What is a tooth extraction?
A tooth extraction is the removal of a tooth from its socket in the jawbone. Dentists try to save natural teeth whenever possible, but sometimes removal is the safest way to protect your health and the rest of your mouth.
Extractions are performed by general dentists and by oral and maxillofacial surgeons, who handle impacted teeth and more complex surgical cases.
Reasons a tooth may need to be removed
Removal is usually a last resort after other treatments have been considered.
- Severe decay that reaches the center of the tooth and cannot be restored
- Advanced gum (periodontal) disease that has loosened the tooth
- A tooth broken or cracked below the gumline
- Infection or risk of infection, especially before certain medical treatments
- Crowding, often before orthodontic treatment, to make room for alignment
- Impacted wisdom teeth that cannot fully erupt or that damage nearby teeth
Simple vs. surgical extraction
The approach depends on whether the tooth is fully visible and easy to access.
Simple extraction
A simple extraction is used for a tooth that can be seen in the mouth. After numbing the area, the provider loosens the tooth with an instrument and removes it. This is typically quick and done with local anesthesia.
Surgical extraction
A surgical extraction is needed when a tooth is broken at the gumline or has not fully come in, such as an impacted wisdom tooth. The surgeon makes a small incision in the gum and may remove a little bone or section the tooth before removing it. Sedation or general anesthesia may be offered.
What to expect during the procedure
Before the appointment, your provider reviews your medical history and any X-rays. Let them know about medications and health conditions, since some require special planning.
- The area is numbed with local anesthesia; sedation may be added for comfort.
- You will feel pressure but should not feel pain during the removal.
- The provider removes the tooth and cleans the socket.
- Gauze is placed over the site to control bleeding and help a blood clot form.
- Stitches may be used after a surgical extraction and sometimes dissolve on their own.
Recovery and aftercare
Most people feel noticeably better within a few days. Protecting the blood clot that forms in the socket is the key to smooth healing.
- Bite gently on gauze for the first hour or as directed to stop bleeding.
- Rest for the first 24 hours and keep your head slightly elevated.
- Use a cold compress on the cheek to limit swelling.
- Eat soft, cool foods and stay hydrated; avoid hot liquids at first.
- Do not smoke, use straws, or spit forcefully for several days, as suction can dislodge the clot.
- Wait 24 hours before gentle rinsing with warm salt water; keep brushing the rest of your mouth.
- Take pain relievers as recommended by your provider.
Dry socket and other complications
Dry socket (alveolar osteitis) happens when the protective blood clot is lost or dissolves before the wound heals, exposing bone and nerves. It causes intense pain a few days after the extraction, often with a bad taste or odor. Smoking and using straws raise the risk.
Dry socket is treatable. Your provider can clean the socket and place a medicated dressing to ease pain while it heals. Contact your provider if you have severe or worsening pain, heavy bleeding, fever, or signs of infection.
Replacing a missing tooth
Except for wisdom teeth, a removed tooth usually should be replaced. A gap can let nearby teeth shift, affect your bite and chewing, and lead to bone loss in the jaw over time. Common replacement options include a dental implant, a fixed bridge, or a removable partial denture. Your provider can help you choose based on your needs and budget.
Find an oral surgeon near you
If you have a painful, broken, or impacted tooth, an oral and maxillofacial surgeon can evaluate it and remove it safely. Browse trusted oral surgery providers in your area to schedule a consultation.
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