What is the procedure and how is it performed?
Dental extraction surgery is the removal of a tooth or teeth. The procedure is usually done in an office setting under local anesthesia with sedation (awake but relaxed and pain-free). The tooth is lifted from the gum and then removed using an instrument called dental forceps. This is accomplished by rocking the tooth back and forth until it separates from the ligaments and bone holding it in place.
For teeth that are below the gum line, such as broken teeth or wisdom teeth, the surgeon may have to remove tissue and bone around the tooth before removal. In some cases the tooth may be removed in pieces. If there is a large defect, sutures may be needed to close the incision.
Why is the procedure performed?
Generally every effort is made to save a tooth. Removing a tooth may be necessary when there is severe decay or infection, is so severe that the tooth can not be saved. Other reasons for dental extraction include advanced gum disease, trauma, an abscess, or orthodontic correction. Removal of a tooth may be part of treating an abscess and preventing spread of infection to other areas in the mouth or neck.
What should I expect during the post-operative period?
If you have had sedation you cannot drive home, will need someone to drive you home. Pain is common after extraction. You should take pain medication as prescribed by your surgeon. You may have been given Antibiotics prescribed before or after surgery if you have a heart murmur or if you have an infection. Be sure to continue the medication as directed.
Your surgeon will have you rinse your mouth with salt water several times a day to reduce pain and swelling for the first several days. Some bleeding in the first 24 hours is normal and biting down on a rolled gauze pad can control this.
Except for going to the bathroom, you should remain at rest with your head elevated for the first 12 to 24 hours. You should stick to a soft cool diet until your pain subsides and the bleeding has stopped. After 2 to 3 days, you should be able to return to normal activities and a normal diet.
What are the risks and complications of this procedure?
Just as there may be benefits to the procedure(s) proposed, medical and surgical procedures also involve risks. These risks include allergic reaction, bleeding, blood clots, infections, adverse side effects of drugs, heart attack, stroke, and even loss of bodily function or life, as well as risks of transfusion reactions and the transmission of infectious disease, including hepatitis and Acquired Immune Deficiency Syndrome, from the administration of blood and/or blood components.
There are also particular risks associated with the procedure(s) proposed. These risks include but are not limited to:
Infection: Swelling, pain or fever that persists or worsens after surgery may be a sign of infection. You should contact your surgeon immediately. A rare but serious complication can occur when swelling extends into the throat or under the tongue and causes difficulty breathing. If you note any difficulty swallowing or breathing contact your surgeon immediately.
Bleeding: Bleeding that continues or worsens after surgery may indicate damage to a blood vessel and require treatment.
Sinus Opening: When upper teeth are extracted it is possible to create an opening into the nasal sinus. It is also possible that a part of the tooth may be pushed into the sinus. This may require a surgical procedure to correct.
Nerve Injury: Injuries can occur to the nerves supplying the jaw, chin, or tongue. This may result in permanent numbness and/or loss of taste.
Dry Socket: Pain that seems to be getting worse after 2 days may be due to a dry socket. This may need to be treated with packing and antiseptic rinse.
Residual Fragments: Broken root tips or bone fragments are not unusual and if they do not work their way out in time may need to be removed.
Before you agree to any operative procedure it is important to remember that each patient is different and that the outcome of any surgical procedure can never be guaranteed. You should understand that there may be complications that have not been mentioned and that it is not possible to anticipate all complications or to answer each and every question. Again, you should be aware that in the practice of medicine unforeseen and unexpected risks or complications not previously discussed may occur. You should also understand that during the course of the proposed procedure(s), unforeseen conditions may be revealed requiring the performance of additional procedures, and such procedures may need to be performed.
Keep in mind that there is no substitute for an open and honest discussion with your own surgeon/physician regarding this procedure.
You should also be given any available treatment alternatives to this procedure by your doctor. Be sure to discuss any questions or concerns with your doctor.
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