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A dental extraction (also referred to as tooth extraction, exodontia, exodontics, or informally, tooth pulling) is the removal of teeth from the dental alveolus (socket) in the alveolar bone. Extractions are performed for a wide variety of reasons, but most commonly to remove teeth that have become unrestorable through tooth decay, periodontal disease or dental trauma, especially when they are associated with toothache. Sometimes wisdom teeth are impacted (stuck and unable to grow normally into the mouth) and may cause recurrent infections of the gum (pericoronitis). In orthodontics, if the teeth are crowded, sound teeth may be extracted (often bicuspids) to create space so the rest of the teeth can be straightened.
Two types of extractions can take place, a simple extraction, and a surgical extraction. A simple extraction is performed on a tooth that can be seen in the mouth. During this procedure, the dentist loosens the tooth with an instrument referred to as an elevator. The dentist then uses forceps to remove the tooth. A surgical extraction is done if a tooth may have broken off at the gum line or has not erupted in the mouth. The oral surgeon will make a small incision into the gum to surgically remove the broken tooth or impacted wisdom tooth.
After a dental extraction, the socket left in the gum goes through three stages as it heals. The first stage is the inflammatory stage, where the gum becomes inflamed, a blood clot forms inside the socket, and granulation tissue forms over the wound. New tissue usually replaces the clot within a week after the procedure. The next stage is the proliferative phase when the wound starts to close. Lastly, the maturation stage is where the cells in the site form new structures, bony networks, and connective tissue, called collagen, which populates the healing area.
About three or four days after dental extraction, there may be some swelling and discomfort. By the fifth day, swelling and discomfort should subside, and a normal diet can resume. It may, however, take up to two weeks for swelling to fully disappear. At the two-week mark, the dentist will assess the extraction site in a post-operative checkup, to ensure it has properly healed. Healing time differs for each person and certain factors can affect healing time such as type 2 diabetes, oral radiation treatment, biological profile, certain medications, HIV or another condition causing a weakened immune system.
There are a few helpful practices that can help you experience a speedy recovery including not rinsing your mouth or drinking through a straw for 24 hours after the extraction. On day two, however, you can gently rinse your mouth with a solution of one teaspoon of salt dissolved in a glass of warm water. On day three, you can resume brushing your teeth gently with a soft-bristled toothbrush. Avoid vigorous spitting or rinsing. When eating, chew soft foods on the opposite side of the tooth extraction. If you experience any swelling in your cheek, you can use a cold pack and ice your check for about 30 minutes and then remove it. If you notice that the swelling persists longer than 2 hours, you can use a hot pack in the same way. Avoid smoking or the use of any tobacco products for at three since after your procedure.