About tooth removal
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; you can usually go home on the same day. For simplicity, we’ll refer to ‘your dentist’ throughout this topic.
You’ll meet the dentist who’s going to do the procedure to discuss your care. It may differ from what’s described here as it will be designed to meet your individual needs.
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. You may be asked to do this by signing a consent form.
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 tooth extraction is usually only an option for young children or adults with learning disabilities. But your dentist may decide it’s right for you. For example, if they need to remove several teeth, 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. A general anaesthetic can make you sick so it's important that you don't eat or drink anything for six hours before your procedure. Follow your dentist or anaesthetist's advice. If you have any questions, just ask.
Alternatives to tooth removal
If you don’t want to have your tooth taken out, there may be other ways to treat your tooth, depending on what’s wrong with it. For information about other options, see our topic on Restoring teeth.
Your dentist will explore all options before they remove your tooth. But sometimes removing your tooth is the best option. Your dentist will explain why, as well as the possible effects on your health if you don’t remove your tooth.
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.
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 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.
Having a general anaesthetic can really take it out of you. You might find that you're not so coordinated or that it's difficult to think clearly. This should pass within 24 hours. In the meantime, don't drive, drink alcohol, operate machinery or sign anything important. Always follow your dentist or surgeon’s advice.
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.
Recovering from tooth removal
It may take you anything from a day to a few days to recover enough to return to your normal routine and go back to work. But most people can go back to their normal activities, including work, the next 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 so you don’t 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.
Your dentist may advise you not to blow your nose or sneeze violently, or suck on straws after you have a tooth removed. This could disturb the healing process.
After your tooth has been removed, there are some things you can do to speed up your recovery.
- Don’t rinse your mouth out for at least 24 hours. This could disturb any blood clot that has formed and you may start bleeding again. After this time, rinse gently with a salt water mouthwash. You can make this yourself by dissolving a teaspoon of table salt in a glass of hot (but not scalding) water. Rinse four times a day to keep the area clean – hold the rinse in your mouth for a couple of minutes before you spit it out.
- When you feel ready to eat, start with soft food that you don’t need to chew much. If possible, eat on the other side to where you had your tooth removed.
- 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.
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. If you use an ice pack, or bag of frozen peas wrapped in a towel, over your jaw for the first day it will help reduce the swelling. It 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 the following.
- 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.
FAQ: Can teeth from either side of my jaw be removed at the same time?
It’s usually possible to have more than one tooth taken out at a time. But your dentist may suggest they remove them separately so your jaw isn’t numb on both sides at the same time.
When you have a tooth, or teeth, removed, your dentist will usually give you a local anaesthetic to block the pain. If you have one of your lower teeth removed, the local anaesthetic might just numb around the tooth but it may also numb your lower jaw, and around your tongue and lip. Depending on the type of anaesthetic your dentist uses, this numbness can last for around three or four hours.
When your mouth is numb, you won’t be able to feel pain as you normally would. This means you could burn your mouth on hot food or drinks. Also, you may bite or chew your cheeks or lips without realising.
If you have your teeth removed in separate appointments, you’ll at least be able to feel one side of your mouth.
FAQ: Why would my dentist remove a tooth from the top jaw when it’s the bottom that hurts?
Your dentist won’t remove a tooth if it isn’t causing any problems. But you might get pain in your lower jaw if a tooth on the upper section doesn’t align with your lower jaw and ‘bites’ into your gum or other soft tissue.
The medical name for this is overeruption, which means a tooth projects beyond the line of functional contact between your upper teeth and lower teeth. This can happen if a lower tooth is missing or impacted, which is when there’s not enough room for it to come out. Your tooth may then 'bite' into lower soft tissues and cause pain.
If you’re worried about having a healthy tooth taken out, talk things through with your dentist as there may be other options.
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- Dental decay. Oral Health Foundation. www.dentalhealth.org, accessed 5 October 2017
- Removal of wisdom teeth. British Association of Oral Surgeons. www.baos.org.uk, accessed 5 October 2017
- Wisdom teeth extraction. Royal College of Surgeons of England. www.rcseng.ac.uk, accessed 5 October 2017
- Oral surgery. Oxford handbook of clinical dentistry (online). Oxford Medicine Online. oxfordmedicine.com, published August 2010
- Postextraction problems. The MSD Manuals. www.msdmanuals.com, last full review/revision August 2016
- The provision of oral health care under general anaesthesia in special care dentistry. British Society for Dentistry and Oral Health. www.bsdh.org, published March 2009
- Paediatric dentistry. Oxford handbook of clinical dentistry (online). Oxford Medicine Online. oxfordmedicine.com, published August 2010
- Guidelines for the management of children referred for dental extractions under general anaesthesia. Association of Paediatric Anaesthetists of Great Britain and Ireland. bspd.co.uk, published August 2011
- Practical local anaesthesia. PatientPlus. patient.info/patientplus, last checked 18 December 2015
- Post-operative instructions following oral surgery. British Association of Oral and Surgeons. www.baos.org.uk, accessed 6 October 2017
- What to do following an extraction. Oral Health Foundation. www.dentalhealth.org, accessed 6 October 2017
- Analgesia, anaesthesia, and sedation. Oxford handbook of clinical dentistry (online). Oxford Medicine Online. oxfordmedicine.com, published August 2010
- Personal communication, Dr Steve Preddy, Bupa Dentist, 10 October 2017
- Wisdom teeth. Oral Health Foundation. www.dentalhealth.org, accessed 9 October 2017
- Restorative dentistry 2: repairing teeth. Oxford handbook of clinical dentistry (online). Oxford Medicine Online. oxfordmedicine.com, published August 2014
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Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, October 2017
Expert reviewer Dr Steve Preddy, Dentist
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