TOOTH EXTRACTION

General Information

DEFINITION-Removal (extraction) of a tooth.

BODY PARTS INVOLVED-Teeth; gums; bones in jaw.

REASONS FOR SURGERY

Routine removals:

• Loss of supporting tissue, bone or gums.
• Infection of the nerve in the tooth.
• Fractured teeth that cannot be restored. Impacted-tooth removals:
• Infection and pain around the lower wisdom teeth.
• Pain upon closing the jaws.
• Destruction or erosion of nearby teeth and bone due to growth of surrounding tissue.
• Lack of space for normal tooth growth.

SURGICAL RISK INCREASES WITH

• Smoking.
• Poor nutrition.
• Chronic disease, especially: rheumatic fever with rheumatic heart disease; heart or blood disease; hypertension; or alcoholism.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES-Dentist or oral surgeon.

WHERE PERFORMED-Hospital, outpatient surgical facility or dentist's or oral surgeon's office.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of mouth.
• After surgery: Blood studies.

ANESTHESIA

• Local anesthesia by injection.
• General anesthesia (sometimes) by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• For impacted teeth, the gum is incised over the tooth to be removed.
• For all extractions, the tooth is grasped with special instruments, rotated and elevated from the surrounding gum and bone.
• A gauze sponge is packed into the space left by the extracted tooth.
• Sometimes, sutures are used to close the gum edges. They usually come out by themselves, but may need removal in 3 or 4 days after surgery.

POSSIBLE COMPLICATIONS-Excessive bleeding or surgical-wound infection.

AVERAGE HOSPITAL STAY-0 to 1 day.

PROBABLE OUTCOME-Expect complete healing without complications. Allow about 3 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• Do not smoke or use drinking straws for the next 24 hours.
• Keep your mouth closed firmly on the gauze sponge. Don't spit.
• Change the gauze sponge about every 30 minutes if it becomes soaked with blood. If not, leave it in place for about 3 to 4 hours after surgery.
• Use ice to relieve pain. Apply an ice pack for 10 minutes at a time every hour for 12 hours after surgery.
• Beginning 24 hours after surgery, rinse your mouth gently as needed with a solution of 1/2 teaspoon of salt in 8 oz. lukewarm water.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY--Rest quietly at home for 24 hours after surgery, then resume limited activity for 1 or 2 days. Then, no restrictions.

DIET--Soft or liquid diet (See Appendix) for 24 hours after surgery. Do not drink alcoholic beverages during this time.

Call Your Doctor If

† Nausea or vomiting begins.

• Medication does not relieve pain.
• Sutures drop out during the first 48 hours after surgery.
• Excessive bleeding (one gauze sponge becoming deep red in 10 to 15 minutes) continues for more than 4 hours after surgery.
• Pain, swelling, redness, drainage or bleeding increases in the surgical area.
• Signs of infection begin: headache, muscle aches, dizziness or a general ill feeling and fever.