Tooth Extraction

Very occasionally, post-extraction numbness may be permanent. You will be advised about your particular risk of this during your appointment.

Teeth are usually removed with a local anaesthetic in the gum to numb the area. Sometimes a tooth can be extracted very simply, but on other occasions, a small cut in the gum is needed to get the tooth out. If this is necessary, then a drill may also be used to free the tooth. This is very similar to the drill your dentist uses when you have a filling and will not cause any pain or discomfort during the procedure.

The type of anaesthesia will have been discussed with you during your consultation and the appropriate advice given.

Local anaesthetic. If you are having a local anaesthetic your whole appointment should take between one to three hours. This includes you reading and signing the consent form, set up time and clean up afterwards; the actual extraction is much shorter. You will be able to go home once we have officially discharged you.

General anaesthetic. If your teeth are judged to be particularly difficult to remove, then you may be offered sedation or possibly a general anaesthetic. In this case you must come into the unit having eaten nothing for six hours and you will only be allowed clear fluids for the two to six hours before your procedure. You can expect your whole appointment to be between two to four hours depending how quickly you recover from the anaesthetic.

You will be able to go home the same day and you must arrange for someone to drive you. For the first 24 hours:

• Someone should stay with you until the general anaesthetic has worn off.
• Do not drive, operate machinery, or do any potentially dangerous activities (like cooking) until you have fully recovered feeling, movement and co-ordination.
• Do not sign any legal documents or drink alcohol.

An Outpatient appointment is generally made for two to three weeks later. This will be sent through the post.

Discomfort. Once the anaesthetic wears off it will be uncomfortable. This is to be expected but is easily dealt with by taking simple pain relief such as ibuprofen and/or paracetamol regularly. Always read the label for directions, especially if you take other medicines or if you have been given prescription pain relief.

Jaw stiffness. There may be some restriction in opening your mouth wide. This will settle in a few days.

Stitches. These are dissolvable but may take a few weeks to disappear.

Numbness. Some lower teeth may be close to the nerves that supply sensation to the lip and tongue. These nerves can be stretched or bruised when a tooth is removed, causing complete numbness or tingling. This is usually temporary and will have settled by the time your mouth has healed.

As your mouth may be numb, do not drink anything too hot or cold. Avoid chewing on that side of your mouth.

Brushing and rinsing your teeth. You can brush your teeth as normal so long as you are careful around the area. Turn off electric toothbrushes and use the brush head only for the first 48 hours. Do not be tempted to rinse your mouth as it is important to allow the socket to heal and not to damage or lose the clot by eating on that side or letting your tongue disturb it.

After 24 hours it is helpful to rinse your mouth gently with warm salt water (dissolve a teaspoon of kitchen salt in a cup of warm water). Do this for three days after meals.

Dry socket. Be protective of the clot in the empty gap. If this is removed the bony socket walls are exposed and causes something very painful called dry socket. If this happens it is important to see your dentist as they can put a sterile dressing into socket to make it feel more comfortable.

Bleeding. There may be a little oozing of blood for a day or so, making your saliva pink. This is normal but if it starts to bleed properly, apply pressure for 10 minutes with a WET gauze or clean tissue (use tap water to moisten). You may need to do this a couple of times. If the bleeding does not stop then contact your dentist or dial 111 if it is out of hours.

Depending on your occupation/job you may be able to return to work the same day if you have had a local anaesthetic. You may wish, however, to take the rest of the day off. You should take two to three days off work if you have had sedation or a general anaesthetic.

Signs of wound infection may develop after a few days, with increasing pain, swelling and redness, and/or you develop a high temperature. Seek advice from your GP as treatment with antibiotics is usually sufficient