Tooth Extraction Cost, Procedure, Reasons and Aftercare for Good Healing

A toothache from decay that has reached the nerve, or a molar that has cracked open, sends many people to the dentist, only to learn that the tooth needs to be extracted. Losing a tooth understandably worries people. They are afraid it will hurt, worried about possible complications and unsure how to look after the wound so it heals well.

In this article, Smile and Co answers the common questions about tooth extraction: what patients need to know, why a dentist may recommend removing a tooth, and how to care for yourself after the extraction. Here is our dentists’ advice.

Tooth Extraction, the Last Step in Treating a Tooth

Tooth extraction is a form of oral treatment in which a tooth that cannot be treated, or that may cause problems in the future, is removed from its socket in the jawbone. Teeth are extracted for many reasons, and the difficulty varies with the reason and with the position of the tooth.

Is Tooth Extraction Dangerous?

Tooth extraction is not dangerous when it is carried out by a qualified dentist. Pulling a tooth yourself, on the other hand, carries risks such as infection or gum inflammation. It is better to have a dentist diagnose the problem first. If the tooth does need to come out, modern, clean instruments in the hands of an experienced dentist keep the procedure as safe as possible and reduce the risks.

Risks and Effects of Tooth Extraction

Even when a dentist performs the extraction, there are still some risks and effects, for example:

• Infection, which can spread to the face or other organs
• A reduced ability to chew food
• If many teeth are lost in several places, the remaining teeth may press on the gums and cause inflammation more easily
• For some people, losing a tooth affects their confidence and how they feel about their appearance

What Is the Difference Between Tooth Extraction and Surgical Removal?

A simple extraction is usually done on a tooth that has come through the gum normally. Surgical removal is for a tooth that cannot come through the gum normally, or one that cannot be extracted in the usual way. The tooth is removed surgically and the wound is stitched closed afterward.

What Is an Impacted Wisdom Tooth?

Wisdom teeth are the permanent teeth at the very back of the jaw. Some come through the gum normally. Others cannot, because bone or gum tissue blocks the way, or because the tooth is tilted and pushing against the tooth next to it.

Reasons for Tooth Extraction

A tooth may need to be extracted for several reasons, such as:

• Extraction as part of orthodontic treatment
  For patients who want braces, whether to change the look of the face or for a slimmer face shape, and who have crowded or crooked teeth, the dentist plans which teeth to extract and how many. This creates space to realign the teeth, prevents neighboring teeth from being pushed out of place in the future, and lets braces, such as metal braces, work more effectively.
• Extraction because of other dental problems
  For example, if decay has reached the nerve and the tooth cannot be saved with root canal treatment and a crown, it may need to be extracted to stop the disease from spreading to neighboring teeth. Wisdom teeth may also be removed to lower the chance that they push against nearby teeth and make them tilt in the future.
• Extraction because of gum disease
  Gum disease, such as periodontal disease, is caused by bacteria and other microorganisms that build up on the teeth. Left untreated, it leads to swollen, irritated gums, gum recession and tooth sensitivity, and the infection may spread to the bone that holds the teeth in place. In the end, the tooth may have to be extracted.
• Extraction because of an accident
  If a tooth takes a hard blow in an accident and breaks, leaving too little tooth structure to repair with a filling or crown, it has to be extracted instead.

Who Should Not Have a Tooth Extracted?

Patients who cannot have a tooth extracted, or who should tell the dentist before treatment, fall into 3 main groups.

• People with diabetes whose blood sugar is poorly controlled People who cannot control their blood sugar well, such as those with diabetes, heal more slowly and get infections more easily than others. Diabetic patients with blood sugar of 90–200 mg/dl can still have extractions or minor surgery. Even so, it is wise to tell the dentist about any medical conditions beforehand, so the team can take precautions and prepare for treatment.
• People whose condition may flare up during dental treatment, such as epilepsy, high blood pressure, asthma or heart disease, as they may become breathless, have palpitations or feel chest pain during treatment People who bleed easily or whose bleeding is slow to stop, such as those with leukemia or a low platelet count, people who have had a heart valve replacement, people taking certain medications such as blood thinners, and people with kidney disease or a history of dialysis

How to Prepare for a Tooth Extraction

1. Look after your health. Get enough sleep and eat nutritious food.
2. Give the dentist a full and honest medical history. If you have a medical condition such as high blood pressure, diabetes or heart disease, let the dentist know for your safety.
3. Eat beforehand, since you may feel too sore to eat after the extraction. After eating, brush your teeth well before your appointment.
4. Avoid wearing jewelry or makeup.

Tooth Extraction Procedure

1. The dentist examines the tooth and decides whether it should be extracted. An X-ray may also be needed.
2. Your blood pressure is measured, because very high blood pressure can cause unusually heavy bleeding and can be dangerous. If your blood pressure is high, the extraction has to be postponed.
3. Once the extraction is confirmed, the dentist applies a numbing gel and then gives a local anesthetic injection. You may feel a slight pressure.
4. When the area is numb, the tooth is extracted. Once it is out, you bite on sterile gauze for about 30–60 minutes until the bleeding stops.
5. The dentist then goes through the aftercare instructions with you in detail.

What Does the Socket Look Like After an Extraction?

After an extraction, the wound is a hollow shaped like the root of the tooth that was removed. Blood in the socket starts to clot, and platelets gather to help stop the bleeding.

Aftercare Following a Tooth Extraction

• Right after the extraction there may still be some bleeding. Bite firmly on gauze until it stops.
• Hold an ice pack against the outside of the face over the extraction site for about 15–20 minutes at a time, with a break in between, during the first 24–48 hours to reduce pain and swelling.
• Do not push at the wound with your tongue or suck on it, and do not spit out saliva or blood, as this makes the bleeding worse.
• Do not use mouthwash for the first 6 hours, and do not rinse with any liquid for 12 hours. After 12 hours, you can rinse with salt water.
• Avoid strongly flavored or spicy food and choose soft food for the first 2–3 days to avoid irritating the wound.
• Avoid alcohol and smoking.
• Take pain relief medication as your dentist directs.

How Much Does a Tooth Extraction Cost?

The price of an extraction depends on several factors, such as the position of the tooth, the angle it sits at, severe gum inflammation or a cyst, so costs vary. At Smile and Co, tooth extraction starts at 1,000 – 2,000 THB.

How to Stop Bleeding After a Tooth Extraction

If the extraction site bleeds, bite firmly on gauze over the area for about 30–60 minutes. If it is still bleeding after that, replace the gauze with a fresh piece until the bleeding stops. Also avoid spitting out blood or saliva, as this can start the bleeding again.