Extractions and wisdom teeth

An extraction removes a tooth that cannot be saved or is causing a problem, with clear guidance on caring for the mouth afterward. This suits a tooth too damaged by decay or injury to restore, and a wisdom tooth that is causing pain, infection or damage to a neighbouring tooth. Dr Annabel Davies provides extractions at BRS Dental on Strand Street, in Cape Town City Centre.

When you might need one

A tooth may need to be removed when it is too decayed or damaged to repair with a filling or a crown, when it is loose because of advanced gum disease, or to make room as part of orthodontic treatment. Wisdom teeth, the last teeth to come through at the back of the mouth, sometimes do not have enough room to emerge properly. If a wisdom tooth becomes impacted, or only partly breaks through the gum, it can trap food and bacteria, leading to pain, infection, decay or gum disease that can also affect the tooth next to it. A wisdom tooth that has come through properly and is not causing any problems does not necessarily need to be removed. Dr Davies normally assesses wisdom teeth between the ages of 18 and 21, and the X-rays taken at a general check-up every 12 to 18 months show how they are developing before then.

What happens at the appointment

The dentist examines the tooth, and X-rays are generally used beforehand to see its position and roots, particularly for a wisdom tooth. The area is numbed with local anaesthetic before the tooth is removed. A straightforward extraction is often completed within a few minutes. Simple extractions, including wisdom teeth, are done at the practice under local anaesthetic. A wisdom tooth that is impacted or awkwardly placed is more complicated to remove, so after Dr Davies has assessed it, she refers it to a maxillofacial and oral surgeon.

Aftercare

Biting gently on gauze over the extraction site for around thirty minutes helps a blood clot form, which is important for healing. Some swelling and bruising in the first day or two is common, and a cold compress held against the outside of the face can help. A soft diet is easier to manage for the first few days, and it helps to avoid hot, spicy or crunchy food, and to avoid drinking through a straw, since this can dislodge the blood clot and lead to a painful condition called dry socket. Gentle rinsing with warm salt water from the day after the extraction, avoiding vigorous rinsing or spitting, helps to keep the area clean while it heals. Persistent or worsening pain, or signs of infection such as fever or swelling, should be reported to the dentist.

How long it takes

A simple extraction is usually a single, short appointment. Wisdom tooth removal can also often be done in one visit, though recovery, including any swelling, stiffness or discomfort, can take a week or two to settle fully.

Getting in touch

Fees for an extraction are discussed with reception. The panel on this page shows how to get in touch. Anyone in pain now can also see the dental emergency guidance on this site.