Dental or tooth extraction, is the removal of teeth from the dental socket in the mouth. These extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become very diseased through tooth decay, periodontal disease, or dental trauma, especially when they are associated with toothache. An impacted wisdom tooth may also be removed when other conservative treatments have failed. Also, if the teeth are crowded, healthy teeth may be extracted to create space so the rest of the teeth can be straightened.
What are the methods for tooth extraction?
Tooth extraction is taught to be a relatively easy procedure. While it is true and also relatively fast, it requires great care, preparation and skill. There are three main methods for tooth extraction.
Simple extraction. This is the most well-known and commonly performed type of dental extraction. This is the picture people have when they think of tooth extraction as it deals with the extraction of the visible tooth as well as its root. These are done for an extremely decayed tooth with a compromised root, or a tooth which for some reason eg trauma also has a compromised root.
Partial extraction. This is the removal of a tooth while leaving the root whole and undamaged within the jawbone. This relatively new method is highly regarded for its positive lasting effects on tooth and jaw health. It is a great option for those planning to replace removed teeth with dental implants, as they make the implantation process go much smoother.
Surgical extraction. This is the last resort in situations where an extraction is needed but a simple or partial extraction is not possible. Here a tooth or tooth fragment, along with the root if needed, that has sustained decay or damage below the gum line is surgically removed.
What are the instructions after tooth extraction?
Tooth extraction usually involves some form of anesthesia to numb the area for the procedure to be performed. This usually wears off after the procedure. Together with the pain of the anesthesia wearing off, there is usually some bleeding after tooth extraction. For these reasons, after tooth extraction, most dentists give their clients some instructions to promote fast healing and minimal pain.
According to a Dental practice site, these instructions immediately after the extraction include:
- To bite hard on the gauze which is placed over the extraction site for 30 minutes. This gauze is to be removed after 30 minutes and not replaced if bleeding has stopped. Residual bleeding can however, last up to 36 hours and the gauze should be replaced and bitten down hard on for 1 hour if there is still bleeding after the first one is removed.
- To continue swallowing saliva as swallowing saliva will create enough pressure to stop the residual bleeding and stabilize the blood clot. It will Swallowing your saliva will prevent a dry socket and resulting pain.
- To apply a cold compress in the area, 10 minutes on, 10 minutes off in the first hour after surgery. This usually resolves after about 24 hours.
- Do not spit, suck on extraction site, smoke cigarettes, rinse the mouth vigorously, or drink through a straw for at least 4 days. These activities or anything done to disturb the blood clot will lead to delayed healing and dry socket pain.
- Take pain medication and other medications as directed, preferably as soon as possible before the numbness wears off.
What is the effect of smoking after tooth extraction with gauze?
Nicotine, the major component in tobacco which smokers inhale is one of the drugs most extensively consumed in the world. It has well-known harmful effects on all processes related to tissue healing such as; inhibition of development of new blood vessels to replace the damaged ones, delay of repair of the over lining tissue in wound healing, and inhibition of production of collagen which helps to form a bridge over the broken tissues in a wound. These effects will cause a delay in the healing of the wound caused by tooth extraction. A study done on rats on the effect of Nicotine after tooth extraction and oral surgery showed that it caused delay in all aspects of wound healing and regeneration of new gums after the procedure.
Secondly, the sucking action of inhaling smoke and the process of expulsion of the smoke can lead to the dislodgement of the gauze which is placed to promote blood clotting and prevent excessive bleeding. This can cause more bleeding. Also, the clot itself can be dislodged by these actions causing exposure of the extracted site to the air. This will cause a type of pain known as dry socket pain. This situation is characterized by an empty-looking (dry) socket with occasional visible bone in the sockets. It is associated with pain which is severe and radiates from the socket to the ear, eye, temple or neck on the same side of the face as the extraction. There may also be accompanying bad breath or foul odor coming from the mouth. A study comparing people who smoked after tooth extraction and those who did not, reported that the smokers had more pain and for a longer time after the procedure than non-smokers.
If you are a smoker and itching to smoke after tooth extraction, with or without gauze in your mouth, the advice is don’t do it! It will cause some problems for you which may make you feel worse. It is wise to post pone smoking for as long as possible, however, if this is not feasible, at least 72 hours is the minimum acceptable time. this will give the blood clot formed more time to be strengthened and also time for wound healing to be already underway before the harmful effects of Nicotine in the cigarettes kick in.