Tooth extraction is a surgical dental procedure where the oral surgeon removes an entire tooth or teeth if they pose a threat of infection or damage to the surrounding tissues. Thanks to the modern anesthetic advances, a dental extraction procedure has become significantly less painful for the patient. The availability of different anesthetic agents (in different concentrations) and the equipment to deliver these agents assure us complete numbness around the tooth or teeth of concern.

What is the protocol in a tooth extraction procedure at the dentist?

A routine protocol involves the dental surgeon applying a topical anesthetic agent first through a spray or with the help of a gel at the region where the needle is to be injected. This helps in minimising the pricking pain of the needle. The dental surgeon then delivers the local anesthetic agent gradually injecting it within the tissues. A couple of minutes later, when the tissues are anesthetized, the dental surgeon uses a spoon-like instrument called the elevator to weaken the tooth from the grasp of the surrounding gingiva. Dental forceps are then used to remove the tooth out of the socket.

At this stage the effect of dental anesthesia is still there. The patient uses gauze pieces to control the bleeding from the tissues. In adults, sutures are taken to approximate the tissues. In children, if a deciduous tooth is removed, then simply biting on the gauze piece for 15-30 minutes will stop the bleeding. The patient is still under the effect of anesthesia and is advised and warned to not chew upon the numbed tissues of lips or cheeks (a common tendency of patients as the tissues are numbed). Spitting is strictly not allowed for 2 days. Patients are also prescribed analgesics and antibiotics, and are warned about the onset of discomfort and pain once the effect of anesthesia wears out. Smoking is not allowed for at least a week after extraction as it delays the healing process. Rinsing should be allowed only after 24 hours of tooth extraction.

Tooth extraction aftercare - What should I do straight after tooth removal?

When it comes to post-operative eating protocols, the first thing a patient should consume is any cold item which does not contain any acids. Usually, patients are advised ice-creams that do not contain any toppings as toppings may enter the socket and cause discomfort. Consuming cold foods leads to constriction of blood vessels in the area of the blood clot which in turn promotes healing of the tissues.

During the first 24 hours after extraction, patients are advised to eat soft and cold foods. These may include yoghurt, pudding, jelly, mashed potatoes, scrambled eggs, steamed rice, cottage cheese, oatmeals, tofu, well-cooked vegetables, soups (normal temperature), protein shakes, smoothies, and soft fruits. It is recommended to have a high-protein and high-calorie diet after tooth extraction for faster recovery of the tissues. Patients are advised to avoid chewing from the site of extraction. In case a food debris gets lodged within the extraction socket, then it should be removed by rinsing with warm salt water. Mouthwashes should be avoided.

There are certain routine foods which need to be avoided during the process of recovery. Drinking carbonated beverages is not allowed. Acidic fruits, sticky foods, drinking with straw, eating hard nuts, popcorns, spicy foods, hot drinks and foods with sharp edges have the ability to irritate the gingival tissues, hamper the healing process and cause evere irritation. At least 5 to 6 glasses of fluids (non-acidic, normal temperature) must be consumed daily for at least one week. These dietary rules should be followed upto 3 days.

How soon can I eat after tooth removal?

The recommended time is 2 hours. Please do not eat any food for two hours after tooth extraction. If the extraction socket is left open (without any stiches) it will be good to extend this time to 3 or sometimes 4 hours so the blood clot can seal the extraction area and stabilize the soft tissues and the gum flaps around the hole. You can still have fluids in small sips like water and sugary juice to keep the sugar levels high.

If sutures (stiches) have been placed to close up the extraction wound the recommended 2 hours period is valid. This will ensure the seal of the suture line wound and prevention of debris packing within the extraction hole. All these instructions are to allow the blood clot to form and to minimize the bacterial and debris invasion within the surgical area. This will ensure smooth healing process and minimum symtoms on the patient side

What happens next?

From the fourth day, patients can try increasing the hardness of their food in order to retrain the muscles and joints responsible for chewing. If the patient still feels discomfort, then he or she should revert back to soft diet until the pain or discomfort is subsided.

Usually, it does not take more than one week for the patient to get back to his or her routine dietary preferences. After one week, if the patient still finds difficulty in chewing, then an appointment must be made with the operating dental surgeon.

Choosing the texture and consistency of foods after a dental extractions plays an important role in the healing of the socket. Patients must take special care in choosing these foods and must consult their oral surgeon in case of any dilemma.