A basic surgical procedure in which severely damaged or infected teeth that cannot be restored are removed from their socket with special instruments after local anesthesia.
Indication
- Teeth that cannot be restored (filling, root canal, crown) due to advanced decay
- Loose teeth due to advanced periodontal disease
- Root fractures after trauma that cannot be saved
- Need for serial extraction as part of orthodontic treatment planning
- Persistent (non-shedding) primary teeth and normally positioned teeth that obstruct eruption
Preparation
- Inquiry about medical history, medications used (especially blood thinners and bisphosphonates) and systemic diseases
- Pre-procedure evaluation with panoramic or periapical radiograph
- Adjustment with physician approval in patients using blood thinners
- Antibiotic pretreatment when needed if active infection is present
- Eating a light meal before the procedure (it is recommended not to come fasting)
How it's performed
- Local anesthesia is administered around the tooth to be extracted
- The gum, periosteum and periodontal ligament are loosened with special instruments
- The tooth is removed from the alveolus with controlled movements using elevators and forceps
- The socket is inspected, and any infected tissue or bone fragments are cleaned out
- A sterile gauze is placed for bleeding control and the patient is asked to bite for 30-45 minutes
Post-procedure
- Bite the gauze for the first 30-45 minutes; for the first 24 hours avoid rinsing, spitting and sucking movements (dry socket risk)
- No smoking or alcohol for the first 24 hours
- Cold application for swelling and pain control, with painkillers as recommended by the physician
- Warm and soft foods on the first day, gradually returning to normal nutrition in the following days
- If sutures were placed, follow-up within 7-10 days; physician evaluation at the end of the healing period for prosthesis/implant planning
Risks
- Bleeding, pain and swelling after extraction (usually subsiding within the first 24-72 hours)
- Alveolar osteitis (dry socket) — more common in smokers
- Infection of the socket
- Transient sensitivity or rarely damage to neighboring teeth
- Rare allergic reactions to anesthetic agents
FAQ
Is tooth extraction painful?
Because the procedure is performed under local anesthesia, no pain is felt; only a sensation of pressure may occur. Pain that may appear after the anesthesia wears off is controlled with the recommended painkillers.
When can I eat after extraction?
It is recommended not to eat anything for the first 2 hours, then to prefer warm and soft foods on the first day. Chewing on the extraction site should be avoided.
Do I need to fill the gap?
Leaving a gap after extraction of permanent teeth can lead to shifting of neighboring teeth and chewing problems. Implant, bridge or denture options should be evaluated together with your physician.
I smoke; when can I smoke again?
Smoking adversely affects the risk of dry socket and the healing time. It is recommended to avoid smoking for at least 48-72 hours; abstaining for longer significantly improves healing.
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