All Dental Topics,Tooth removal

Tooth removal

28 Jun , 2015  

Why does a tooth need to be removed?

Tooth removal is generally required when bacteria have entered the root canal system and a root canal is not advised or financially not viable. Bacteria can enter the root canal system via a crack, a deep cavity, and periodontal disease. When a root canal is infected, there is often associated toothache.

There are other reasons for tooth removal such as for creating space in orthodontics, and when wisdom teeth are impacted.

Why do some wisdom teeth require tooth removal?

Wisdom tooth removal is due to a lack of jaw space for the wisdom teeth to erupt correctly into position. With little jaw space a wisdom tooth can become “impacted” where it is partially through the gum or completely hidden under the gum. Impacted wisdom teeth are often at 45 and 90 degree angles and cause localised gum infections (pericorinitis).

Impacted wisdom teeth are often surgically removed by a general dentist or by an oral or maxillofacial surgeon (specialist). If you have a medical insurance policy covering impacted wisdom teeth and your wisdom teeth are impacted then your dentist will refer you to an oral or maxillofacial surgeon.

Left untreated, some of the issues associated with impacted wisdom teeth include:

  • Infections under the overlying gum (pericorinitis)
  • Decay within the wisdom tooth
  • Decay in the adjacent tooth
  • Pain
  • Bad breath (halitosis)
  • Limited mouth opening (trismus)
  • Pathology formation in the jaw bone

What is the tooth removal process?

Length of Treatment:  10 min – 45min for single tooth removal.  30minutes – 1.5 hours for up to 4 wisdom teeth. For multiple teeth requiring extraction, appointments can be split across a couple visits.

Below is the tooth removal treatment approach:

  • Sedation (IV or orally) if you are particularly anxious
  • Local anesthetic (injection) to numb the tooth
  • The dentist will carefully apply pressure to extract the tooth
  • If the tooth will not loosen with pressure alone then a surgical procedure allows a gutter of bone to be removed around the tooth or the tooth is sectioned.
  • The socket is debrided, rinsed and packed
  • If required, stitches will be applied to assist the healing process
  • If non-dissolveable stitches are used, the patient will need to return for a follow-up visit 1 week later
  • Post-treatment instructions will be given to the patient

What are the post treatment instructions for a tooth removal?

After a tooth removal, the goal for fast healing is to maintain a blood clot in the tooth socket. To avoid blood clot disruption:

  • On the day of surgery avoid excessive exercise, vigorous rinsing, and hot liquids
  • Maintain excellent oral hygiene and be careful when cleaning near the socket.
  • If there is excessive bleeding, bite down on a wet tea bag for 30 minutes. Should bleeding not stop after pressure application, contact your dentist. Saliva can dilute the blood and make the bleeding appear worse than it is.
  • Medicating with analgesics (pain killers) is very important before the numbness wears off.  See the pain relief post for more detailed information.
  • Avoid smoking (increases risk of a dry socket) and alcohol.
  • Antibiotics may be prescribed if the tooth removal was difficult or the tooth was very infected.
  • 24 hours after the procedure commence warm salty warm water rinses.
  • Contact you dentist or specialist should you experience a bad taste and ache after 72 hours. This is likely the result of a dry socket.
  • Contact you dentist or specialist if you have sutures and they have not dissolved after 7 -10 days.


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