Bruce M. MacNicol, DDS, MS, FRCD (C)
Michael T. Jackson, BA, DDS, MSc, FRCD (C)
Andrew P. Gater, DDS, HBSc, FRCD (C)
Mohammad Mokhtari, DDS, HBSc, FRCD (C)
705-302-0357

Multiple Dental Extractions


The extraction of a tooth is the permanent removal of the tooth. One of our dentists removes the tooth from its socket when it is no longer able to be saved. At Huronia Oral Surgery Group, if you have a tooth that has been severely damaged due to decay or fracture, our first priority will be to save it with a filling, crown, and other restoration options. However, if it is necessary to remove the tooth in order to maintain the health of your mouth, we can do that and help you maintain healthy bone levels following the extraction. If you need to have other teeth removed, you should rest assured that there are a variety of great restorative options available to help you maintain your smile. Our surgeons, Dr. MacNicol, Dr. Jackson, or Dr. Gater can help.

Tooth extractions fall into two categories:

•  Simple extraction: A simple extraction means that the tooth is able to be pulled entirely from the socket using forceps in one piece. In order for this procedure to happen, the tooth needs to have a single and straight root shape, this allows for a straight path of removal. A simple tooth extraction can be completed by a general dentist in our office.
•  Surgical extraction: A surgical extraction means that it is necessary to make a cut below the gumline to remove the tooth. This may be due to the shape of root, or if a tooth is impacted, or if a tooth has fractured or decayed making it more complicated to pull. Our oral surgeons are able to complete complicated extractions, orthodontic surgeries, implant placements, jaw surgery, and wisdom teeth removal. If necessary, surgical procedures can be done under IV sedation for greatest patient comfort

REASONS TO HAVE A TOOTH EXTRACTED

The most common dental extraction procedure is the removal of your wisdom teeth. Additionally, there are a variety of reasons that we may recommend a tooth extraction:

•  A baby tooth needs to be removed to allow the permanent tooth to erupt.
•  A tooth has decayed beyond repair.
•  The tooth has been severely compromised due to gum disease.
•  A tooth is badly positioned or twisted below the gum line, such as impacted wisdom teeth.
•  A tooth is badly infected and cannot be saved with a root canal or another procedure.
•  The tooth has fractured in such a way that makes it impractical or impossible to repair.
•  The tooth is non-functional and it would be a healthier choice to replace it with dentures, implants, or a dental bridge.

THE TOOTH EXTRACTION PROCEDURE

A simple tooth extraction procedure is performed after the tooth has been anesthetized by injecting a local anesthetic around the nerve. A topical numbing gel can be used to minimize the discomfort of the injection. Most patients should only feel the pressure of the pulling, there should be no pain during the procedure.

The extraction process requires specialized tools that allow for the release of the periodontal ligament that holds your tooth in place. The tooth will then be loosened within the socket by placing leverage on it. With the tooth loosened sufficiently, the dentist is then able to use forceps to remove the tooth from the jaw.

In some cases, if a tooth has several roots or if they are twisted, even a loose tooth may not be removable in one piece. In these situations, your dentist will need to section it into smaller pieces, and these extractions will be considered surgical rather than simple.

THE EXTRACTION OF MULTIPLE TEETH

Some procedures require the removal of multiple teeth. When a plan has been created that involves the placement of a dental appliance, we may extract multiple teeth at once as part of this plan. The removal of many teeth at one time is quite different than the extraction of one or two teeth. The bone must be shaped and smoothed prior to the insertion of a denture, so because of this, the following conditions may occur, all of which are considered normal:
•  The area operated on will swell reaching a maximum in two days. Swelling and discoloration around the eyes may occur. We recommend the application of a moist warm towel to help eliminate any discoloration quicker. The towel should be applied continuously for as long as tolerable beginning 36 hours after surgery (remember ice packs are used for the first 36 hours only).
•  A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is normal and should subside in 2-3 days.
•  If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline.
•  There may be a slight elevation of temperature for 24-48 hours. If temperature continues or is unusually high, notify our office.
•  If immediate dentures have been inserted, sore spots may develop. In most cases, one of our oral surgeons at Huronia Oral Surgery, will see you within 24-48 hours after surgery and make any necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.

POSTOPERATIVE CARE AFTER AN EXTRACTION

Following the extraction of a tooth, it is common to experience certain symptoms, and knowing how to handle them can minimize your discomfort:

Bleeding - We expect a certain amount of bleeding following your extraction. It should cease within 8-12 hours following your extraction. You can control the bleeding by keeping your head at least somewhat elevated, even with just a pillow, and by placing pressure over the gums with clean gauze. The oozing of pink fluid for another day or two is also normal. If you experience heavy bleeding past this time frame, be sure to call our office right away.

Pain - Following your extraction, it is common to experience discomfort or pain. In most cases, over the counter medications like Aleve or Tylenol will help to ease your discomfort. Make sure that you never take any pain medications on an empty stomach, as this can cause nausea.

Swelling - Some swelling is also common after a tooth extraction, especially within the first two days. We recommend reducing swelling by applying an ice pack to the side of your face for 10 minute intervals in the first 6 hours following your extraction.

Diet and nutrition - After the anesthesia has worn off you can start drinking and eating right away. However, for the first 48 hours, you should limit your dietary choices to soft foods. Be sure to drink at least eight glasses of water per day, and avoid drinking through a straw or consuming hot liquids.

Oral hygiene - After extraction, a clot will form over the site of the extraction. Therefore, you should avoid brushing over this area for the first 24 hours following your procedure. However, you should rinse with warm saltwater or alcohol-free mouthwash.

If you have any additional questions about how to care for your mouth following a tooth extraction, or if you are experiencing symptoms that don’t seem to be normal, please contact one of our oral surgeons:

Bruce M. MacNicol, DDS, MS, FRCD ©
Michael T. Jackson, BA, DDS, MSc, FRCD ©
Andrew P. Gater, DDS, HBSc, FRCD ©

Or by contacting Huronia Oral Surgery, at our Barrie, Ontario L4N 8J6 office by calling 705-302-0357.

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