Tooth extraction is the removal of adult teeth to solve problems such as tooth decay, infection or crowding. The goal of the dentist or oral surgeon is to extract the entire tooth, including its root, from its socket in the gum. This procedure is usually done while you’re under localized or generalized anesthesia in a dentist’s office or clinic, and it’s usually painless and well tolerated.
This article will give you an idea of how tooth extraction works, its risks and recovery afterwards.
Prepare for the procedure
Prior to the procedure, you will need to undergo a dental evaluation and imaging to ensure that tooth extraction is the best course of action. Several dental problems require tooth extraction:
- Tooth infection (which are “abscesses” or collections of discharge)
- Crowded or crooked teeth
- Significant gum disease affecting the stability of teeth
- Damage to a tooth due to impact, accident or fall
Once your dentist determines that you need an extraction, they will need to review your general health. Inform them of the medications you are taking, your medical history and your current state of health. Because they increase the risk of infection, tell them if you have or have had any of the following:
Simple extractions are sufficient for many cases of tooth decay, abscesses and other problems. They can be performed by a dentist. Here is a quick description of this procedure:
- Numbness: The area around the affected tooth, especially the gums and surrounding bone, is numbed using a local anesthetic. This will avoid pain and discomfort during the procedure and usually goes away within a few hours.
- Loosening: The dentist tilts and begins to loosen the targeted tooth using a tool called an “elevator”. You may feel pressure when this happens, but you shouldn’t feel any pain.
- Tie rod: Once the tooth is loose enough, the dentist uses forceps to physically remove the tooth structure. The newly emptied tooth socket bleeds at first, but quickly coagulates.
- Final steps: The empty socket is cleaned out and the jaw bone is reshaped as needed. The gums may require stitches in some cases, and you will need gauze to absorb any bleeding.
More complex cases require oral surgery. Surgery may be needed for impacted teeth (when they push in at the wrong angle or without coming out of the gums) or when wisdom teeth need to come out. This work involves:
- Antibiotic drugs: Patients usually take an antibiotic before the procedure to prevent infection.
- General anaesthesia: Unlike simple extraction, surgical extractions are generally performed under general anesthesia and sedation (“sleep”). Your vital signs will be monitored carefully while you are under.
- Multiple extractions: If more than one tooth needs to be removed, this is done under general anesthesia using methods similar to those described above. The specific treatments needed depend a lot on the size and extent of the dental problem.
- Complex deletion: In some cases, parts of the surrounding bone may need to be removed or reshaped. Dental surgeons access these areas through incisions in the gums. Additionally, they may need to employ a “section” or break the tooth into parts and extract them in stages.
Extraction of wisdom teeth
Wisdom teeth are an extra set of adult teeth that emerge behind your upper and lower back molars. Usually appearing in young adults between the ages of 18 and 24, they can lead to crowding and impaction of the teeth. Their removal is by far the most common reason for surgical tooth extraction.
Risks of tooth extraction
Complications of tooth extraction are rare. However, there are a number of risks associated with the procedure. These include:
- Site infection
- Nerve damage
- Damage to other teeth, dental crowns or fillings
- Bruising, swelling and/or pain at the site
- Persistent pain following the operation
- Reactivity to anesthesia or other medications taken after the procedure
- Prolonged healing of the region
- Dry socket
What is a dry socket?
In most cases, after a tooth extraction, the blood pools and clots, allowing the remaining gum tissue and bone to heal. Dry socket occurs when this clot falls out of the socket before healing is complete (within days of the procedure). This condition exposes nerves and bones, leading to pain and bad breath.
Recovery after tooth extraction is gradual and depends a lot on each case. All told, it takes one to two weeks for the socket to heal, although sometimes it takes longer – up to a month or more – for the surrounding bone to regrow and recover completely. This process can be broken down into three steps:
- Inflammation: The blood in the socket coagulates after the extraction of the tooth. Over the next week, calcification or scarring of the affected area occurs as tissue gradually regrows and replaces the clot. This causes an inflammatory response in the area.
- Proliferation: From one to two weeks after the procedure, immature bone cells and other types accumulate in the area. Over time, tissues, blood vessels, nerves and bone material grow back.
- Maturation: In the final stage of healing, bone cells mature and tissues and other structures complete their development. Some bone loss is expected, which is monitored by the dentist.
Follow-up care for tooth extraction
The most important thing after a tooth extraction is that you do what you can to make sure everything heals properly. The most critical and often most uncomfortable recovery period is the first two days. You and your dentist will need to be vigilant throughout your recovery. At the start, here is what you should keep in mind:
- Use prescribed pain relievers as directed or over-the-counter varieties.
- To manage pain, apply ice to the face near the affected area for 10 minutes at a time, as needed.
- After 24 hours, gargle your mouth with salt water (1 teaspoon [tsp] salt in 8 ounces [oz] hot water) several times a day.
- Do not brush your teeth or floss for the first 24 hours after the procedure.
- Change gauze pads before they get soaked with blood.
What can you do to ensure a full and complete recovery? Here is a breakdown:
- Avoid touching the affected area with your tongue.
- Rest and try to relax afterwards.
- Don’t smoke, vape, or drink alcohol during your recovery.
- At the start of recovery, choose soft, easy-to-eat foods, such as gelatin or a light soup.
- Gradually reintroduce foods that are harder to chew.
- Keep your head up when you lie down.
- Do not use straws and do not suck with your mouth.
- Be careful and follow your dentist’s orders regarding brushing and flossing.
- Be careful with stitches; some dissolve on their own, while dentists must remove others.
Bisphosphonates and bone recovery
Bisphosphonates are a class of drugs that prevent bone resorption, which is the breakdown of bone cells. They are used to treat conditions such as osteoporosis, Paget’s disease and bone cancer. Applied intravenously or topically, they are also prescribed in cases of tooth extraction that have resulted in significant bone loss.
When to call the dentist
Throughout your recovery, it will be important for you to monitor your dental health and several follow-up appointments will be necessary. There are several signs to call your dentist or surgeon:
- Fever, chills or other signs of infection
- White or yellow discharge from the site and severe swelling
- Severe pain or excessive bleeding for more than several hours after the procedure
- Difficulty swallowing
- Cough, chest pain, or difficulty breathing
- Hives and/or rash
Tooth extraction is the clinical removal of a tooth or teeth. It is used to treat a range of problems, such as tooth crowding, impaction, tooth infection, loose teeth due to gum disease, or damage due to trauma.
There are two types: simple extraction is performed under localized anesthesia, while surgical extraction – often involving remodeling of the surrounding bone – is more invasive and performed under general anesthesia.
Aftercare involves managing symptoms, avoiding smoking and drinking, eating soft foods, and making sure there are no complications.
A word from Verywell
There is no doubt that tooth extraction can do a lot for your smile. As with all of these procedures, this work has both dental health and cosmetic benefits. If you’re suffering from toothache, gum loss or other issues, you need to act fast and get the help you need. The sooner a dentist is on the case, the better off you will be.
Frequently Asked Questions
How painful is a tooth extraction?
With sufficient localized or general anesthesia, you should not feel any pain during the procedure. However, there is always a pinch when the drugs are injected, and some discomfort and tenderness is expected during your recovery. Tell your dentist or surgeon if you experience excessive pain.
Are tooth extractions covered by insurance?
In most cases, dental insurance will cover all or part of the dental extraction costs. It all depends on your plan. Talk to your dentist or oral surgeon’s support staff about what is covered; they may also be able to help find other ways to cut costs or make payment manageable.
What should I eat after tooth extraction?
As your mouth heals, you will need to be very careful about what you eat and how you eat it. Here’s a quick breakdown of what to keep in mind:
- Start with a mostly liquid diet: mixed soups, yogurt, and pudding
- Drink plenty of fluids and avoid hot drinks or alcohol
- As you recover and feel comfortable, gradually reintroduce solid foods
- Avoid using the affected tooth when chewing
- Do not use straw
What is the average cost of a wisdom tooth extraction?
The amount you pay for a tooth extraction depends on the extent of the work needed, as well as your level of insurance coverage. Generally speaking, dental plans will cover some or all of the cost. Without insurance, the average cost of a simple extraction is $150 to $300 per tooth. For surgical extractions, this rises to a range of $225 to $2,300.