In consultation with your dentist, the decision has been made to extract a tooth, molar or root remnant. At The Delft Dental Practice, we believe it is important that you fully understand what the advised treatment entails, the possible consequences and your alternatives.
What does the treatment involve?
The dentist or oral surgeon will give you an anesthetic prior to treatment. Once this has taken effect, the dentist loosens the tooth by making a twisting or prying motion. Usually the tooth is pulled out completely. If the tooth is very fixed, it will be taken out in sections.
How long does the treatment last?
From the time the treatment begins until you are allowed out of the chair takes about 15 minutes. But every tooth is different, so treatment may take longer or shorter. If the treatment takes longer, it does not necessarily mean that you will have more complications.
Is the treatment painful?
Pulling a tooth can feel unpleasant. However, because of the anesthesia, you will usually not feel any pain.
Does the treatment cause post-treatment pain?
After treatment, it is normal that you may experience pain. You can control the pain with painkillers. Local anesthesia wears off after 2 to 4 hours. It is best to start the painkillers about 1 hour after the procedure. We recommend that you read the package insert carefully. If the pain returns after about 3 days, it is usually due to inflammation of the wound (alveolitis). You should then contact the practice for follow-up treatment.
Will you be prescribed medication and what should you watch out for?
Sometimes you may be prescribed a course of antibiotics. Please note that it is important that you always complete this course of treatment, even if there are no more symptoms. If you experience hypersensitivity symptoms such as itching or a rash, contact the practice. Painkillers can be used as needed. Be careful not to take aspirin, Chefarin or acetylsalicylic acid-containing painkillers, as they thin the blood. For patients taking blood-thinning drugs (anticoagulants), it is important that your INR value is determined 24 to 72 hours before the procedure and does not exceed 3.5. If the INR is higher than 3.5 and cannot be adjusted to a lower value, you will be referred to an oral surgeon.
For patients taking (intravenous) bisphosphonates, there is a risk of death of the jaw bone (osteonecrosis). Bisphosphonates are drugs used to treat osteoporosis (osteoporosis). To reduce this risk, it is important that extraction take place before or after the intake period of (intravenous) bisphosphonates.
Are there any potential complications?
The success rate of tooth extraction is high, however, the following complications can occur:
- Swelling: A thick cheek, blue-yellow discoloration and reduced mouth opening are normal. Swelling should subside after about a week.
- Restricted mouth opening: Restricted mouth opening is also common after surgery. After a few days, mouth opening returns to normal.
- Fever: Fever may occur during the first few days. If you suddenly develop a high fever above 39 degrees or the fever above 38.5 persists for more than 4 days, contact the practice.
- Post-bleeding: During the first few days, blood clots may turn saliva red, which may give the impression of post-bleeding. However, this is rarely the case. In a post-bleeding case, there is more blood than saliva in the mouth. In that case, it is best to bite down firmly on a double-folded gauze for half an hour. If the bleeding does not stop after that, contact your practice.
- Bone breakdown: If a molar or tooth or root remnant has been pulled from you, you should be aware that the jawbone will shrink at this location.
Rare complications during or after treatment:
- A broken off root during extraction. The dentist may decide not to remove it in these cases.
- During pulling, surrounding jawbone may break partially or completely.
- Ingestion or inhalation of a tooth/teeth/root.
- The formation of a small opening from the oral cavity to the nasal sinus.
- Damage to a nerve (possible when pulling a molar in lower jaw) due to anesthesia or the pulling itself.
- Inflamed hematoma or abscess.
- Delayed wound healing.
- Inflammation of the part of the bone where the root was.
Advice for the first few days after treatment:
- Caution: The anesthesia will last for several hours. Until the anesthesia wears off, you should not eat or drink hot food. Also beware of biting your numb lip, tongue or cheek.
- Food and drink: As the anesthesia wears off, you may eat some food but it is best not to consume hard or hot food to spare the wound. After the procedure, you may carefully drink something but no hot or alcoholic beverages.
- Oral hygiene: The wound heals best when the blood can clot well. Therefore, you should not rinse your mouth on the day of surgery. From the second day you may carefully brush again with a soft toothbrush. You can use chlorhexidine as a mouthwash, which is available at the drugstore. From the day after the procedure you can rinse your mouth with it after every meal.
- Smoking and alcohol: It is best not to drink alcohol for the first 48 hours and to delay smoking for as long as possible. Both are bad for wound healing.
- Sutures: Usually sutures are made with material that will dissolve on its own after 1 to 2 weeks. If it does not, you will be given an appointment to have the sutures removed.
- Filling of missing teeth: Because of function or for the "face," you can have the space filled with a fixed device such as an implant or bridge or with a removable device such as a plate denture or frame denture.
- Physical exertion: Avoid strenuous physical activity for the first two to three days.
When do you contact your practice directly?
- you develop a fever above 39°C after the extraction (slight elevation is normal);
- after 4 or 5 days after the extraction, the pain and/or swelling does not diminish but gets worse;
- the wound continues to bleed after extraction despite the measures already mentioned;
- the gums around the extraction inflame;
- swelling or bruising occurs in other parts of the face.
Any questions?
If you have any further questions, please feel free to contact the front desk of your practice. It is important to us that your questions are answered before treatment takes place.
Sincerely,
The Delft Dental Practice
0152023397
receptie@ddtp.nl