Tooth extraction

Removing a tooth (extraction) is the last option, not the first. A tooth is taken out when it cannot be repaired, or when keeping it would cost you more than losing it. At Kallada Smile, teeth are removed by Dr. Pavya Priya, a registered dentist.

What it is

A tooth sits in a socket of bone, held by fibres. Numbing removes the feeling, an instrument widens the socket and stretches those fibres, and the tooth comes out. You should feel firm pressure and hear noise rather than pain. Tell us the moment you feel anything sharp: we stop and add more anaesthetic.

A simple extraction is one where the tooth is visible and can be gripped. A surgical extraction is one where the tooth is broken at the gum line, or buried in bone. The gum is opened and the tooth is taken out in pieces.

Wisdom teeth are one of the commonest surgical cases, because they arrive last and often have no room.

Signs you might need it

• A tooth broken so far down that nothing is left to build on.
• Decay that has destroyed the tooth below the gum line.
• A root canal that has failed and cannot be redone.
• Advanced gum disease that has loosened the tooth in its socket.
• A wisdom tooth that keeps swelling, or that is decaying the tooth in front of it.
• A milk tooth that has not fallen out while the adult tooth is coming in beside it.
• A tooth that has to go to make room, as part of a plan for braces.

Removal is a decision, and in most cases there is time to make it. Dr. Pavya explains what keeping the tooth would involve and what it would cost. You decide.

What happens at Kallada Smile

Options

What can go wrong

Removing a tooth is a small operation. The clot in the socket can be lost, which is a dry socket: a deep ache that starts two to four days later and spreads to the ear. Bleeding can restart, and bruising, swelling and a jaw that will not open fully can follow a surgical case. A lower wisdom tooth can sit against the nerve that supplies the lip, the chin and the tongue, so removing it can leave numbness or an altered feeling there; it usually recovers over weeks or months, and in a small number of cases it does not. An upper back tooth sits close to the sinus, and the two can open into each other. A root tip is sometimes left in place on purpose, because removing it would do more harm than leaving it. Dr. Pavya says before you decide which of these applies to your tooth, and refers the cases that belong with an oral surgeon.

How long it takes and how many visits

A simple removal takes 15 to 30 minutes, including the numbing, in one visit.

A surgical removal takes 30 to 60 minutes, with a review at about a week if stitches were placed.

Where a tooth is infected and swollen, antibiotics may come first and the removal happens a few days later. That is not a delay for its own sake; a swollen area does not numb well.

Plan to go home quietly afterwards rather than back to work, especially after a surgical case.

Looking after it afterwards

• Bite firmly on the gauze for an hour. If bleeding restarts, bite on a clean rolled handkerchief for another half hour and message us if it does not stop.
• No rinsing, spitting or hot drinks for the rest of the day. All three dislodge the clot that has to form.
• No smoking for at least 48 hours. Smoking is the single biggest thing that brings on a dry socket. Avoid rinsing hard, spitting and drinking through a straw for the rest of the day too, so the clot is not disturbed.
• Eat soft, cool food on the other side. Rice and curd, kanji, ice cream.
• From the next day, rinse gently with warm salt water two or three times a day, especially after eating.
• Take the medicine exactly as prescribed. A deep ache starting on day two to four, spreading to the ear, usually means a dry socket, though a spreading infection can feel much the same and is treated differently. Come in rather than increasing the painkillers.
• Swelling peaks at about 48 hours after a surgical case, then settles. Cold on the cheek for the first day helps.