Tooth extraction

What to tell your dentist before you have a tooth extracted

Although having a tooth out is usually very safe, the procedure can allow harmful bacteria into the bloodstream. Gum tissue is also at risk of infection. If you have a condition that puts you at high risk for developing a severe infection, you may need to take antibiotics before and after the extraction. Before having a tooth removed, let your dentist know your complete medical history, the medications and supplements you take, and if you have one of the following:

damaged or man-made heart valves

a congenital heart defect

an impaired immune system

liver disease (cirrhosis)

an artificial joint, such as a hip replacement

a history of bacterial endocarditis

After you've had a tooth extracted

Following an extraction, your dentist will send you home to recover. Recovery typically takes a few days. The following can help minimise discomfort, reduce the risk of infection and speed recovery.

Take painkillers as prescribed or over the counter products suggested by your dentist - such as ibuprofen, aspirin or paracetamol.

Bite firmly but gently on the gauze pad placed by your dentist to reduce bleeding and allow a clot to form in the tooth socket. Change gauze pads if they become soaked with blood Otherwise, leave the pad in place for three to four hours after the extraction.

Apply an ice bag to the affected area immediately after the procedure to keep down swelling. Apply ice for 10 minutes at a time.

Relax for at least 24 hours after the extraction. Limit activity for the next day or two.

Avoid rinsing or spitting for six hours after the extraction to avoid dislodging the clot that forms in the socket.

After six hours, gently rinse your mouth with a solution made of half a teaspoon of salt in a glass of warm water.

Do not drink from a straw for the first 24 hours.

Do not smoke, as it can inhibit healing.

Eat softer foods (such as soup or yoghurt) the day after the extraction. Gradually add solid foods to your diet as the extraction site heals.

When lying down, prop your head up with pillows. Lying flat may prolong bleeding.

Continue to brush and floss your teeth, and brush your tongue, but avoid the extraction site. Doing so will help prevent infection.

When to call the dentist

It is normal to feel some pain after the anaesthesia wears off. For 24 hours after having a tooth out, you should also expect some swelling and residual bleeding. However, if pain is severe or bleeding continues for more than four hours after the extraction, you should call your dentist. You should also call your dentist if you experience any of the following:

signs of infection, including fever and chills

nausea or vomiting

redness, swelling or excessive discharge from the affected area

cough, shortness of breath or chest pain

The initial healing period usually takes about one to two weeks. New bone and gum tissue will grow into the gap. Longer term, however, having a tooth (or teeth) missing can cause the remaining teeth to move, affecting your bite and making it difficult to chew. For that reason, your dentist may advise replacing the missing tooth or teeth with an implant, fixed bridge or denture.