An extraction is the surgical removal of a tooth from the jaw.
This is done for a variety of reasons, and is a fairly common procedure in most General Dental offices across the country. Extractions range from "Simple" to "Surgical", with most being surgical. Simple Extractions are usually done for Orthodontic purposes, crowding purposes and some periodontal purposes.
Once the tooth is removed, the socket is cleaned and debrided. A medicine, Chlorhexidine, is used to irrigate the socket and provide a bacteriostatic environment, which is conducive to rapid healing. Dr. Hoffman will then place an antibiotic and bone grafting material into the socket, to allow bone regeneration to occur more completely and rapidly, this grafting process will also reduce post-operative discomfort significantly. Bone grafting allows the patient's bone to remain full, thick, and normal in appearance. This will facilitate better placement of a future implant, bridge, or better fit for a partial denture – all used to restore the area of the extracted tooth. No bone grafting is used in Orthodontic, or crowding, dental cases, as this delays the multidisciplinary care involved.
Extractions do not hurt while being performed, but the area may be slightly sore after the procedure is completed and the anesthesia has worn-off.
Usually, Dr. Hoffman prescribes a day-or-two of medication for discomfort, ensuring you sleep well during the night, and are comfortable during the day. Many times you are not allowed to drive on these various medications, so if you are in doubt, please ask. The level of discomfort most patients state is low, and only last 24-48 hours. On a scale of 0-10, with 0 being asleep, and 10 being the worst pain imaginable, most patients state their discomfort is between a 1-to-3.
There is usually a little blood seepage from the wound for the first 24-hours, so do not sleep on your best pillow covers the first night. Please remember, a little blood, mixed with a lot of saliva, looks like a lot of blood; however, it usually is very normal. Dr. Hoffman will not let you leave without achieving "hemostasis", which means all bleeding is under control and the patient is ready to manage his or her own care at home. Most patients will leave with gauze in place to keep pressure on the extraction site, as well as a possible ice pack, both to keep swelling to a minimum. Please do not forget to remove the gauze from your mouth if you are going to sleep or nap. A patient could potentially choke on that gauze while sleeping and potentially die. Do not forget this, as many patients go home "beat" from the adrenalin associated with the visit, being worried and such (although there is nothing to truly worry about). Please remove the gauze before you lay down to sleep.
Dr. Hoffman will call you the next day, usually in the morning, to see how you are feeling. Most patients feel "just fine" and are back to work, school, and living normally. It is best if heavy lifting is removed from daily living activities for the following 2-5 days, depending on the type of extraction. This is to ensure the clot remains in place and you do not develop alveolar osteitis (AKA: Dry Socket). This is a painful possibility, usually occurring 3-5 days after the procedure is completed. Most patients who smoke are at a greater risk of developing this painful phenomenon. Under normal conditions, will be seen by Dr. Hoffman 10-days after the procedure to remove the sutures and re-evaluate healing. At this time restrictions are relaxed significantly, to completely.