If your tooth is damaged or decayed and can’t be repaired, or is very difficult to repair, you may decide to have it removed (extracted). Your dentist will consider removing a tooth a last resort. If your tooth is broken or decayed, they’ll try to repair it with a filling or crown first. But if they can’t repair it, the best option may be to take your tooth out.
What is it?
A tooth which is very decayed or damaged or loose because of gum disease may have to be extracted (taken out of your mouth).
Wisdom teeth sometimes have to be extracted if they have come through at an awkward angle and are causing problems.
Teeth are sometimes taken out from children’s mouths to help other teeth grow straight when they are crowded.
What will my dentist do?
Some teeth are easier to take out than others. A local anaesthetic (an injection in your mouth) will be used to numb the tooth before it is extracted.
While the tooth is being taken out, you may hear some noises and feel some pressure as your tooth is being eased out but no pain.
Sometimes, stitches are put into the gum to help the mouth to heal.
You may need a day or so off work to recover, depending on how difficult the extraction was.
The dentist will give you a pad of gauze to bite on to stop any bleeding.
The dentist will give you advice on how to look after the space where the tooth was while it is healing.
They will also advise you on which painkillers to use so that you are not in any discomfort when the anaesthetic wears off.
They will give you written instructions too, which will have details of how to contact the practice if you are having any problems.
The removal of wisdom teeth, or third molars, is one of the most common surgical procedures carried out in the UK.
The wisdom teeth grow at the back of your gums and are the last teeth to come through. Most people have four wisdom teeth – one in each corner.
Wisdom teeth usually grow through the gums during the late teens or early twenties. By this time, the other 28 adult teeth are usually in place, so there isn’t always enough room in the mouth for the wisdom teeth to grow properly.
Because of the lack of space, wisdom teeth can sometimes emerge at an angle or get stuck and only partially emerge. Wisdom teeth that grow through like this are known as impacted.
When to come and see us at Belhaven?
You should make an appointment if your wisdom teeth are causing severe pain. We will check your teeth and advise you whether they need to be removed.
Should we conclude that you may need to have your wisdom teeth removed, we will typically take an X-ray to provide us with a clearer view of the position of your teeth.
Why are wisdom teeth removed?
Your wisdom teeth don’t usually need to be removed if they’re impacted but aren’t causing any problems. This is because there’s no proven benefit of doing this and it carries the risk of complications.
Sometimes, wisdom teeth that have become impacted or haven’t fully broken through the surface of the gum can cause dental problems. Food and bacteria can get trapped around the edge of the wisdom teeth, causing a build-up of plaque, which can lead to:
- tooth decay (dental caries)
- gum disease (also called gingivitis or periodontal disease)
- pericoronitis – when plaque causes an infection of the soft tissue that surrounds the tooth
- cellulitis – a bacterial infection in the cheek, tongue or throat
- abscess – a collection of pus in your wisdom teeth or the surrounding tissue as a result of a bacterial infection
- cysts and benign growths – very rarely, a wisdom tooth that hasn’t cut through the gum develops a cyst (a fluid-filled swelling)
Many of these problems can be treated with antibiotics and antiseptic mouthwash.
Wisdom teeth removal is usually recommended when other treatments haven’t worked.
How wisdom teeth are removed
Any of our dentists at Belhaven can remove your wisdom teeth, however in certain circumstances we may refer you to a specialist.
Before the operation, the procedure will usually be explained to you and you may be asked to sign a consent form.
You’ll usually be given a local anaesthetic injection to numb the area around the tooth. You’ll feel some pressure just before the tooth is removed, as your dentist or oral surgeon needs to widen the tooth socket by rocking the tooth back and forth.
A small cut in the gum is sometimes necessary, and the tooth may need to be cut into smaller pieces before it’s removed.
It takes anything from a few minutes to 20 minutes, or sometimes even longer, to remove a wisdom tooth.
After your wisdom teeth have been removed, you may have swelling and discomfort, both inside and outside your mouth. Occasionally, some mild bruising is also visible. This is usually worse for the first 3 days, but it can last for up to 2 weeks.
As with all surgery, there are risks associated with removing a wisdom tooth. These include infection or delayed healing, both of which are more likely if you smoke during your recovery.
Another possible complication is “dry socket”, which is a dull, aching sensation in your gum or jaw, and sometimes a bad smell or taste coming from the empty tooth socket. Dry socket is more likely if you don’t follow the after-care instructions given by your dentist.
There’s also a small risk of nerve damage, which can cause a tingling or numb sensation in your tongue, lower lip, chin, teeth and gums. This is usually temporary, but in rare cases it can be permanent.
What to do after an extraction
After having your tooth removed it is important to follow these instructions. This will help your mouth to heal as quickly as possible and prevent infection.
- Avoid rinsing your mouth out for the first 6 hours
If you rinse your mouth you will wash away the blood clot and you may start bleeding again.
- If you do start bleeding again, fold a clean hankie or tissue into a sausage shape and bite firmly for 20 minutes. Repeat if necessary.
- Keep your mouth as clean as possible
- Gently rinse your mouth after every meal with hot salt mouthwashes (1 teaspoon of salt dissolved in warm water).
- Brush the other teeth twice a day as normal, taking care to be gentle around the socket area.
- Do not smoke for at least 48 hours
The chemicals in cigarette smoke cause severe pain and infection in the socket.
- Do not drink alcohol for at least 48 hours
Alcohol thins your blood making you more likely to start bleeding again.
- Try to eat on the opposite side from the extraction socket to avoid disturbing the blood clot.
- Avoid eating hot food & drinks, spicy foods and hard or chewy foods.
- Allow your food to cool down before eating.
- Avoid strenuous exercise and activity and drink plenty of fluids.
- If you feel small pieces of bone working their way out of the socket, don’t worry, this is normal
- If you are experiencing discomfort or tenderness following the extraction you may find it helpful to take a painkiller:
Either: Paracetamol, four times daily (breakfast, lunch, dinnertime, bedtime)
Or: Ibuprofen, three times daily (e.g. 11am, 3pm, 8pm)
If the discomfort is severe you can take both Paracetamol and Ibuprofen as directed above. Do not take ibuprofen if you suffer from stomach problems or asthma.
It will normally take about 2 weeks for the mouth to heal.