Removing a tooth can sometimes be a confronting experience for patients, however the majority of the time it is a relatively straightforward procedure. Your dentist will assess your medical history, the tooth that needs to be extracted and the surrounding structures to determine the complexity of the extraction. If the tooth extraction is simple it can be performed by your general dentist. However, if the extraction requires more complex management (e.g. some wisdom teeth or previously root canal treated teeth) you may be referred to an oral maxillofacial surgeon.
All tooth extraction procedures start the same way by providing local anaesthesia to your tooth and the surrounding tissues. The dentist will use a numbing gel where the needle will be placed to help maximise your comfort during the injection. You will be numb in the area of the injection for a few hours, so it is important that you do not consume hot foods or drinks immediately after the extraction as you may burn yourself without realising.
Once the injections have been provided, the gums around the tooth to be extracted will be tested to ensure they are fully numb. The dentist may also ask you some questions to confirm the injections have worked. For example, if your lower back tooth has been anaesthetised, the dentist may ask if your lip is feeling fat, tingly or rubbery.
After it has been confirmed that your tooth is fully numb, your dentist will start using instruments to loosen your tooth. These instruments help separate the gums away from the teeth and help elevate them out of the supporting bone. You will feel a lot of pushing forces against your tooth. If at any point you feel pain you can notify your dentist who may need to top up your anaesthetic.
Once the tooth is sufficiently mobile, the dentist will use forceps on the tooth to remove it from your mouth. In some cases, if the tooth is difficult to remove, a surgical extraction may be commenced. This involves cutting a small piece of gum around the tooth and removing a small amount of bone to get better access to the tooth.
After the tooth has been removed, the extraction socket may be rinsed and a piece of gauze placed on the extraction site until any bleeding has stopped. Your dentist will go through some post-operative instructions with you to help maximise the healing of your extraction site. These instructions will include important information surrounding pain relief, managing any bleeding, infection, oral hygiene and diet.
Dr Sindhu Parthasarathy
BBiomed (Melb), DDS (Melb)