Tooth extraction and wisdom teeth

Reasons a tooth may need to come out

• Decay too extensive to repair with a filling, crown or root canal
• Severe periodontal (gum) disease with bone loss, leaving the tooth loose
• A fracture that runs below the gumline
• Infection that cannot be resolved by root canal therapy
• Wisdom teeth that are impacted, partly through the gum, decayed or repeatedly infected
• Making room before orthodontic treatment

Regular and surgical extractions

A regular extraction removes a tooth that is fully through the gum, under local anaesthetic, usually in a single short visit. A surgical extraction is needed when a tooth is broken at the gumline, has curved roots, or is impacted, as many wisdom teeth are; a small incision in the gum and sometimes sectioning of the tooth allow it to be removed gently. Both are done here in the office. For complex impacted wisdom teeth, or if you would prefer general anaesthesia, we refer to an oral surgeon.

Wisdom teeth

Not every wisdom tooth needs removing. If yours have come through straight and can be cleaned, we simply keep an eye on them. Removal is recommended when they are impacted, trapping food and causing infection (pericoronitis), damaging the tooth in front, or developing decay that cannot be treated. A panoramic X-ray shows their position and their relationship to the nerve in the lower jaw.

Aftercare

• Bite on the gauze for 30 to 45 minutes to let a clot form; avoid rinsing, spitting, smoking or drinking through a straw for 24 hours
• Take the pain relief we recommend before the freezing wears off
• Soft, cool foods for the first day; then chew away from the site
• From the next day, rinse gently with warm salt water after meals
• Call us if pain gets worse after day three, if bleeding does not stop, or if you have swelling with fever. These are not normal and we want to see you

Replacing the tooth

Unless it is a wisdom tooth, we will discuss whether and how to replace the tooth (an implant, bridge or denture) so that the neighbouring teeth do not drift and your bite stays balanced.