A person will have a consultation with their dentist or oral surgeon prior to the extraction.
During the consultation, the doctor will ask for a thorough medical history. They will also ask about any medications that the person is taking.
Some people need to stop or start taking certain medications in the days leading up to the surgery, depending on the amount of teeth, bone, or both to be removed.
A person may also receive certain medications on the day of the surgery.
Stopping blood thinners
Many people take blood thinning medication to prevent the formation of blood clots in vessels. These medications can lead to more bleeding during surgery.
A dental surgeon can usually control bleeding at the site of the extraction by:
- using topical clotting medications on the gums
- packing the tooth socket with foam or dissolvable gauze
- stitching up the extraction site
Using gauze and applying pressure after the procedure can also help stop bleeding.
However, anyone who takes blood thinners should let their dental surgeon know during the consultation.
In order to tell whether the person should temporarily switch to a different blood thinner or stop taking this type of medication, the surgeon may need to see the results of a recent blood test.
Typically, people do not need to stop taking blood thinners prior to tooth extractions. Anyone considering stopping this treatment should consult their dentist or physician first.
In a few circumstances, a dentist may prescribe antibiotics before a tooth extraction.
For example, they may do so to treat dental infections with widespread symptoms, such as a fever or malaise, along with local oral swelling.
Toothaches without swelling do not require antibiotics. Always take antibiotics exactly as directed by a doctor, and avoid unnecessary use.
A person may need antibiotics if they have a high risk of infective endocarditis, an infection of the heart valves or the interior lining of the heart chambers.
According to the American Heart Association (AHA), people with certain heart conditions have an increased risk of developing this infection following dental surgery.
The AHA and American Dental Association recommend, therefore, that people with any of the following take antibiotics prior to dental surgery to reduce the risk of infection:
- a prosthetic cardiac valve
- a history of cardiac valve repair with prosthetic material
- a cardiac transplant with structural abnormalities of the valve
- certain congenital heart abnormalities
- a history of infective endocarditis
Anesthesia during surgery
The person will receive an injection of local anesthetic close to the site of the extraction. This will numb the area so that the person will not feel any pain. The numbness will continue for a few hours after the surgery.
A person can request additional anesthetic or sedative medication to minimize anxiety during the procedure. The dentist or surgeon may offer:
- nitrous oxide, also known as laughing gas
- an oral sedative medication
- intravenous, or IV, sedation
- general anesthetic
A person who receives general anesthetic will be completely asleep during the procedure.
Some dentists do not have the options above at their offices. If a person requires any of these, they should let their dentist know during the consultation, and the dentist may refer them to an oral surgeon.
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