Tooth Extraction in Singapore

What is a tooth extraction?

A tooth extraction is a dental procedure in which a tooth is removed from its socket in the jawbone. The procedure is typically performed by a dentist or an oral and maxillofacial surgeon when a tooth is damaged, decayed, infected, or causing other dental issues.

How do you know if you need a tooth extraction?

There are several reasons why a dentist might recommend a tooth extraction. Here are some common reasons:

1. Tooth decay: 

   • Extensive tooth decay that has damaged a tooth beyond repair may necessitate extraction. If the decay extends to the pulp (innermost part of the tooth containing nerves and blood vessels) and there is insufficient tooth structure remaining, extraction may be recommended.

2. Gum disease: 

   • Advanced gum disease (periodontal disease) can lead to the loss of bone support around the teeth. In some cases, this loss of support can be extensive which result in the tooth becoming shaky and loose. Hence, an extraction may be necessary to prevent further complications.

3. Infection: 

   • A tooth that is severely infected, especially when the infection has extended to the pulp (the portion of the tooth that contains nerves and blood vessels), may require extraction if root canal therapy is not a viable option.

4. Impacted wisdom teeth: 

   • Wisdom teeth, also known as third molars can be impacted whereby they have insufficient space to fully emerge or grow properly. This can cause pain, swelling, and potential damage to surrounding teeth. In such cases, extraction may be recommended.

5. Pre-orthodontic treatment: 

   • Sometimes, orthodontic treatment may require the removal of one or more teeth to create space for proper alignment.

6. Trauma: 

   • If a tooth is severely damaged due to trauma, such as a sports injury or accident, and cannot be effectively restored, extraction may be necessary.

7. Failed previous treatments: 

   • If previous dental treatments have failed to resolve issues with a tooth, extraction might be considered as a last resort.

8. Preventive reasons: 

   • In some cases, tooth extraction may be recommended as a preventive measure to avoid potential future problems, especially in individuals with compromised immune systems or before certain medical treatments.

It is important to note that tooth extraction is typically considered when all other options for preserving the tooth have been exhausted. Dentists will thoroughly evaluate the situation and discuss the reasons for extraction, as well as potential replacement options if needed. It is vital to inform your dentist if you have any underlying medical conditions, are on any medications or have any allergies especially if you have had allergic reactions to medications, anaesthesia, or any dental materials, prior to the procedure.

Tooth extraction procedure: What happens during an extraction?

The specific method of tooth extraction can vary depending on the tooth's location, the condition of the tooth, and the complexity of the extraction. There are two main types of tooth extractions: simple extractions and surgical extractions.

Simple extraction

1. Local anesthesia: At the start of the procedure, the dentist will administer a local anesthetic to numb the area around the tooth. This ensures that discomfort is minimised during the extraction.

2. Loosening the tooth: Using an instrument called an elevator, the dentist gently loosens the tooth from its socket.

3. Extraction with forceps: Once the tooth is sufficiently loosened, the dentist uses forceps to grasp the tooth and remove it from the socket.

4. Gauze placement: After the extraction, the dentist will place a piece of gauze over the extraction site and ask you to bite down firmly to help control bleeding and encourage blood clot formation. This is an essential step for wound healing.

Surgical extraction

• Anesthesia: Depending on the complexity of the extraction, the dentist or oral surgeon may use local anesthesia, conscious sedation, or general anesthesia.

• Incision: In some cases, particularly for impacted teeth or those not easily accessible, the dentist may need to make a small incision in the gum tissue to access the tooth.

• Bone removal: If necessary, the dentist may need to remove a small amount of bone around the tooth or divide the tooth into sections to facilitate extraction.

• Suturing: After the tooth is extracted, the dentist may place sutures to close the incision.

• Gauze placement: Similar to a simple extraction, gauze is placed over the extraction site to control bleeding.

What to expect after a tooth extraction? 

After a tooth extraction, it is essential to follow proper care instructions to promote healing and prevent complications. Here is what you can generally expect:

1. Bleeding: 

   • Some bleeding is normal after the extraction. Your dentist will provide you with some gauze to bite down on to help control bleeding. Change the gauze as instructed.

2. Swelling: 

   • Swelling around the extraction site may occur. You can use an ice pack wrapped in a thin cloth to reduce swelling. Apply it for 15-20 minutes at a time, with breaks in between.

3. Pain: 

   • Pain and discomfort are common after a tooth extraction. Your dentist may prescribe pain medication or recommend over-the-counter pain relievers. Follow the prescribed dosage and instructions.

4. Rest: 

   • Take it easy for the first 24 hours after the extraction. Avoid strenuous activities, as they can increase bleeding and delay healing.

5. Diet: 

   • Stick to soft foods for the first few days. Avoid hot or spicy foods, alcohol, and do not drink through a straw, as this can dislodge the blood clot that forms in the socket, leading to a painful condition called dry socket.

6. Oral hygiene: 

   • Follow your dentist's instructions for oral care. Avoid vigorous rinsing, spitting, or using a straw for the first 24 hours. After 24 hours, gentle warm saltwater rinses are recommended to cleanse the extraction site to minimise the risk of infection.

7. Medication: 

   • Take any prescribed antibiotics as directed to prevent infection.

8. Follow-up: 

   • Attend any follow-up appointments scheduled by your dentist. They will monitor your healing progress and address any concerns.

9. Complications: 

   • While complications are rare, it is crucial to be aware of signs of infection (increased pain, swelling, redness, or discharge) or dry socket (severe pain a few days after the extraction). If you experience any unusual symptoms, contact your dentist promptly.

Remember that individual experiences may vary, and it is essential to follow your dentist's specific post-operative care instructions. If you have any concerns or questions, do not hesitate to reach out to your dental care provider.

Tooth extraction aftercare: How to take care of an extraction wound and what to avoid? 

After the extraction, it is essential to follow the dentist's post-operative care instructions, which may include:

• Taking prescribed medications (such as pain relievers or antibiotics).

• Applying ice on the face near the extraction site to reduce swelling.

• Maintaining good oral hygiene practices without disturbing the extraction site.

• Attending follow-up appointments to monitor healing.

• Avoiding hot or spicy foods, drinking alcohol, and drinking through a straw.

• Avoid strenuous physical activities.

• Refrain from smoking and using tobacco products, as they can delay healing and increase the risk of complications.

It is important to note that while discomfort and swelling are normal after a tooth extraction, severe pain, prolonged bleeding, or other unusual symptoms should be reported to your dentist promptly.

It is always advisable to discuss any concerns or questions about the tooth extraction procedure with your dentist beforehand. They can provide personalised information based on your specific situation.

FAQ

Why is a tooth extraction necessary?

Tooth extractions may be necessary due to various reasons, including severe tooth decay, advanced gum disease, impacted wisdom teeth, crowding, or trauma. Your dentist will recommend extraction if preserving the tooth is not feasible or is detrimental to your overall oral health.

Is tooth extraction painful?

Dentists typically use local anaesthesia to numb the area around the tooth, ensuring you do not feel pain during the extraction. You may feel pressure or some sensations, but it should not be painful. If you are anxious, your dentist may offer additional sedation options.

How long does a tooth extraction take to complete?

The actual extraction usually takes a short amount of time, often less than 30 minutes. However, the overall appointment time may be longer, considering pre-extraction preparations and post-operative instructions.

How long does it take to heal from a tooth extraction?

The initial phase of healing usually takes a few days to a couple of weeks, while full recovery of bone and soft tissues may extend over several weeks to months. The speed of recovery depends on factors such as the type of extraction, your overall health, and your adherence to post-operative care instructions.

What is a dry socket, and how can it be avoided?

A dry socket occurs when the blood clot, formed after a tooth extraction, becomes dislodged or dissolves prematurely, leaving the underlying bone and nerves exposed. This condition can cause intense pain. To minimise the risk of a dry socket, follow your dentist's post-operative care instructions. This includes refraining from activities that may disturb the blood clot, such as using straws and excessive rinsing.

What kind of food to eat after tooth extraction?

In the initial stages of recovery, you should opt for soft foods and avoid hot or spicy items. As you heal, reintroduce a regular diet gradually. Follow your dentist's recommendations regarding the timing and selection of foods to promote a smooth recovery process.

When can I resume my usual activities after a tooth extraction?

During the initial 24 hours, prioritise rest and steer clear of strenuous activities. After that, slowly ease back into your regular routine based on your comfort level. Avoid vigorous exercise and activities that could impact the healing site for a few days.

What should I do if I experience prolonged or severe pain after the extraction?

It is normal to experience some discomfort, but severe or prolonged pain may indicate complications like infection or a dry socket. Contact your dentist promptly if you have any concerns about pain or notice unusual symptoms.

Always consult with your dentist for personalised advice and information based on your specific situation.