Having a tooth removed is understandably an upsetting prospect for many patients. Sometimes this is the only remaining option, for example if you have a very broken down, infected and painful tooth. Once the tooth is anaesthetised (numb), the dentist can start to loosen it, ready for it to be removed. Having a tooth removed is not comfortable but doesn’t usually feel painful. It is an odd sensation and you will probably feel a lot of pressure or pushing. It is normal to require a lot of pressure to remove a tooth and you might hear some strange sounds as the tooth comes loose. This is normal and your dentist will talk to you about the risks of tooth removal before doing the procedure. There are lots of instruments which may be used and these can look quite intimidating. Remember, it is unlikely the whole instrument will be used – it is normally just the tip. Also, these help the dentist to loosen the tooth, making the procedure more comfortable for you.
If the dentist can’t access the tooth or grip on to the root of the tooth with their instruments, they may have to remove the tooth surgically. This procedure is slightly different, as a small cut is made in the gum, allowing the dentist to see underneath. Sometimes a small amount of drilling is needed to either cut the tooth into smaller pieces, or to remove it from the jaw bone. This shouldn’t damage any other teeth and the procedure should be painless. However, if there has been a little bone removal, it can be sorer afterwards during the recovery process. Usually a couple of dissolving stitches will be placed to ensure the gums heal as nicely as possible.
It is essential that you do not smoke following a dental extraction for at least 48 hours. Smoking significantly increases your risk of getting a painful post-operative complication known as a ‘dry-socket’ or ‘alveolar osteitis’. Alcohol should also be avoided for the first 24 hours as it increases the chance of bleeding after the procedure, as may vigorous exercise.
Risks of tooth removal include infection, swelling, bruising, bleeding and pain. The tooth can break and the decision then has to be made whether to remove it surgically or leave it in place. There is also a risk of nerve damage. This risk is greater for lower molar teeth, especially if the tips of the roots are close to the large nerve in the jaw known as the inferior alveolar nerve. If this nerve is damaged or bruised, you may experience either temporary or permanent altered sensation to the lip, teeth, tongue, cheek and chin on that side. This may include pain, numbness, tingling and altered or loss of taste. Your dentist will be able to discuss with you risks that are specific to your case, as not all of these risks apply to everyone.