Tooth Extraction Recovery

One of the things that we dread most, is visiting the dentist. But something that supersedes that dread, is when the dentist tells us that our tooth has outlived its life, and needs to be extracted.

Somehow, you've managed to brace yourself into getting that tooth extraction done, so what next? How long is the recovery going to take? Is there a fixed recovery period? What do you do, if you have pain after tooth removal?

Immediately after an extraction, the blood vessels in the socket release platelets, which help form a network mesh, which is known as the blood clot. This clot takes a few hours to start getting organized and is the most important component of the extraction recovery.

Often, pain after tooth extraction is associated with dislodgement of this clot. Once the blood clot is firmly in place, the remodeling of bone begins. After a week or so, the osteoblasts (bone forming cells) start laying down the bone, which helps in the closure of the socket. The final visible stage is the complete sealing of the socket by a layer of gums.

There is no fixed time, as it varies depending on a lot of factors. Some of these factors are enlisted here:

Health of the Patient: If the patient is a diabetic or an anemic, then wound healing takes longer, thus, increasing the recovery time. Also, if the patient is immunocompromised in any way, then the chances of a superinfection are high, thus prolonging the recovery period.

Type of Extraction: Depending on the type of extraction done, the recovery time will vary. For a simple extraction, especially of mobile teeth, there is not much bleeding, and hence, the recovery time considerably decreases.

However, if it is a surgical procedure, like extraction of impacted wisdom teeth, involving incisions, bone drilling, etc., then in such cases, wisdom teeth removal recovery is much longer. Extra post extraction care also needs to be taken after a disimpaction.

Health of the Tooth: If there was a long-standing tooth decay, with the infection extending into the bone, then the recovery time will be longer, as the bone will take longer to fully heal.

Presence of any Superinfection: If the wound gets infected, before it fully closes, then the time taken for the wound to heal is longer.

Although there is little that can be done to speed-up the recovery time, there are certain tooth extraction aftercare pointers that should be kept in mind. These are:

►After extraction, keep the gauze pack firmly in place for at least half an hour. This will aid in formation and stabilization of the clot.

►Do not drink with a straw after extraction. The negative pressure created while sucking from a straw can lead to dislodgement of the clot, which in turn can lead to pain post extraction.

►Eat only light and cold food (ice cream, yogurt and rice etc.) after an extraction. Try and maintain a semi-solid diet for two days after an extraction, as heavy chewing leads to a high risk of dislodgement of clot.

►Start taking the prescribed medications (painkillers or antibiotics) within a few hours after the extraction. This will help prevent pain and any infection, thus considerably reducing the recovery time.

►Gargle with warm salty water, from the second day onwards, to prevent any infection from taking place in the oral cavity.

►Use an ice pack, later in the day, after the extraction to help constrict the blood vessels, which will help prevent formation of a swelling and thus, decrease the tooth extraction recovery time.

►Do not smoke for at least 24 hours after an extraction, as smoking can be a very serious hindering factor for wound healing.

►Do not brush too vigorously after an extraction, as this may dislodge the blood clot.

►If there is excessive bleeding or pain after tooth extraction, inform your dentist immediately. Both of these can be signs of clot dislodgement, which can lead to severe pain.

►Follow the instructions given by your dentist, as after all, they are for your own good!

This is a serious condition and shouldn't be ignored under any circumstance. Extraction is a procedure that dentists use as a last resort, and hence, it is a procedure that should provide relief from long standing pain. Here are a few conditions where one may experience post extraction pain:

Periapical Infection: If, after a tooth extraction, there is still pain, then it could be that the tooth was so badly carious, that it has led to a tooth abscess, or the infection has reached the jawbone. One needs to check for periapical infection with the help of an x-ray.

Infection of the Wound: Certain people like diabetics and immunocompromised individuals are at a high risk of superinfections. Tooth extraction recovery time is longer in these people.

For example, in diabetics, the open wound, which has exposed blood vessels containing blood that is high in sugar, acts as an invitation to microorganisms. Hence, there is greater risk of a superinfection. If this occurs, contact your dentist immediately.

Dry Socket: Dry socket after tooth extraction is an extremely painful emergency condition seen in tooth removal recovery period. This pain is almost unbearable.

This condition occurs when the clot is dislodged before it is fully formed, and hence, symptoms start showing approximately a week after extraction. The patient complains of excruciating pain. The dentist needs to immediately wash the area with betadine, which helps soothe the wound.

Infected Pocket After Wisdom Tooth Removal: After wisdom tooth extraction, especially if the third molar is horizontally impacted (often called 'sleeping molars'), patients may complain of pain and swelling behind the last standing molar.

This is because, the bone formation is not complete behind the second molar, and hence, sometimes food seeps in through the gums and gets lodged in the space behind the second molar. This may then harbor micro-organisms and lead to periodontal diseases.

Thus, one needs to take extra care after extraction of wisdom teeth, as pocket formation is nearly inevitable. One should consult a periodontist for help in such situations.

If you want to do away with tooth extractions altogether, just remember to practice some basic dental care like brushing those pearly whites twice a day and visiting your dentist (at least!) twice a year!