Dental Extractions under Local Anaesthesia

What does a dental extraction involve?

This is a routine procedure and involves the removal of a tooth using dental forceps and other instruments such as elevators.

What type of anaesthetic is used?

The tooth is extracted using a local anaesthetic. This is injected into the gum, or area surrounding the tooth. This takes a few minutes to numb the area and means that you will feel no pain whilst the extraction is carried out, however you may feel some pressure.

Like all medicines, local anaesthetics may sometimes cause side effects, as well as the effects that are needed. You may experience dizziness, blurred vision, drowsiness and occasionally loss of consciousness.

Serious side effects are rare and include fits, low blood pressure, slowed breathing and changes in heartbeat, which may be life-threatening. If you have concerns about any of these effects you should discuss them with your dentist.

What can I expect after the extraction? You may have:

• Discomfort after the local anaesthetic wears off – this can be managed by taking painkillers.
• Slight oozing of blood from the socket.
• A small amount of swelling around the area of the extraction for a few days afterwards.

What are the possible problems?

Most extractions are straightforward procedures, with few complications or problems.The following are some of the problems that may occur:

• Bleeding – this can usually be stopped by applying pressure over the extraction area for at least ten minutes with a rolled up handkerchief or swab. Packing of the socket or placement of a suture (stitch) is occasionally needed

• A localised infection may result in loss of the blood clot from the extraction socket – this is known as a ‘dry socket’. A ‘dry socket’ can be quite painful but is self-limited. It responds well to local treatment – antibiotics are rarely indicated.
• Teeth occasionally break during an extraction – your dentist will tell you if you are particularly at risk of this.
• If the tooth breaks, then it is possible that a Minor Oral Surgical (MOS) procedure may be necessary. Further information will be given to you by the dentist undertaking your treatment. (See also PIF 833 Surgical Removal of Teeth or Roots.)
• Some upper molar teeth may be close to the maxillary sinus. This can occasionally lead to post-extraction complications. Your dentist will explain this in greater detail, if you are particularly at risk.

Are there any alternative treatments available?

Once the decision has been made that your tooth needs removing, there is no alternative treatment. If you leave the tooth as it is, any problems will continue.

What will happen if I don’t have any treatment?

Any toothache you suffer will continue and may get worse. If the root of the tooth becomes infected then this will eventually result in pain and swelling. Serious complications such as infection of the jaw bone (osteomyelitis) or abscess formation in the face or neck rarely occur but can be life threatening.

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Further information

If you experience any urgent postoperative difficulty on a Saturday, Sunday or after 5.00 pm on a week day, please contact the NHS helpline by telephoning 111.

Depending on your situation, the NHS 111 team can connect you to a nurse, emergency dentist or even a GP and can arrange face-to-face appointments if they think you need one.

Local Anaesthesia Department, Liverpool University Dental Hospital Tel:          0151 706 5060

Text phone number: 18001 0151 706 5060

NHS 111

Tel: 111