Tooth Extractions

Dr. Hoffman may determine that you need a tooth extraction for any number of reasons. Dr. Hoffman has extensive experience extracting teeth from her hospital-based residency training at Brigham and Women’s Hospital in Boston, MA. Extractions are only done at Silver Maple Dental when they provide the best outcome for the patient. Teeth may be extracted due to large cavities, advanced periodontal disease, fractures, or poor positioning (impacted teeth or in preparation for orthodontics).  By removing a tooth for any of the above reasons, you can reduce the risk of infection. 

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 and systemic health. Prior to an extraction, Dr. Hoffman will discuss alternatives to extractions as well as replacement of the extracted tooth. These options can include implants, bridges, partial dentures, and/or full dentures.

The Extraction Process

Dr. Hoffman will numb your tooth, gums, and bone prior to extraction.  She always checks that it is fully numbed prior to beginning. During the extraction process you will feel a lot of pressure. Dr. Hoffman has been a patient during this procedure many times due to rough-housing with her brothers.  She will do her best to ensure that you have a positive experience.

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, insert  another gauze pad and bite firmly for another 30 minutes. You may have to do this several times to staunch the flow of blood. This action is called pressure hemostasis.

After the blood clot forms it is important not to 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. Smoking after extractions increases the risk of alveolar osteitis or dry socket. Dry socket typically occurs 3-5 days after an extraction and is caused by the inability of a clot to form.  It can be more painful than the extraction itself and takes time to treat. We strongly advise you not to smoke for at least 1week post-operative.

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. Dr. Hoffman will recommend NSAIDS such as ibuprofen for pain. These medications are most effective at treating inflammation. She will rarely prescribe an opioid for pain.  The swelling usually subsides after 48 hours.

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. There are times when Dr. Hoffman will prescribe an antibiotic prior to an extraction if the area is highly infected . This will reduce the swelling prior to proceeding with the extraction and make the anesthesia at the time of the extraction more effective. Drink lots of fluids and eat nutritious, soft food on the day of the extraction. We advise eating soft foods such as yogurt, smoothies, lukewarm soup, eggs, and pasta for up to 1 week after an extraction.

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. Avoid brushing directly over the extraction site. 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. For patients of record our on-call number is (575) 568-7225.