s instructions after tooth removal.
You will feel numb from the local anaesthetic. Avoid eating and drinking until the anaesthetic wears off to prevent injury to your tissues from biting and burns and prevent possible choking and inhalation of food and drink.
Your dentist will stop the bleeding after the tooth is removed and make sure you have clotted, but there is still the risk of bleeding starting again if the area is knocked. Prevent bleeding by leaving the socket alone – do not suck on it and keep your fingers and tongue away. Avoid hot food and drink that day as warm temperatures thin your blood and encourage bleeding. Avoid severe exercise and bending over – take it easy for the rest of the day. Avoid mouth rinsing for the rest of the day so you don’t dislodge the clot. If you accidently knock the area and there is bleeding, you can control it by sitting in an upright position and applying direct pressure to the socket with gauze for 30 minutes.
The next day you can promote healing by frequent warm saline mouth baths (1/2 a teaspoon of salt in a glass of water), rinsing twice daily with an antiseptic mouthwash such as Savacol, tooth brushing and flossing where possible and avoiding alcohol and smoking for 2 weeks. You should take analgesics (pain killers) and antibiotics as prescribed by your dentist. Seek help by contacting your dentist if there are any problems.