Tooth removal

Why are teeth removed?

There are lots of reasons why you might need to have a tooth removed. For example, if you have:

• Severe tooth decay
• Gum disease (periodontal disease)
• A broken tooth that can’t be repaired
• An abscess (a collection of pus) on your gums or around your teeth
• Crowded teeth – when your teeth don’t have enough space in your jaw
• Impacted wisdom teeth – you can read more about this in our separate topic: Wisdom teeth removal

Your dentist will usually remove a tooth in your dental surgery. But sometimes an oral surgeon will do the procedure in hospital if your extraction is more complicated. You can usually go home on the same day.

At Bupa Dental Care, we have over 350 practices throughout the UK and a network of clinicians that are experienced at dealing with all dental issues. If you're experiencing pain or think you might need a tooth removed, contact your local practice and we'll be happy to help.

Preparing for tooth removal

Your dentist will explain how to prepare for your procedure. They’ll ask about your dental and medical history. It’s important to let them know about any medical conditions, allergies or recent surgery, as well as any medicines you’re taking.

Your dentist will discuss with you what will happen before, including any pain you might have. If you’re unsure about anything, ask. No question is too small. Being fully informed will help you feel more at ease and will allow you to give your consent for the procedure to go ahead.

Anaesthesia for tooth removal

You’ll usually have your tooth (or teeth) removed under a local anaesthetic. This completely blocks pain from your gums, although you’ll still feel pressure. You’ll stay awake during the procedure, so you’ll be aware of what’s happening. If you’re very anxious about having your tooth removed, it might be possible to have a sedative, which relieves anxiety, makes you feel sleepy and helps you to relax.

Having a general anaesthetic for an extraction is usually only an option for young children or adults with learning disabilities. However, your dentist may decide it’s right for you if several of your teeth need to be removed, or the extraction is going to be more difficult than usual.

If you’re going to have a general anaesthetic, your dentist will refer you to a hospital to have your procedure.

The procedure: tooth removal

Once you’re sitting comfortably in a chair, your dentist will inject a local anaesthetic into the area around your tooth or teeth. They’ll wait a few minutes to allow the injection to work and ask you a few questions to see if it’s taking effect.

The roots of your tooth sit in a socket (hole) in your gum. Your dentist will widen your tooth socket and gently loosen your tooth before they remove it. Sometimes your dentist may need to put a stitch in the empty socket to help it heal.

You’ll feel some pressure in your mouth when you have a tooth removed but it shouldn’t be painful. If you do feel any pain, let your dentist know straightaway.

If you have any questions or concerns, please contact your dentist, or speak to your local Bupa Dental Care practice.

Aftercare for tooth removal

Your gum may bleed for a few minutes after you have your tooth taken out. Your dentist will give you a piece of soft padding to bite on to stop the bleeding and you’ll be able to go home once it’s stopped.

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

If you have had a general anaesthetic or sedative, you’ll need to rest until the effects of the anaesthetic or sedative have worn off. Ask a friend or family member to take you home and ask them to stay with you for a day or so while the anaesthetic wears off.

You don’t always need a follow-up appointment after you’ve had a tooth removed. But if you had a complicated procedure, you might need to go back to see your dentist so they can check how you’re healing. You’ll be given a date for this while you’re in practice.

Recovering from tooth removal

Most people can go back to their normal routine the same day. Only if you have a more difficult surgical extraction, will it take a few days to recover. See how you feel and follow your dentist’s advice.

If you had a local anaesthetic, it may take a few hours before the feeling comes back into your mouth. Don’t have any hot food or drinks until it comes back otherwise you might burn or scald your mouth. Also take care not to bite your tongue, particularly when you speak, drink or eat. Rest as much as possible and keep your head up to reduce the bleeding.

Your mouth may feel sore once the anaesthetic wears off. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Your dentist may suggest that you take paracetamol and ibuprofen together. Always read the patient information leaflet that comes with your medicines. If you have any questions, ask a pharmacist for advice.

Some people find that their pain is worse about three days after the procedure, but then settles down again within a week to 10 days. This is completely normal. If you’re in severe pain and it gets worse, contact your dentist. They’ll check that nothing else is causing it, such as an infection.

Tips to make sure the tooth removal area heals properly

• Don’t rinse your mouth out for at least 24 hours after a tooth removal. This could disturb any blood clot that has formed, and you may start bleeding again.
• After 24 hours, rinse gently with a salt water mouthwash (made using salt and hot, but not boiling water), four times a day to keep the area clean.
• Eat soft food once you first have your tooth removed, so you don’t have to chew much.
• If your gum bleeds, bite down on a clean pad of material such as a clean handkerchief for at least 15 minutes.
• Don’t drink alcohol for at least 24 hours and don’t smoke for as long as possible, but at least for the rest of the day.
• Brush your teeth but keep your toothbrush away from the healing wound, to begin with, brushing closer to it each day. You could try softening your toothbrush in hot water before you brush.

You may have stitches, depending on which tooth was removed, and why. The stitches will dissolve by themselves within a week to 10 days, so you won’t need to have them removed.

It’s important to brush these carefully for three to four days after your surgery to stop food getting trapped. But be careful so you don’t dislodge any newly-formed blood clots that may have formed over your empty tooth socket.

Have questions about tooth pain or a tooth extraction or Would you like to see a Bupa Dental Care NHS or private dentist? Find a practice near you.

Side-effects of tooth removal

After your tooth is removed, you may have some side-effects, which shouldn’t last long.

You’re likely to have some discomfort for a few days afterwards and you may have some swelling. You can use an ice pack or frozen peas wrapped in a towel to reduce the swelling. Your discomfort should settle down completely within about 10 days. You might have some bruising for a couple of weeks and your jaw may feel a little stiff for a week. Don’t force your jaw open if it’s stiff.

You might notice some bleeding for a day or two. The blood will be mixed with your saliva, which can make it look like there’s more blood than there actually is. But if the bleeding doesn’t stop, contact your dentist.

Complications of tooth removal

Complications are when problems occur during or after a procedure. Complications of having a tooth removed include:

• Damage to other teeth. This might happen when your dentist removes your tooth, particularly if the teeth next to the one being removed have a large filling or crown.
• Sensitive teeth. The teeth next to the one that’s removed may feel sensitive and this may last several weeks.
• Poor healing. If the blood doesn’t clot in your tooth socket, it won’t heal properly. This is called dry socket and can be very painful. You’re more likely to develop dry socket if you smoke or take oral contraceptives. See your dentist straightaway. They’ll put a dressing in the socket and prescribe you some antibiotics.
• A nerve injury. You might get a tingling or pins and needles or a numb feeling in your gum near the tooth socket. This may be caused if your nerves are bruised in the procedure, but it won’t usually last long.

If you think you may have complications from a tooth extraction, seek advice from your dentist as soon as possible.

Replacing removed teeth

Once you’ve had a tooth extraction, your dentist will usually recommend you fill the gap where your tooth used to be. Gaps left by missing teeth can put a strain on neighbouring teeth, affect the way you bite and leave you more susceptible to tooth decay and gum disease. Some of the treatment options available for replacing missing teeth are:

• Dental implants: A dental implant is a long-term, discreet solution for replacing missing or failing teeth. A dental implant itself is a titanium screw that’s placed directly into your jawbone, replacing the missing root of your tooth.
• Dental bridges: A dental bridge essentially bridges a gap in your mouth. A bridge replaces a missing tooth by using a false tooth that’s bonded to the natural teeth on either side of the gap.
• Dentures: Dentures are removable plastic or metal frameworks that carry single or multiple false teeth. They’re suitable for filling multiple gaps or if you have no teeth at all.

If you’re currently having a tooth extraction procedure, speak to your dentist about options for replacing missing teeth.

If you’re interested in replacing missing teeth from a previous extraction, you’ll need to book a consultation with a dentist to discuss which treatment is most suitable for you.