Tooth Extractions

You and Dr. Yowell or Dr. Buckbee may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.

To avoid these complications, in most cases, Drs. Yowell or Buckbee will discuss alternatives to extractions as well as replacement of the extracted tooth.

The Extraction Process

At the time of extraction the doctor will need to numb your tooth, jaw bone and gums that surround the area with a local anesthetic.

During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.

You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.

If you do feel pain at any time during the extraction please let us know right away.

Sectioning a Tooth

Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.

After Tooth Extraction

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. Bite on a gauze pad for 30-45 minutes immediately after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times to staunch the flow of blood.

After the blood clot forms it is important to not disturb or dislodge the clot. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities may dislodge or dissolve the clot and hinder the healing process. Limit vigorous exercise for the next 24 hours, as this increases blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.

Use pain medication as directed. Call our office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time even if signs and symptoms of infection are gone. Drink lots of fluids and eat nutritious, soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

After a few days you should feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately.

ORAL HYGIENE AT THE SURGICAL SITE: 

  • It is important to maintain a high level of oral hygiene after dental surgery. Normal brushing and flossing procedures should be followed throughout the mouth EXCEPT in the area where surgery was performed. This reduces the accumulation of bacteria (plaque), reduces the chances of infection, and minimizes unpleasant mouth odor. Unless otherwise directed do not brush or floss the surgical site for 1 week. 

RINSING:

  • Avoid all rinsing for 12 hours after extraction. This is to ensure the formation of a healing blood clot which is essential to proper wound healing. Disturbance of this clot can lead to increased bleeding or the loss of the blood clot. If the blood clot is lost, a painful condition called a dry socket may occur. 
  • DO NOT RINSE VIGOROUSLY or SPIT EXCESSIVELY as this disturbs the surgical area and delays healing.
  • Start rinsing your mouth gently every 6 hours with warm salt water rinses (1/2 teaspoon salt with 1-cup water) beginning the day after surgery. Continue this for several days, then rinse 3-4 times a day for the next 2 weeks.

PAIN: 

  • Varying amounts of discomfort for 1-3 days after surgery is normal.  How much and how long it lasts depends on the type of surgery done, how long it took, and your unique response to it.  Take any pain medication prescribed as directed. The local anesthetic administered during your surgery normally is effective for several hours. We recommend you take some pain medication before the local anesthesia effects wear off. Taking the pain medication with soft food and a large volume of water will lessen any side effects of nausea or stomach upset. 
  • Unless directed otherwise, take 800mg (4 tablets of 200mg) ibuprofen three times per day for the first 24-48 hours. 
  • Do not take the medication on an empty stomach. 
  • Norco contains codeine or a similar narcotic, and can make you feel light-headed and nauseous.  Take proper precautions while taking these medications (i.e. do not drink alcoholic beverages, operate an automobile, etc.) 

BLEEDING: 

Some bleeding is normal, and blood-tinged saliva may be present for 1-2 days following surgery.  Placing fresh, moistened gauze over the surgical area and biting down firmly for 30-60 minutes should control bleeding. If bleeding persists. This may be due to the gauze pads being clenched between the teeth rather than exerting pressure directly on the surgery site. Try to reposition the gauze. 

  • To prevent excessive bleeding follow these steps: 
  • Don’t spit vigorously or use a straw for 7 days after the surgery.
  • Avoid strenuous activity for 2-3 days as it can increase blood pressure and trigger excessive bleeding.
  • Do not rinse for the first 24 hours.  
  • Slow oozing of blood is expected and you may notice blood in your saliva for 1-2 days.  If you notice continued bleeding, apply biting pressure with clean rolled-up gauze to the area for 30 minutes.  If bleeding persists or becomes heavy, substitute a moist tea bag (first soaked in water, squeezed and dry and wrapped in moist gauze) on the area for 20-30 minutes. If these attempts are unsuccessful and the bleeding is excessive, please call our office. 

SWELLING & BRUISING: 

  • Some swelling and/or bruising after surgical procedures is normal.  Usually this swelling can be limited by the application of an icepack extra orally to the side of your face over the surgical area.  Apply for 10-15 minutes at a time, once or twice per hour during first 24 hours after the surgery.  Sleep with your head propped up for the first two nights. 

DIET: 

  • Restrict your diet to soft foods and liquids for 1 week, unless directed otherwise. Remember, adequate nutrition is essential for feeling better as well as for healing.  
  • Avoid eating hard crunchy, spicy, acidic foods, popcorn, peanuts, strawberries, or food with tiny seeds or kernels (chia seeds, poppy seeds, sesame seeds). 
  • Do not drink through a straw. 
  • No tobacco products (cigarettes, chewing tobacco, snuff, etc.) for 2 weeks.  Use a nicotine patch if necessary. 

Tobacco products will promote bleeding and interfere with healing. 

FEMALES: If you were prescribed an antibiotic and are currently taking oral contraceptive, you should use an alternate method of birth control for the remainder of this cycle as certain antibiotics can interact with your oral contraceptive and lead to pregnancy. 

NAUSEA:  If any nausea develops, take an over the counter Dramamine tablet at the first sign. 

EMERGENCIES: 

  • If you are experiencing an emergency during our office hours call the clinic at (620) 241-0842.
  • After hours, and for emergencies only, please call our office at (620) 241-0842. A 24-hour live answering service will answer and relay the information to one of the doctors who will be in touch with you as soon as possible. 

IMPORTANT DRUG INFORMATION, PLEASE READ 

Ibuprofen (Advil/Motrin): This is a medication used to control mild to moderate pain.  The medication also has an anti-inflammatory action, helping to decrease swelling and inflammation at surgical sites.  It works best when taken before the surgery followed by consecutive doses.  The major side effect of Ibuprofen is stomach upset.  Take Ibuprofen with meals or with milk to lessen this complication.  If you are prone to stomach ulcers, take this medication cautiously and discontinue if you have any stomach pain, nausea, or vomiting.  Do not take Ibuprofen if you have had any allergic type reactions (itching, swelling, rash, difficulty breathing, etc.) after taking Advil, Motrin, aspirin, or other non-steroidal anti-inflammatory medications.  

**Do not take ibuprofen if you are pregnant or nursing. Speak with your doctor about other ways to manage your post-operative pain. 

 

Non-Narcotic Pain Management Alternating dosage of over the counter Ibuprofen and Tylenol every 4 hours has been scientifically shown to be just as effective as narcotics for management of pain. Please use the following regimen as long as your medical doctor has not given you any restriction to the use of Ibuprofen and/or Tylenol. 

Ibuprofen 600mg  🡪 4 hrs 🡪  Tylenol 325mg  🡪 4 hrs 🡪  Ibuprofen 600mg  🡪 4 hrs 🡪  Tylenol 325mg 

 

Norco (Hydrocodone + Acetaminophen) This medication is used to control moderate to severe pain. This medication may make you drowsy, so avoid operating any machinery, making business decisions, or driving while taking this medication.  Take 1 tablet every 4-6 hours for the pain. This medication may be taken in conjunction with ibuprofen (generic or brand name Motrin or Advil). You CANNOT take Tylenol in addition to this medication. This medication is optional and not necessary if the ibuprofen is sufficient to manage your pain. There is a potential for addiction to this medication, so please only fill this medication if absolutely necessary. Destroy any unused medication by returning to a pharmacy.