When a patient's medical history warrants it, extra precautions are sometimes required at the dental clinic. Tooth extraction is performed for numerous reasons—such as significant decay that has led to pulp necrosis (death of the tooth's nerve tissues). The tooth may also be strategically removed to correct spacing issues for upcoming orthodontic work (giving other teeth room to align themselves). Extra precautions can be essential in tooth extraction if the procedure is likely to trigger more bleeding than would otherwise be expected.
It's not as though a typical dental extraction (or even a more intricate surgical extraction) would create much bleeding. Post-extraction bleeding will continue temporarily, and the resulting wound can be staunched with (regularly changed) pieces of sterile gauze until the bleeding ceases. Some patients may have trouble clotting or forming the red and white cells and fibrin combination that constitutes a clot. This clot must form in the empty dental socket to facilitate healing.
Diabetics, hemophiliacs, and people on prescribed anticoagulants—these are some of the circumstances when a patient may have difficulty forming a clot after tooth extraction. This isn't to suggest that you're ineligible for tooth extraction. After all, it can be a medical necessity when the tooth cannot be restored. Your dentist will employ a specialist method, using a special tool called a dental elevator.
Standard tooth extractions require little more than brute force. The tooth is firmly gripped with dental forceps, and your dentist applies the necessary pressure. The tooth's periodontal ligaments break, and the tooth detaches from its socket. This approach is not appropriate for you. The dental elevator allows the tooth to be gently prised out of its socket before the final stage is completed with forceps.
Instead of a pull force, dental elevators use leverage. The tooth is loosened using a conventional elevator, gently rocking the tooth loose in its socket. Please rest assured that you will have received a potent local anesthetic prior to your extraction, so you won't feel a thing. With the tooth now loose, your dentist can use a fine-headed tool called a luxator, which can be angled underneath the loose tooth to sever its periodontal ligaments. The tooth will now offer no resistance when forceps are used, and your extraction is complete.
This form of extraction minimizes bleeding, and your dentist can take further precautions. Sutures are not routinely used in standard extractions, but in your case, sutures can be applied, stitching the wound closed. These may be self-dissolving, or your dentist might schedule a follow-up appointment for their removal.
Even when you're not prone to quick clot formation, tooth extraction is a reasonably straightforward dental procedure—with the correct safeguards in use.
Contact your dentist for more information about tooth extraction.