Tooth extraction is the most common procedure in dentistry, and the extraction itself is only a local trauma, but there are strict indications for tooth extraction. If a tooth is extracted under unsuitable conditions, it often brings undue loss and pain, and in serious cases, it can be life-threatening. Some patients go to the hospital in order to have their teeth extracted, but after the doctor asks for medical history and relevant examination, they are told that they can’t have their teeth extracted today, and the time is wasted. Therefore, before tooth extraction, you should be prepared as follows to understand which cases are not suitable for tooth extraction? 1. Be psychologically prepared. Before tooth extraction, you should be fully prepared mentally, keep your mood calm, eliminate the fear, tension and dread of tooth extraction, and cooperate with the doctor during the extraction process. For tooth extraction, many patients have fear psychology and insist on “carrying on” and not pulling out if they can. The tooth that needs to be extracted is often no longer functional and is already a lesion, so early extraction is beneficial to health. Many patients think that the anesthetic for tooth extraction will be too painful to bear. Nowadays, the needle used for anesthesia is so fine that it is like a mosquito bite, which is not very painful. After the anesthesia takes effect, tooth extraction is a painless process. There are many people who are afraid of hammer and chisel, but these are relatively old methods of tooth extraction. So the whole extraction process only requires the patient to open his mouth to cooperate. The pain is also only mild for a day or two after the operation and can be relieved by painkillers. Excessive tension may easily cause fainting, and the doctor will have to resuscitate at that time, but all these can be avoided. 2. Be physically prepared. Tooth extraction may seem to be a minor surgery, but in no small way there will be a lot of physical exertion. Especially after the extraction of complex obstructed teeth, it is often impossible to enter normal diet for several days, which has a certain consumption on the body. Therefore, it is important to have a good sleep and rest before the extraction, and not to go directly to the extraction when you are tired, fatigued, have a cold and fever, or lack of sleep, so as not to reduce the tolerance to the extraction procedure to the point of postoperative fever, severe wound pain or even infection. When the overall health condition is poor, tooth extraction should be postponed. If you need to travel within three days after tooth extraction (such as doing airplane or long-distance train) or must attend important meetings, lectures or participate in strenuous sports, etc., it is recommended to extract teeth at a later date to avoid post-operative bleeding. 3. Do not be hungry. You should eat properly before tooth extraction and do not extract teeth on an empty stomach to avoid hypoglycemic shock or fainting. You can only eat liquid food about two hours after tooth extraction, so don’t starve your belly before surgery to avoid being more hungry and unable to eat after surgery. Some patients come to the hospital on an empty stomach because they think they need to do a checkup for tooth extraction, then they must eat even after the checkup is done before they can extract the tooth. 4. The tooth hurts so much that it cannot be extracted. The tooth should be extracted only after the inflammation subsides, and oral amoxicillin/cephalosporins and metronidazole can be taken to reduce inflammation. Teeth should not be extracted when there are acute infectious diseases, acute inflammation in the oral cavity, or acute inflammation of the teeth (manifested as severe pain) to avoid spreading the disease. 5. Never conceal the disease. Some elderly people, who are suffering from cardiovascular diseases, concealed their heart disease history from the doctor because of the severe toothache and the eagerness to extract the tooth, resulting in the induction of angina and transient cerebral circulation disorder after tooth extraction, which was only rescued from life threatening by the doctor. Be sure to inform your doctor if you suffer from any of the following diseases High blood pressure. Patients with high blood pressure should have their hypertension controlled before considering tooth extraction and take antihypertensive medication on a regular basis before and after surgery. Severe hypertension that is not controlled before tooth extraction can easily lead to cardiovascular accidents and postoperative bleeding, which can be life-threatening in severe cases. Heart disease. Any type of heart disease or heart discomfort should be explained to the doctor. Patients who have had a myocardial infarction within 6 months; or who have had a recent attack of angina pectoris; or who have congestive heart failure should not have their teeth extracted. Blood disorders. Hemophilia, thrombocytopenia, leukemia, leukopenia, anemia, etc. may cause more than bleeding or wound infection and even endanger life. Diabetes. High blood sugar can reduce the immunity of the body and make it easy for wound infection and delayed wound healing to occur. Blood sugar should be controlled before tooth extraction, and fasting blood sugar should be below 8.88 mmol/L before tooth extraction. If insulin is being injected, tooth extraction can be performed one or two hours after the injection. Due to the decrease of immunity of the body, antibiotics should be used before and after tooth extraction to prevent infection. Liver disease. People with significant impairment of liver function can cause more than postoperative bleeding because their internal blood clotting mechanism is affected. Liver preservation treatment should be given first, and tooth extraction should be performed only after liver function is basically normal and coagulation function is normal. Long-term use of anticoagulant drugs, such as aspirin and warfarin, should be stopped for 1 week before tooth extraction. If you have been taking hormones for a long time, please consult your internist if you need to adjust the hormone dosage and take oral antibiotics to prevent infection before and after surgery. Patients with malignant tumors should avoid tooth extraction as much as possible to avoid tumor spread. Patients who have undergone radiotherapy to the head and neck should avoid tooth extraction as much as possible to avoid radioactive osteonecrosis. The affected teeth should be treated before radiotherapy and teeth that cannot be retained should be extracted. Patients with hyperthyroidism should have their teeth extracted only after the hyperthyroidism has been controlled. It is best to get the guidance of the treating physician. Age over 70 years is a risk factor in itself and extraction under cardiac monitoring is recommended. 6. Please note for women: tooth extraction is generally not recommended during menstruation and taking contraceptive pills to avoid wound infection after causing more than bleeding. Tooth extraction should be avoided during pregnancy (especially in the first and second trimester) to avoid causing miscarriage or premature delivery. If tooth extraction is necessary, the middle trimester of pregnancy is relatively safe. Therefore, it is important to prepare for the extraction in order to solve the problem efficiently so as not to increase the number of visits. Also inform your health condition truthfully. The doctor will decide whether to perform the extraction procedure or prepare accordingly according to the patient’s health condition, such as the choice of anesthetic, whether the extraction needs to be performed under cardiac monitoring, etc. And if the medical history is concealed, you may not be lucky to save your life.