What is a tooth extraction??

A tooth extraction is the removal of a tooth from its socket in the bone. Tooth extractions are a common dental procedure but can often cause a lot of anxiety for patients.

The most common reasons a tooth will require extraction are:

• Deep decay or severe gum disease in a tooth
• Trauma to the tooth following a knock to the jaw from a sporting injury or fall
• Not enough space for the teeth

In some cases, extraction may be the only treatment option available however in other cases, alternative treatment options may be available. Your dentist should discuss any alternative treatment options with you prior to any extraction.

I have been warned that I may need a surgical extraction. What is the difference between simple and surgical extractions?

Simple extractions: These are extractions performed on teeth that are visible in the mouth. It involves application of local anaesthetic injection to anaesthetise the tooth that will be removed. Pressure is then applied to the tooth to loosen it within its socket. Once the tooth is loose, forceps are applied and the tooth is further loosened until it can be lifted out of the socket.

Surgical extractions: In some cases, a simple extraction may turn into a surgical extraction, especially on teeth with severe decay, extensive fillings or abnormally curved or large roots. Surgical extraction involve removal of bone surrounding the tooth and/or the division of the tooth into parts prior to extraction to help the tooth come out more easily.

What is the expected recovery time?
Recovery time following a simple extraction can vary widely but it generally takes a few days for patients to feel back to normal. Full healing will take several weeks.

Some things to take note of:

• Bite on the gauze firmly for 30-45 minutes. If the pad becomes soaked with blood, replace it with a clean one.
• Do not to rinse or spit on the day of the extraction. This can lead to early loss of the blood clot. If the blood clot is lost, this results in dry socket – which can be very painful due to delayed the healing process.
• Smoking on the day of extractions and the days following – can also lead to early loss of the blood clot and dry socket.
• Limit strenuous activity for 24 hours
• A patient can generally eat normally on the day of the extraction but in some cases a soft diet may be required for 24 to 48 hours following the extraction.

What if I am taking bisphosphonates?

You MUST inform your dentist if you are taking this medication.

Bisphosphonates are important drugs that prevent the loss of bone mass, they are the most commonly prescribed drugs used to treat osteoporosis and other bone diseases.

However, they can lead to bisphosphonate-related osteonecrosis of the jaws, (BRONJ) after dental extraction. The risk with oral bisphosphonates is about 1:3000 but the risk with intravenous forms can be much greater. Owing to the long half-life of these drugs (7 years), just stopping the drug for a few weeks or even months may not reduce the risk of developing BRONJ after an extraction.