Ok, I have to get my first molar (I believe it's number 30) extracted. The tooth has a previous root canal and it hurts when I chew. I'm opting for extraction vs trying to "save" it, and we'll do an implant as soon as we can-now of they're no sign on infection when it's extracted, or later if there is. The tooth is slightly loose-I think it's actually cracked, but regardless I don't want it in my mouth.

I have had my front teeth extracted, and it wasn't too bad. I've had another lower molar extracted and it was horrible. But I was younger then, and too nervous to speak up and say it hurt.

Overall, how hard is a 1st molar extraction? Has anyone had that done while awake? I am wondering how hard it is? I'd appreciate any experiences, and how long it took to recover. Thanks!

Hi socasusie,

I am in the dental field and have assisted on thousands of tooth extractions. I have also personally had teeth extracted.

Teeth teeth can be a bit tricky to remove if the tooth is fractured as it may break off and need to be removed in sections. However this is a common occurrence and seen every day in dentistry. It is imperative that the oral surgeon debride the socket thoroughly to remove the periodontal ligament and any visible necrotic tissue and bone. If the socket is not debrided thoroughly, you could have complications in dealing with residual infection. NEVER assume that the dentist is going to perform the debridement. You can read several posts on here about patients who had problems because of that not being done.

I always encourage dental patients to make it clear to the surgeon that you expect the socket to be debrided thoroughly to reduce the risk of complications due to residual infection. Informed patients who verbalize this concern are without a doubt treated differently and more thoroughly by dentists who normally do not debride the socket.


Regarding having a molar extracted.... I personally have had 4 second molars extracted to allow my wisdom teeth to come in. These teeth were all removed at different times throughout my life. I only had problems with one which was when I was 12 yrs old and my dentist broke the tooth resulting in me having to see the oral surgeon. But the OS removed it without a problem.

I also encourage people to see oral surgeons for their tooth extractions as they are best equipped to perform this type of dentistry.

Hope this information was helpful to you! All the best to you

Bryanna

Thanks Bryanna! I will definitely ask. What exactly is debridement?

I'm also just worried about it hurting while its happening. I can handle the post extraction pain.

Hi socasusie,

A debridement is a thorough scraping of the tooth socket once the tooth is removed. This step of the surgery is very important and should not be overlooked. Unfortunately, not all dentists perform this step and that's when post op problems can arise.

It is important to be very numb, of course, during the procedure. You will feel pressure and hear cracking sounds... but there should be no pain. When there is an active infection like an abscess, sometimes the anesthetic is not as effective as it would be if there were no infection. The reason being is that infection causes the area to be very acidic. Local anesthetic is very ph sensitive so in unfavorable situations like infection, the nerve fibers have a difficult time allowing the anesthetic through. But there are several ways to work around that and oral surgeons know those ways.

Also, anxiety can delay the effectiveness of local anesthetics. That's why some people will say ...." I was more numb when I got home than I was in the dental chair"!

Also, vitamin C reduces the effectiveness of anesthetic whereas the B complex enhances the effectiveness. So avoid vitamin C prior to the extraction... take it afterwards for healing.... and take a B complex supplement 1-2 hours prior to the appt. if you can.

Bryanna

First, thank you for explaining the anesthesia. I've never understood and that makes perfect sense. I'm horrible to get numb-I'll for sure take the vitamin B if it could help.

I'm sure the dentist will be agreeable to doing the debridement, he's very agreeable to making his patients happy if the request is not crazy.

Thank you again for all your help!

Hi socasusie,

You are welcome

Make sure to tell the dentist that you have a hard time getting numb and explain an experience that you had as this will tell him what type of injection to give you.

Have a good nights sleep... we'll see you tomorrow

Bryanna

One more question-my appt is Friday. What vitamin B? One that has all of, or something else? Sorry, there were several choices. Lol!

Also, you always seem to have good suggestions on for after dental work. I have lupus on top of having this done- any suggestions besides protein shakes with fruit?

Hi socasusie,

I will copy and paste my previous suggestion...
"Also, vitamin C reduces the effectiveness of anesthetic whereas the B complex enhances the effectiveness. So avoid vitamin C prior to the extraction... take it afterwards for healing.... and take a B complex supplement 1-2 hours prior to the appt. if you can."

It is best to have your diet menu prepared ahead of time as it is just easier to have what you need instead of having to go get it or make it. You will be eating soft foods for several days. It is ideal to eat nutritiously (organic and non gmo if possible)and avoid all sugars, including sugar substitutes.

Some nutritious foods would be....
Eggs, home made soups with plenty of veggies, veggie juices (home made in a blender), fruits without seeds, baked chicken cut up small, red potatoes or yams, healthy smoothies without sugar, plain unsweetened yogurt and add your own fruit to it. Incorporate greens into your juice mixtures like kale or cucumber.... even parsley! Drink plenty of filtered water throughout the day as you are healing. Take a probiotic like Culturelle daily prior, during and after the surgery for several weeks if not indefinitely to restore the good bacteria in your intestinal tract.

I'm sure you can think of many other soft foods. If not then do a google search for soft food diet... just be mindful of the unhealthy suggestions

Having Lupus or other auto immune disorders is something to be mindful of any time you have any type of surgery. It is imperative to take very good care of your self afterwards to avoid or minimize a flare up.

I'm sure you will do well! Keep us posted

Bryanna

Thanks Bryanna-the first store I went to didn't have B Complex, only separate b's, but I went to a health store and they had a b complex. I actually have a probiotic I love and take daily-it counteracts the lupus medication side effects.

You got me thinking-there is this fabulous korean soft tofu stew I love (it even has kimchi in it which is loaded with probiotics) I'm making that! Thank you for all the wonderful suggestions, you got me thinking of some yummy easy foods! I won't lie though, I won't juice-but there is a great natural juice place by my house, and I'll weasel my friend into getting them for me. Hehehe.

And my rheumatologist is absolutely involved in this dental work, and how to make me heal faster with nutrition and rest being key. All the suggestions I was finding online for post extraction food was ice cream, jello, and mashed potatoes. Needless to say that was going to give my body what it needed!

Thanks again, and I'll for sure let you know how it all goes!

Ok, had the extraction/implants placed yesterday. I'm not going to lie it was rough! For some reason I always forget I have hard teeth/bones-most dentists equate it to drilling rocks. It took around an 45-a hour to get out, he had to cut it into several pieces, and one point was like you have absolutely amazing bone strength, tough for extractions, but great for implants. He had to stop like 5 times to give me more shots, but he did get me numb and try to keep me numb. He said the nerve (spot?) they have to hit is very, very, deep/far back in my jaw, and that even with the long needle it's hard to get to. I did forget to ask for the debridement, but at one point between the extraction and implant he was using some instruments and a lot of fluid in a syringe. I asked why he said he had to clean very, very well because the root canal and that if any bacteria was left it would cause problems long term.

With narcotic pain meds and alternating Advil its fine though. Waiting for the prednisone to kick in as well (my rheumatologist and him coordinated and felt it would be helpful considering the lupus piece, and I'm grateful they worked to figure out what would help me most).

I'm on straight liquid diet until tomorrow. Lots of lukewarm soup for me!

Thank you again for all the advice, happy it's done until around January when I'll do the same thing on the other side-I have a cracked molar there too, and am already missing the second molar.