In Surgery Procedure for Simple Tooth Extractions

Simple Tooth Extractions

Once a patient has agreed to treatment their medical history is updated and radiographs are taken to provide the dentist with all relevant information to ensure treatment is possible to take place in surgery. Simple tooth extractions require only one visit to the surgery and are often a relatively quick treatment. Once the surgery (relevant sterile instruments and materials set up for use) and patient have been prepared by the dental nurse, the procedure can begin.

Typical In- Surgery Tooth Extraction Procedure

  • Local anaesthetic is administered
  • Elevators of dentists’ choice are used between the gum and sides of the tooth concerned to loosen the tooth from its supporting and surrounding structures
  • Once the tooth is relatively mobile, forceps shaped for a specific tooth are held in a specific position on the tooth
  • The dentist pushes and may rotate or lever the forceps while in place, to further loosen it in its socket
  • The tooth is removed
  • The socket is squeezed by the dentist to encourage any bleeding to stop, and to encourage the gum tissue to heal
  • A sterile bite pack – either gauze, cotton wool, or both, is placed over the socket and the patient is instructed to bite down onto it for ten minutes
  • The dentist then removes the bite pack and checks that the bleeding has stopped (haemostasis has been achieved)
  • The patient is given written post operative instructions and spare sterile bite packs in case of further bleeding

Post operative instructions given to patients are a basic list of ‘do’s and don’ts’ for patients to follow after extraction. An example of these instructions is given below;

  • Do not rinse the area of extraction for at least 24 hours
  • Do not drink alcohol for 24 – 48 hours
  • Do not do any strenuous exercise for 24 – 48 hours following extraction
  • Do not drink very hot fluids for at least 24 hours
  • All of the above may disturb the blood clot which forms in the socket and allows healing to occur
  • Do start to use a hot salty mouthwash after meals after 48 hours
  • If bleeding occurs, place a bite pack (provided) over socket and bite down for 20 minutes
  • If bleeding persists contact the surgery for advice (telephone number provided for out of hours)
  • If painful take painkillers that would normally be taken for a headache (avoid aspirin)
  • (Remember that blood mixed with saliva can look like there is more blood than there really is!)

The dentist may ask the patient to book another appointment within the next few weeks to review healing and to discuss possible treatment options to fill the gap created by extraction.

About the author

I’ve been a dental nurse for over 13 years, and have worked in various parts of the country in orthodontic practices, general dental practices, within the community dental services, for both NHS and private practices. Within that time I’ve seen quite a few changes, not only with the way services are provided, changes in laws and regulations but also with the use of new materials and more advanced treatments. The one thing that hasn’t changed at all in my time as a dental nurse is the importance of people receiving and understanding clear information about dentistry, treatments, regulations and jobs for example.

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