Tooth extraction refers to the complete removal of one or more teeth from the mouth. This is a procedure that is usually performed by a dental surgeon. Milk teeth may be removed from a child’s mouth without intervention from the dentist as they loosen as a matter of course to give way to permanent teeth.

Reasons for tooth extraction

• Teeth affected by tooth decay or periodontal disease to the extent that they cannot be treated with a dental filling, crown or root canal work
• Injury or trauma that has led to a broken or damaged tooth that is beyond repair
• A dental or gum abscess that has weakened the root of the tooth
• Malocclusion or crowding of teeth
• Impaction of teeth (most commonly of the wisdom teeth) that has led to failure of the tooth to emerge form the gum

What is involved in tooth extraction?

Removal of the tooth or teeth may require one or more visits to the dentist. Some individuals may opt to have removed teeth replaced with an artificial tooth or denture. Usually, a detailed history of any dental disease, allergy, chronic medical conditions or regular use of medications is obtained before extraction. Some medications such as blood thinners (eg, aspirin or clopidogrel) need to be stopped at least a week to 10 days before the procedure as their presence in the blood may lead to severe bleeding afterwards.

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A local anaesthetic agent such as lignocaine is injected near the tooth to numb the area of pain. The patient may be conscious and given a sedative to ease anxiety. Once the area around the tooth is numb, the dentist grips the tooth with instruments and gently rocks it from side to side until it loosens from the tooth socket and is ready to be removed. The person feels a slight tug on the tooth but there is not usually any pain. The whole process may take a few minutes.

Once the tooth is removed, the gum may or may not require stitches to close the gap and the wound. Soft cotton padding is then given to the patient to bite into to prevent bleeding. Once home, a patient may take pain relief pills such as paracetamol or ibuprofen to numb any pain occurring as the effects of the local anaesthetic wears off. Antibiotics may be prescribed for some patients.

Before discharge, the patient is advised not to rinse their mouth for at least six hours, after which, warm water mixed with a pinch of salt may be used to rinse the mouth gently. Soft food may be eaten after bleeding stops. It takes around a week to recover completely and the area of wounded gum needs to be avoided by the tooth brush while brushing the teeth.

Risks of tooth extraction

The risks and disadvantages of tooth removal include:

• Pain
• Bleeding
• Jaw stiffness
• Infection of the wound
• Dry socket. This occurs when a blood clot that is supposed to form in the tooth socket to protect the bone and nerves underneath, becomes dislodged or dissolves, exposing the bone and nerves and causing severe pain and possibly infection. Immediate treatment is required.