The dentist or surgeon will numb the tooth first to make the person more comfortable. While a tooth extraction may still be unpleasant, it can be key for relieving dental pain and preventing future problems.

In this article, we outline the different types of tooth extraction and why people need them. We also describe preparation and what to expect after the procedure.

What is tooth extraction?

A tooth extraction is the removal of a tooth.

Dentists and oral surgeons remove teeth for various reasons. Some examples include:

• dental cavities
• gum disease
• dental infections
• trauma or injury to the tooth or surrounding bone
• wisdom teeth complications
• preparation for a dental prosthesis
• žpreparation for dental braces, if the teeth are very crowded
• baby teeth not falling out at the proper age

Types

The right type of tooth extraction depends on the tooth’s shape, size, position, and location in the mouth.

Dental surgeons may classify extractions as simple or surgical. A simple extraction involves a tooth that is visible above the gums and that a dentist can remove in one piece.

A surgical extraction is more complicated and involves the removal of gum tissue, bone, or both. The surgeon may need to remove the tooth in pieces.

Wisdom teeth are the last to erupt and usually the first to require extraction because in many people, they are impacted. This means that they have not fully emerged from the gums.

Wisdom teeth extraction is a common procedure in oral surgery.

Preparation

A person will have a consultation with their dentist or oral surgeon prior to the extraction.

During the consultation, the doctor will ask for a thorough medical history. They will also ask about any medications that the person is taking.

Some people need to stop or start taking certain medications in the days leading up to the surgery, depending on the amount of teeth, bone, or both to be removed.

A person may also receive certain medications on the day of the surgery.

Stopping blood thinners

Many people take blood thinning medication to prevent the formation of blood clots in vessels. These medications can lead to more bleeding during surgery.

A dental surgeon can usually control bleeding at the site of the extraction by:

• using topical clotting medications on the gums
• packing the tooth socket with foam or dissolvable gauze
• stitching up the extraction site

Using gauze and applying pressure after the procedure can also help stop bleeding.

However, anyone who takes blood thinners should let their dental surgeon know during the consultation.

In order to tell whether the person should temporarily switch to a different blood thinner or stop taking this type of medication, the surgeon may need to see the results of a recent blood test.

Typically, people do not need to stop taking blood thinners prior to tooth extractions. Anyone considering stopping this treatment should consult their dentist or physician first.

Starting antibiotics

In a few circumstances, a dentist may prescribe antibiotics before a tooth extraction.

For example, they may do so to treat dental infections with widespread symptoms, such as a fever or malaise, along with local oral swelling.

Toothaches without swelling do not require antibiotics. Always take antibiotics exactly as directed by a doctor, and avoid unnecessary use.

A person may need antibiotics if they have a high risk of infective endocarditis, an infection of the heart valves or the interior lining of the heart chambers.

According to the American Heart Association (AHA), people with certain heart conditions have an increased risk of developing this infection following dental surgery.

The AHA and American Dental Association recommend, therefore, that people with any of the following take antibiotics prior to dental surgery to reduce the risk of infection:

• a prosthetic cardiac valve
• a history of cardiac valve repair with prosthetic material
• a cardiac transplant with structural abnormalities of the valve
• certain congenital heart abnormalities
• a history of infective endocarditis

Anesthesia during surgery

The person will receive an injection of local anesthetic close to the site of the extraction. This will numb the area so that the person will not feel any pain. The numbness will continue for a few hours after the surgery.

A person can request additional anesthetic or sedative medication to minimize anxiety during the procedure. The dentist or surgeon may offer:

• nitrous oxide, also known as laughing gas
• an oral sedative medication
• intravenous, or IV, sedation
• general anesthetic

A person who receives general anesthetic will be completely asleep during the procedure.

Some dentists do not have the options above at their offices. If a person requires any of these, they should let their dentist know during the consultation, and the dentist may refer them to an oral surgeon.

In this article, learn more about nine home remedies for relieving a toothache at night.

6 ways to treat a toothache at night

Treating a toothache at night may be more difficult, as there is not much to distract a person from the pain.

However, people can try the following methods to relieve pain:

1. Oral pain medication

Taking over-the-counter (OTC) pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil) is a quick, simple way for many people to effectively reduce mild-to-moderate toothaches.

Always stay within the recommended dosage on the packaging.

If the toothache is severe, it is best to see a dentist and speak to them about stronger pain relievers.

2. Cold compress

Using a cold compress may help ease the pain of a toothache.

Applying a bag of ice wrapped in a towel to the affected side of the face or jaw helps constrict the blood vessels in the area, which can reduce pain to allow a person to fall asleep.

Applying a cold compress to the area for 15–20 minutes every few hours in the evening may also help prevent pain when going to bed.

3. Elevation

Pooling blood in the head may cause additional pain and inflammation. For some people, elevating the head with an extra pillow or two may relieve the pain enough for them to fall asleep.

4. Medicated ointments

Some medicated ointments may also help reduce toothache pain. OTC numbing gels and ointments that contain ingredients such as benzocaine may numb the area.

However, benzocaine is not suitable for use by young children.

5. Salt water rinse

A simple salt water rinse is a common home remedy for a toothache.

Salt water is a natural antibacterial agent, so it may reduce inflammation. This, in turn, helps protect damaged teeth from infection.

Rinsing with salt water may also help remove any food particles or debris stuck in the teeth or gums.

6. Hydrogen peroxide rinse

Periodontitis is a serious gum infection that generally occurs as a result of poor oral hygiene. It can cause issues such as soreness, bleeding gums, and teeth that come loose in their sockets.

The author of a 2016 study found that rinsing with hydrogen peroxide mouthwash helped reduce plaque and symptoms of periodontitis.

People should always dilute food-grade hydrogen peroxide with equal parts water. Swish the solution in the mouth, but do not swallow it.

This remedy is not suitable for children, as there is a risk they may accidentally swallow the mixture.

This article discusses some of the potential health benefits of consuming baking soda and lemon juice mixtures.

A note about pH

The idea of combining baking soda and lemon juice draws on basic principles of acidity and the pH scale.

Scientists use the pH scale to measure the acidity of a solution. A solution can have a pH level between 0 and 14.

The lower the pH, the more acidic the solution, so:

• pH levels below 7 indicate an acidic solution
• pH levels above 7 indicate an alkaline, or base solution
• neutral solutions, such as pure water, have a pH of 7

Baking soda, also known as sodium bicarbonate, is a base. This means that when people dissolve baking soda in water, it forms an alkaline solution. For example, a 0.1 molar solution of baking soda has a pH of around 8.3.

Lemon juice contains citric acid and has a pH of around 3. Adding baking soda to lemon juice will raise the pH to produce a more neutral solution.

Skin care

Usually, the skin has a weakly acidic pH of about 5.7. Bases, such as baking soda, will increase the pH of the skin. Higher pH levels can disrupt the barrier function of the skin, which may lead to dryness, excess oil production, and acne.

Lemon juice appears to have obvious skincare applications because it contains concentrations of vitamin C and citric acid, which both provide powerful skin benefits. Citric acid is an alpha-hydroxy acid (AHA) that manufacturers commonly use in chemical peels.

However, skin cells naturally repel water-soluble molecules, such as vitamin C. This means that very little vitamin C will actually penetrate the skin.

The high acid content of lemon juice can lower the pH level of the skin. Low pH levels may cause skin irritation, hyperpigmentation, and UV light sensitivity.

Alternatives

Using a homemade mixture of baking soda and lemon juice may potentially be harmful to the skin. Instead, a person can try using neutral cleansers or chemical peels that contain AHAs, such as glycolic acid.

Neutralizing stomach acid

Excess stomach acid can cause uncomfortable symptoms, such as heartburn, vomiting, and indigestion.

Many people with excess stomach acid take over-the-counter (OTC) antacids to relieve their symptoms. Consuming baking soda and lemon juice together may also neutralize stomach acid in a similar fashion as an antacid.

A 2017 study examined the antacid effects of various foods. The authors of this study created artificial stomach acid with a pH of 1.2. Although lemon juice by itself had almost no effect, sodium bicarbonate successfully neutralized the synthetic stomach acid.

Many OTC antacids contain sodium bicarbonate and citric acid. Lemons and other citrus fruits are rich sources of naturally-occurring citric acid.

When a person mixes lemon juice and baking soda, the citric acid reacts with the sodium bicarbonate to produce a buffer called sodium citrate. A buffer refers to a weak acid or base that prevents drastic pH changes. Although lemon juice does not neutralize stomach acid, it may help stabilize the pH level inside the stomach.

Alternatives

Using baking soda and lemon juice to combat excess stomach acid may be a good home remedy, as effective OTC antacids contain similar ingredients.

However, mixing the correct proportions of baking soda and lemon juice can be difficult.

Consuming a mixture with too much baking soda may cause diarrhea and gas, whereas too much lemon juice could trigger acid reflux and make symptoms worse. Purchasing an antacid at the drug store is often much safer.

Other home remedies for reducing excess stomach acid include:

• avoiding or reducing acidic foods and beverages
• limiting caffeine intake
• limiting alcohol consumption
• eating smaller meals
• drinking more water
• getting enough sleep

People with severe or persistent acid reflux or heartburn should speak to a doctor or gastroenterologist.

Manufacturers use xylitol as a sugar substitute because its sweetness is comparable with that of table sugar but with fewer calories.

Xylitol is a common ingredient in many products, from sugar-free chewing gum to toothpaste. People also use xylitol as a table-top sweetener and in baking.

In this article, we look at the uses and potential health benefits of xylitol. We also cover its side effects, drug interactions, dosage, and alternatives.

Uses

Xylitol has a similar level of sweetness to sugar but with a fraction of the calories. It is a popular ingredient in a variety of products, including sugar-free gum and toothpaste.

Manufacturers add xylitol to a range of foods, including:

• sugar-free candies, such as gum, mints, and gummies
• jams and jellies
• honey
• nut butters, including peanut butter
• yogurt

Xylitol is also an ingredient in some dental care products, including:

• toothpaste
• mouthwash
• other fluoride products

Xylitol sweeteners are available to purchase online.

Potential benefits

Xylitol has several potential health benefits, including:

Low glycemic index

Xylitol has a low glycemic index (GI). This means that consuming it does not cause spikes in blood glucose or insulin levels in the body. For this reason, xylitol is a good sugar substitute for people with diabetes.

Due to its low GI, xylitol is also a weight loss-friendly sugar substitute.

Also, a 2015 study revealed that xylitol had significant blood glucose-lowering effects in rats that ate high-fat diets.

Dental health

Xylitol is an ingredient in many dental hygiene products, including toothpaste and mouthwash. This is due to the fact that xylitol is non-fermentable, which means that the bacteria in the mouth cannot convert it into the harmful acid that causes tooth decay.

The oral bacterium Streptococcus mutans is largely responsible for plaque, which is the sticky, white substance that can accumulate on the outside of a person’s teeth.

Plaque binds lactic acid against the surface of the tooth. This acid breaks down the enamel and leads to tooth decay.

While it is normal for people to have some plaque on their teeth, excess amounts can lead to tooth decay, cavities, and gum disease.

A 2017 systematic review suggests that xylitol reduces the amount of S. mutans bacteria in the mouth, which reduces the amount of plaque and may help prevent tooth decay.

A 2014 study examined the effects of xylitol on Porphyromonas gingivalis, which is the bacterium responsible for gingivitis, or gum disease. If left untreated, excess amounts of P. gingivalis can move into the bloodstream and lead to systemic inflammation.

In the study, scientists grew samples of P. gingivalis in a laboratory and added them to human cell cultures pretreated with xylitol. They saw that xylitol increased the production of immune system proteins and inhibited the growth of the bacteria.

Side effects and safety

The United States Food and Drug Administration (FDA) have approved xylitol as a food additive. Xylitol is generally safe, but like other sugar alcohols, it can cause digestive issues such as bloating and diarrhea in some people.

It is worth noting that xylitol can be very toxic to dogs. It is vital to store products containing xylitol in a safe place that pets cannot reach. Anyone who thinks that their dog has consumed xylitol should call their veterinarian or the Animal Poison Control Center immediately.