Extractions & Wisdom Teeth

Tooth Extraction

Tooth Extraction

What is a tooth extraction?

A tooth extraction involves the complete removal of a tooth from your mouth. There are several reasons why your dentist may recommend tooth extraction, such as:

  • Tooth decay
  • Gum disease
  • Broken or irreparable tooth
  • Crowded teeth
  • Impacted wisdom teeth

In situations where a tooth is beyond saving, tooth extraction may be recommended.

What's the treatment like?

During your tooth extraction appointment, your dentist will use a local anaesthetic to make sure the area being treated is fully numb, so you won't feel any discomfort. If you're nervous about the anaesthetic, speak to your dentist about the other options available, like sedation, and they'll be able to recommend the most suitable.

Tooth Extraction

In order to remove your tooth, your dentist might need to take a little gum or bone tissue away first, especially when it's impacting the tooth needing to be removed. This is particularly common with wisdom teeth. Once the anaesthetic has taken effect, your dentist will use dental forceps to remove your tooth. This is done by moving the tooth back and forth to detach it.

Once the tooth has been fully removed, your dentist will use gauze to stop any bleeding, and use stitches to repair the gap should this be necessary. The whole treatment shouldn't take longer than 15 minutes.

After your treatment

Once you've had a tooth extraction, taking the following steps can help you to avoid discomfort;

  • Keep the area clean, brushing and flossing as normal, and avoid touching it with your tongue.
  • If you experience discomfort, your dentist will have recommended painkillers to take as prescribed.
  • To avoid swelling, use an ice pack for ten minutes at a time.
  • Once 24 hours have passed, gently rinse your mouth with a salt water solution. About half a teaspoon of salt in a glass of lukewarm water should suffice.
  • If you notice your extraction area bleeding persistently after 24 hours, get in touch with your dentist for advice.
  • Avoid smoking.
  • Avoid any strenuous activities for the next 24 hours or so.
  • Try not to eat hard foods while the area is healing.
  • Avoid drinking through a straw.
  • A blood clot will eventually form over the extraction site, so avoid rinsing your mouth or spitting so you don't dislodge it.

For more information on tooth extractions, or if you have any queries about our services, get in touch today.

What's next?
  • Take painkillers as prescribed
  • After the treatment, apply an icepack to the face for ten-minute intervals to keep any swelling down
  • After the first 24 hours, gently rinse your mouth with a solution of half a teaspoon of salt mixed with a glassful of lukewarm water
  • Continue to brush and floss your teeth as normal, but avoid the extraction site. A clean mouth aids healing
  • If persistent bleeding occurs after the first 24 hours post treatment, contact your dentist
  • Avoid touching the extraction site with your tongue
  • Avoid any strenuous activities for at least 24 hours after the treatment
  • Avoid spitting or rinsing your mouth for 24 hours after treatment to avoid dislodging the blood clot that will have formed over the extraction site
  • If you smoke try to avoid doing so until healing is complete
  • Avoid eating hard foods while healing is taking place
  • Avoid drinking through a straw

Wisdom Teeth Removal

Wisdom teeth can cause a variety of problems:

  • tooth and/or jaw pain
  • Infection of the gum and soft tissues surrounding the wisdom tooth Swelling of the mouth or face
  • Limited mouth opening
  • Decay of the wisdom tooth or the adjacent tooth to the wisdom tooth
The Problems Wisdom Teeth Can Cause
Wisdom Teeth Problems

Not to mention the sleepless nights and time off work or education. These problems are commonly caused by a tooth decay and /or recurrent infection in or around the wisdom teeth.

The decision to remove any wisdom tooth is made following a careful examination and discussion our oral surgery specialists. At your consultation appointment you will be advised about whether your wisdom tooth/teeth need removing and you will also be advised regarding the risks and benefits for such a procedure. Wisdom tooth removal may also be done for other reasons such as orthodontic therapy or as part of more complex corrective jaw operations.

We offer wisdom tooth removal under local anaesthetic with or without sedation for phobic patients.

Wisdom Teeth

What are wisdom teeth?

They are the third molars and the last teeth to emerge at the back of your mouth. This usually occurs in late teens ('the age of wisdom'). Most people have four, two in the upper jaw and two in the lower jaw.

Impacted wisdom tooth Wisdom tooth pain

Infected gum tissue overlying impacted wisdom tooth (Above)

Why am I having mine removed?

Surgical removal can be required for several reasons. Often, wisdom teeth get stuck ('impacted') against the adjacent tooth or within the jawbone and are not able to come through fully into the mouth.

A partially exposed wisdom tooth can be difficult to keep clean. This can then cause chronic infection and discomfort in the surrounding gum tissue. Such infections may require treatment with antibiotics.

A wisdom tooth can also become decayed or cause decay in neighbouring teeth. Your dentist may not be able to treat this decay until the wisdom tooth has been removed.

Decay Example
Tooth Decay
  • 1 Extensive decay affecting upper and lower impacted wisdom tooth
  • 2 Impaction of lower wisdom tooth leading to development of decay in the lower second molar
  • 3 Extensive decay affecting impacted lower wisdom tooth
Impacted Wisdom Teeth
impacted

Impacted wisdom teeth can also adversely affect the attachment of adjacent teeth or be associated with cystic lesions.

  1. 1 Horizontally impacted wisdom tooth adversely affecting attachment of second molar
  2. 2 Extensive cystic development around impacted lower wisdom tooth

Wisdom teeth should only be removed if they are causing problems. We will discuss this with you during your appointment.

How will it be removed?

This depends on the position of your tooth and the way it is impacted. Some can be quite straightforward to remove. More commonly, simple extraction is not possible and surgery is necessary to remove it.

The type of the surgery needed depends on the position of the wisdom tooth. This may influence whether your operation is carried out under local anaesthesia alone or with additional intravenous sedation.

All options can be discussed with you during a consultation appointment.

How long will the operation take?

This again depends on the position of your tooth, and whether the operation is being carried out with local anaesthesia alone or with additional intravenous sedation.

An appointment for surgery under local anaesthesia usually lasts 45 minutes. When intravenous sedation is used, an appointment usually lasts 90 minutes. The longer time allows for the recovery period needed before you can be discharged home.

Will there be any stitches?

Sometimes stitches are needed and they are usually dissolvable. If non-dissolvable stitches are used, they are quick and easy to remove. An appointment will be arranged for this, usually one week after surgery.

Will I be in pain afterwards?

You should not feel any pain immediately after the operation, as the area of surgery will be numb from the local anaesthetic. As the numbness wears off, the area might become uncomfortable and then you should take painkillers. We will supply you with these, with information about doses.

Could there be any after-effects?

This depends on the operation. If there are any issues in particular to be aware of, they will be discussed with you beforehand. There may be swelling and bruising in the area of surgery as well as some discomfort which might limit jaw opening. Bruising is usually at its most obvious two to three days after surgery and varies between patients. It normally resolves itself after 10 to 14 days.

Occasionally, an impacted lower wisdom tooth can be very close to nerves supplying the lower teeth, lip, chin, cheek and tongue. These can get bruised when the tooth is removed, resulting in the sensation of numbness or tingling in these areas.

This change in sensation only affects 2-5% of patients and is usually temporary. It can take up to six months to fully resolve itself. It only very rarely becomes permanent. If this is a factor for you to be aware of, due to the proximity of your wisdom tooth to the nerves, we will discuss it with you during your consultation.

If appropriate, we might advise that it would be beneficial to arrange a further investigation to assess this potential proximity between your wisdom tooth and the nerve. This would comprise a specialized CT scan to provide a three-dimensional image of the area. A written report of the scan's findings would also be provided; a further consultation appointment would then be arranged to discuss this report.

When can I return to work?

This depends on your occupation and how you are after your treatment. It may be possible to return to work the next day. Some people need to take some time off work, especially if the operation has been carried out under intravenous sedation. We will give you appropriate advice for your particular circumstances.

After your operation

After your surgery, we will give you an information sheet with instructions to help bring about a quick recovery. We will discuss this with you before you are discharged home, to ensure that the information is clear and understood.

The main points are as follows.

On the same day, after the operation:

  • Get plenty of rest in the first few hours after your operation.
  • Do not rinse your mouth or drink hot fluids.
  • Relieve discomfort by taking the supplied painkillers as directed and use ice packs to reduce discomfort at the operation site.

From the following day onward:

  • Keep your mouth as clean as possible by gently brushing your teeth as usual.
  • Use salt water mouth rinses (one teaspoon of salt in a cup of warm water) every four hours for seven days. This will help to keep the operation site clean and clear of debris.
  • Avoid smoking. The local action of nicotine in the mouth has been shown to have a detrimental effect on healing after surgery and greatly increases the likelihood of wound infection developing.
  • Continue to take the painkillers and any other supplied medications as directed and use ice packs for the next two to three days.
  • If bleeding is troublesome, you can usually control it by placing dampened gauze over the wound and applying pressure for 15 to 20 minutes (slight oozing can be expected for a short time following surgery).

If you have any other complications or require advice after treatment, please call 09 215 8234 and leave a message including a contact telephone number. We will return your call as soon as we can.