Removing the tooth is called as “Tooth Extraction”. Badly damaged tooth and root with dental caries, erosion, attrition, fracture tooth or periodontal infection that cannot be saved by any mode have to be removed. Third molar tooth are most of the time extracted.
Tooth extraction is done under local anesthesia with Lignocaine/Articaine. After few minutes the area where the tooth to be extracted becomes numb. The dentist checks whether the area is numb and then proceeds for tooth extraction. So it is normally done without pain, but you can feel the pressure while extraction.
There are 32 permanent teeth for normal adult. Third molar tooth called as Wisdom tooth erupts around 18-22yrs of age. As its last to erupt it has less space for it. Most of the time, it erupts in different angulations and gets buried in the jaw bone. Due to improper position, it catches dental caries (decay) or gum disease frequently and early. Or if it does not erupt, at times it forms a dental cyst inside the jaw bone. Most of the time it is removed by a simple extraction or by minor surgery if it is buried in the bone (impaction).
Impacted teeth are removed by surgical extraction in which bone surrounding the tooth is removed and the tooth is extracted. It may require a suture which helps in healing. Suture can be removed in one week. Sometimes an absorbable sutures are placed. It is usually performed under local anesthesia.
If the person undergoing tooth extraction is diabetic or hypertensive, it should be controlled with proper drugs under a physician’s guidance. If he or she is a heart patient say eg., a recent attack of myocardial Infarction (heart attack), they should get the fitness certificate from a physician for tooth extraction.
Also if any long term drugs for any disease is taken or he/she has any disease of vital organs like kidney, liver, brain, lungs, should also have the fitness for tooth extraction from the attending physician in a written manner.
Instructions to be followed after extraction:
1) After tooth extraction, usually a sterile cotton ball packed in a gauze is asked to bite firmly in the tooth extracted place for atleast ½ an hr. So that, due to the pressure bleeding stops and a clot is formed.
2) One should not spit or gargle after tooth extraction
3) One should not take hot food (solid / liquid) on that particular day after tooth extraction, as it prolongs the bleeding time which delays healing of the wound. But any colder drink or semisolid (ice cream) can be taken on the day of extraction as it helps in blood clotting. One should not use a straw to take any liquids, as the negative pressure created in the oral cavity during this increases the bleeding in the tooth extracted place and also disrupts the formed blood clot, which also delays the healing.
4) Smoking / alcohol are strictly to be avoided atleast 3-5days after tooth extraction. Smoking by its inherent heat disrupts the blood clot and alcohol interferes with the antibiotic drug metronidazole and there by induces dizziness and vomitting.
5) Warm salt water/ mouthwashes used after the day of tooth extraction fastens the healing and also maintains an antibacterial and sterile area around the tooth extracted place.