My Experience

I had an extraction of molar #30 (lower right side) at the office of an oral surgeon in Princeton, NJ. My primary dentist, the oral surgeon, to whom I was referred, and my former dentist (whom I really respect and like personally) recommended the extraction due to what appeared on X-ray to be an infection in the tooth and a likely crack in the tooth down to the bone.

I had a root canal and cap on this same tooth a year-and-a-half ago, suffered a painful and subsequent infection that required antibiotics, and then developed a small painless bump, or “fistula” as the dentist called it, on the gum near the tooth. This, I learned, was nature’s way of draining the infection, which was essentially encapsulated in the tooth and held in place by the cap.

The procedure was at 1 pm so I made sure to have a half sandwich and some yogurt before the procedure to avoid being faint or hungry afterwards. One might think it’s best not to eat before a dental procedure or surgery but I learned several years ago when I had gum surgery that if you are not having general anesthesia for oral surgery it’s better to have something light in your tummy.

I walked into the doctor’s office, checked in and paid the copay of $315. The receptionist smiled broadly and seemed surprised, so I guess most people don’t provide the check before the procedure or forget to bring it entirely. I wanted to get this out of the way so I could leave immediately after the procedure and just concentrate on recovery.

After waiting for about 5 minutes the receptionist led me in to a procedure room where a dental assistant took my blood pressure. It was high for me – 146/90, which surprised and alarmed me. When I asked her if that was a problem she said no, that I was probably anxious about the procedure. About 5 minutes later the oral surgeon came in and asked me how I was doing. He took a look at my tooth and asked me if I had had any other problems with it since my visit a few weeks before. I told him no, and he reviewed with me the consent form that included a list of risks, including possible damage to the surrounding teeth, bleeding, etc. They seemed like manageable and non-life-threatening risks, so I signed the form.

The oral surgeon then swabbed the gums near my tooth and the back of my mouth with some sort of flavored anesthetic. He waited a few minutes and then produced what looked like long needles and gave me two shots of Novocain. These shots were somewhat painful, though not terribly so, and he delivered them quickly and with skill.
I then was left alone for about 20 minutes so the Novocain could take effect.
Then the surgeon came back with the assistant and poked at the area with an instrument to make sure I was fully numb, which we thought I was. He shut the door and I knew the fun part was going to start.

I can’t say I recall all of the procedure but he began to pull and tug at my tooth with some sort of instrument and I believe he was successful at getting the cap off; there was a little pain but it wasn’t too bad. Then he started to grab at whatever was left and I felt bad pain, so bad that he had to stop. He then produced another needle and went in to the area next to the tooth, right into the infection, he later said; the pain was pretty bad but over quickly.

He soon started digging and pulling and then stopped. He then got a new tool, and started drilling. I stopped him and asked what he was doing. He said he was going to break the tooth into two pieces so it would come out more easily. This seemed to make sense, and at this point there was no pain so I let him do his stuff. After he had successfully broken the tooth in two, he tugged and pulled at one piece, then tugged and pulled at the other and I could see some ugly brownish tooth parts coming out…not pretty and clearly infected. A good thing I decided to go through with this. No one should have that in their mouths festering… and I always practiced such good oral hygiene! I have to say that the actual breaking up of the tooth and the extraction itself was quick and not terribly painful.
What was most painful was the third injection right into the infected area, which had to be done so he could get at it and get it out.

I felt ok right after the procedure. I had to sit in a small room that had a couch in it in case I felt light-headed, and they gave me folded up gauze to put over the area to stanch the bleeding. I sat there for about 15 minutes. Then the dental assistant came to see me to review the post-op care: Keep pressure on the gauze for an hour by biting down firmly. Hold the ice pack on for 10 minutes on then 10 minutes off for an hour to keep down the swelling. If the bleeding didn’t stop after an hour, change the gauze and hold for another hour. Keep icing for the next few hours. They told me not to drink anything with a straw for the day (it tends to disrupt clotting) and not to brush my teeth or rinse with mouthwash that day. I have to admit that I found that unacceptable and I did run a Q-tip with warm water over my teeth later that night.

The bleeding did stop after an hour although on the way home I found myself gagging a bit on the gauze and replaced it with some extra gauze the dental assistant had given me.
This gagging happened again when I got home and I think the whole idea of having bloody gauze in my mouth was a bit too much for me. Once the bleeding stopped, I had a few sips of iced-tea and felt better.

I took Advil for the pain – one at about 5 pm that night and one the next morning. The oral surgeon’s office called at 6 pm that night to get my social security number for the insurance form and I asked them if I could have a cocktail. They said yes, it would be OK, and I had a strong Gin and Tonic, avoiding the area where the surgery was.

The next day I did not have pain, and had just a bit of swelling on the right side of my face. However, the next two days I did have some minor pain and tenderness in the area where the tooth was extracted and took Advil. I am next scheduled for surgery in this area to have a possible bone graft and a dental implant.