When is surgical extraction needed?
Surgical removal is needed when a tooth cannot be saved and cannot simply be pulled without major trauma to the surrounding tissue. We only carry it out when there is no alternative and you have been fully advised. Typical situations:
- A tooth is severely decayed and the root is affected – we first consider root canal treatment or a root tip resection.
- A tooth is misaligned or strongly tilted, typically a wisdom tooth.
- A complicated fracture, especially a longitudinal one, makes extraction difficult and carries a risk of infection.
- Teeth are severely displaced or supernumerary.
- Teeth are fused to the bone or have extremely curved roots.
Procedure
It starts with an examination and consultation. We go through your medical history to take possible complications into account and use X-rays to decide whether surgery is needed. Our team includes oral surgeons who perform extractions right here in our practice in Baar.
The procedure is usually done under local anaesthesia. In some cases, especially when several teeth are removed, we use twilight sedation (analgosedation) or general anaesthesia. Surgery takes between 30 minutes and 2 hours, depending on the situation.
We open the gum, expose the tooth with special instruments and, if necessary, remove a little bone – preserving as much bone as possible for a later restoration. We then smooth the bone edges and clean the socket. Sometimes we fill it with bone substitute to prevent bacterial colonisation and inflammation. The wound is either stitched or fitted with a strip dressing that lets secretions drain while protecting it from germs.
You will usually receive an antibiotic and painkillers. After about 10 days we remove the stitches and check how it is healing.
Preparation
- Tell us about any illnesses – such as heart or circulatory disease or diabetes – intolerances and medication, especially blood thinners. If anything is unclear, we contact your doctor.
- Bring your heart or allergy card if you have one.
- Sometimes an antibiotic is needed beforehand; we also tell you whether to continue or pause certain medication.
- Do not take painkillers as a precaution and avoid caffeinated drinks. A light, healthy meal beforehand is recommended.
- Avoid rushing and physical exertion on your way to us – this helps prevent increased bleeding.
Pain and aftercare
Thanks to local anaesthesia, the extraction is almost painless; at most you feel pressure. How much it hurts afterwards depends on the procedure, your sensitivity and aftercare. Pain and swelling are usually harmless but can be unpleasant. What helps:
- Painkillers as instructed by us regarding dose and use.
- Cooling with a cold compress or an ice pack wrapped in a cloth on the cheek – about 20 minutes on, then about 20 minutes off.
- Sleeping with your head raised for the first few nights to reduce pressure on the wound.
- Following our advice on eating, drinking, oral hygiene and smoking.
- If the pain does not improve, come in for a check. Fever or persistent bleeding can indicate inflammation – contact us straight away.
Healing
The initial healing phase usually takes one to two weeks; small wounds often heal within a week. After that you can eat and brush as usual. Larger wounds take two to three weeks, and the underlying bone up to three to four months.
Rest for up to two days and avoid physical work and sport – longer if you have circulatory problems. The follow-up visit matters so that we can spot any complications early.
Closing the gap
A missing tooth can lead to bone loss, shifting teeth, headaches and difficulty eating; neighbouring teeth lose support and your bite changes. Once the wound has healed, the gap should therefore be restored soon – with a removable denture, a bridge or an implant, depending on your needs. Our specialists in prosthetics and implantology work together to find the best solution.