Tooth removal

A tooth removal is a procedure to take your tooth out completely. It’s only done when absolutely necessary, like if your tooth is severely infected or damaged and can’t be saved with other treatments. If you do need a tooth removal, your dentist will explain your options to replace it.

Reasons for tooth extraction

There are lots of reasons you might need to have a tooth pulled, like if you have:

• severe tooth decay
• gum disease
• a badly broken tooth that’s beyond repair
• an infection (abscess) inside your tooth or on your gums
• crowded teeth – when your teeth don’t have enough space in your jaw
• impacted wisdom teeth – when your wisdom teeth are blocked from fully erupting by a nearby tooth

How to prepare for tooth extraction

Before booking your procedure, you’ll have an initial consultation with your dentist. They’ll go through everything with you so you know what to expect, and answer any questions you may have. Your dentist will ask you about your medical history to make sure a tooth extraction is suitable for you. They’ll also take x-rays of your mouth to get a better look at your teeth and gums prior to extraction.

Extraction of the tooth

Most extractions can be simple and quick, but some may take longer depending on the condition of the tooth that’s being removed. Most are carried out by a general dentist at your local practice. Your dentist will start by injecting a local anaesthetic into your gums. This numbs the area so you don’t feel any pain, but you’ll still be awake and feel some pressure. They’ll use dental instruments to gently loosen and remove your tooth from its socket. Sometimes, they might need to make a small cut in your gum to access your tooth and apply stitches to help it heal.

Once your tooth is out, they’ll clean the area and ask you to bite down on a piece of gauze to help stop any bleeding. This encourages a blood clot to form, which is part of the healing process.

If your case is more complex – like removing multiple teeth or an impacted tooth  – you might be referred to a specialist oral surgeon to have a surgical tooth extraction. Sometimes, you might be given a sedative or general anaesthetic to help, which will either make you drowsy or fall asleep during the procedure.

Before you go home, your dentist or surgeon will give you advice about looking after your teeth and gums. They might prescribe you painkillers and may sometimes prescribe antibiotics to reduce your chances of developing an infection.

Recovering from tooth extraction

After a tooth extraction, you’ll usually be able to go home the same day and get back to your normal routine when you feel up to it. If you’ve had a local anaesthetic, it can take a few hours for the feeling to come back in your mouth. It’s best not to eat or drink anything hot until it does, so you don’t accidentally burn or bite your mouth.

If you’ve had a more complex procedure under sedation or a general anaesthetic, it could take a few days to recover and you might need to take some time off. Ask someone to take you home and stay with you until the effects of the anaesthetic have worn off.

It’s normal to have a bit of pain and bleeding for a day or two after having a tooth pulled. You might also have some swelling, bruising and a stiff jaw for a week or two. If you’ve had stitches, these will dissolve by themselves within 1-4 weeks, depending on the type you’ve had.

If the pain or swelling gets worse, you have a high temperature, or the bleeding doesn’t stop by applying pressure, contact your dentist for advice.

What to do after tooth extraction

To help your recovery after a tooth removal, try the following.

• Don’t rinse your mouth or drink through a straw for the first 24 hours. This could dislodge the blood clot, which is needed to prevent bleeding and infection.
• After 24 hours, gently rinse your mouth with warm salty water, 3-4 times a day, to keep it clean.
• Place an ice pack wrapped in a towel over your cheek for up to 25 minutes, every two hours to reduce any swelling.
• If you experience any bleeding, bite down on a piece of clean material for five minutes.
• Eat soft foods like yoghurt, soup and eggs for the first few days.
• To relieve pain after tooth extraction, take any antibiotics or painkillers your dentist has recommended or prescribed.
• Keep cleaning your other teeth carefully, but avoid brushing your stitches for the first 3-4 days.
• Don’t smoke or drink alcohol for at least 24 hours, longer if possible.
• Prop your head up with pillows when you sleep or lie down.
• Avoid strenuous exercise for 24 hours, as this can increase your heart rate and chance of bleeding.

Tooth extraction complications

As with any surgical procedure, there can sometimes be small complications after a tooth extraction, like:

• Dry socket. If the blood doesn’t clot in your tooth socket, or the clot moves, it won’t heal properly. This is known as dry socket and causes pain and delayed healing.
• An infection. Bacteria can enter the place where your tooth was removed, leading to an infection. Signs may include swelling, pus, fever, or a bad taste in your mouth.
• Damage to nearby teeth. This might happen when your dentist removes your tooth, particularly to the teeth next to the one being removed.
• A nerve injury. In rare cases, a tooth extraction can bruise the nearby nerves, causing numbness, tingling, or pain in the lips, tongue, or chin. But it won’t usually last long.
• Bone fragments. Sometimes tiny pieces of bone may come to the surface of the gum after an extraction. These can be uncomfortable but usually come out on their own or can be removed by the dentist.

If you think you have any complications from a tooth extraction, contact your dentist immediately for advice.