Exodontia or Tooth extraction
The tooth extraction or exodontia refers to the removal of tooth or tooth roots with minimum pain, discomfort and trauma to the patient.
The tooth extraction or exodontia is performed because of one of the following reasons.
- Grossly decade or infected tooth because of dental caries
- Pulpitis (Inflammation of the dental pulp)
- Periapical inflammation of the periodontal tissues
- Abscess because of periapical inflammation and pericoronitis (inflammation of soft tissues around partially erupted tooth)
- Cracked or Fractured tooth
- Tooth associated with numerous pathologies such as tumors, cysts, and fracture of bones of the jaw
- Grossly displaced, Impacted tooth and supernumerary tooth
- Part of the orthodontic treatment plan
- Retained deciduous tooth
Post Extraction care
The post tooth extraction care instructions add less than ten minutes to the patient appointment time but these instructions are of paramount importance as these tooth extraction aftercare instructions minimize the negative sequelae of tooth extraction and resulting patient discomfort. These post-extraction instructions also reduce the overhead costs that are associated with the removal of a tooth.
The following are the evidence-based guidelines for post tooth extraction care of the extraction site. These post-extraction instructions not only apply to the normally extracted tooth but the same also applies to surgical extractions including wisdom tooth extractions.
Following these guidelines as mentioned reduce the post-extraction costs but also fasten the healing process after tooth removal.
Haemorrhage Control
Bite firmly on moistened gauze placed on the tooth extraction site. The gauze is placed to control the bleeding from the tooth extraction site. Bite firmly on the gauze pack for at least 20 to 25 minutes and avoid chewing the gauze or opening the mouth.
It is normal for the tooth extraction site to ooze slightly up to 24 hours after tooth removal.
Spitting and Rinsing
Avoid rinsing with water or any other medicated solution or spitting saliva for 24 hours post-extraction as it may dislodge the newly formed clot and trigger bleeding from the extraction site.
After twenty-four hours rinse the mouth with a glass of warm saline water for a three to four times a day for a week.
Food and Drinks
Do not eat any food immediately after tooth removal as the tooth extraction area is under the effect of local anesthesia and there is a chance of injury to oral soft tissues. Avoid hot food, fluids, carbonated drinks, and hard food. Instead, choose a cool, soft and liquid diet with high calorie and fluids. The soft diet keeps the tooth extraction area comfortable by preventing trauma and bleeding from the tooth extraction site and hasten the healing process.
For two to three days after tooth removal chew the food from the opposite side of the dental arch. The patient should be advised to avoid using a straw while drinking as this creates negative intraoral pressure that may dislodge the newly form clot and results in bleeding from the tooth extraction site.
Smoking
Those who smoke should avoid smoking for at least 24 hours post-extraction. As tobacco smoke and nicotine interfere with the formation of clots and delay the process of wound healing at the tooth extraction site.
Medications
To avoid pain and discomfort after tooth removal take the medicines as prescribed and do not modify the drug dose, add other drugs or stop using the medication. Do not locally apply any medication at the tooth extraction site for pain relief or rapid healing as it may cause harm to the soft tissues.
The initial or first dose of medication short be taken earlier post-extraction this prevents discomfort before the effect of local anesthesia disappears. These medications are for the relief of the post-extraction pain but also reduces inflammation and swelling.
Oral Hygiene Maintenance
As part of post-extraction care, the mouth should be kept clean as possible as this reduces the microbial load, reduces food particles and dead cells and helps in healing of the tooth extraction site. After tooth extraction, the brushing of the teeth that are away from the tooth extraction site can be performed as usual. Brushing of teeth adjacent to the tooth extraction site should be avoided after tooth extraction to prevent pain and bleeding from the tooth extraction site. Resume the normal tooth brushing routine, use of floss and mouthwash 2 to 3 days post-extraction.
After 24 hours of tooth extraction gently rinse the mouth with a warm saline rinse or any other rinse recommended by the doctor. The water should be warm and not hot to prevent burn or damage to the tissues. Rinse the oral cavity with the warm saline for at least three times a day especially after meals for one week.
Rest
The strenuous exercise or work should be avoided for 12 hours post-extraction because strenuous work or exercise may result in increased bleeding from the extraction site. Keep your head in a slightly upright position on the pillow.
Post extraction follow up
The patient should visit the dentist within 1 week or as advised after tooth extraction to check the progress of the healing of the tooth socket. Besides, if the sutures were placed after tooth extraction they will be removed from the tooth extraction site during this follow up appointment.
It is advisable to give the patients written post-extraction care instructions in addition to the verbal instructions. These written post tooth extraction instructions should also contain the operating dentist or dental practice telephone number and email address. So the patient may contact in case of any concern or query.