Tooth extractions
Sometimes a tooth is too damaged, infected, or crowded to keep. Taking it out is called an extraction, and the area is numbed first. Before any tooth comes out, we’ll talk about whether it can be saved and how you might replace it.
At a glance
- Visits
- To confirm: Typical number of visits
- Time per visit
- To confirm: Typical time per visit
- Numbing
- Local numbing
- Recovery
- Most people feel better within a few days
- Provided by
- Dr. James Minici, general dentist
What it is
An extraction removes a tooth from its socket (the space in the jawbone that holds the root). There are two kinds:
- A simple extraction is for a tooth you can see above the gum. Your dentist loosens it and lifts it out.
- A surgical extraction is for a tooth that’s broken at the gumline or hasn’t fully come in. It may mean a small opening in the gum, or taking the tooth out in pieces.
Dr. Minici, a general dentist, provides extractions. Some cases, such as teeth that sit deep in the bone or close to a nerve, are referred to an oral surgeon.
Who it helps
An extraction may be needed for:
- Decay or a crack too deep to repair
- An infection that a root canal can’t clear
- A tooth loosened by gum disease
- Crowding, sometimes before braces or aligners
- Wisdom teeth that are causing problems
Keeping your own tooth is usually the first choice when it’s possible. If your dentist suggests an extraction, it’s fair to ask why, and what would happen if you waited. If your face is swelling or you have a fever, see emergency dental care.
What happens
- Exam and X-rays. An X-ray shows the roots and the bone around them. You’ll also talk about whether and how to replace the tooth.
- Numbing. We numb the area, which feels like a pinch and then a spreading numbness in your lip or cheek. If you’re nervous, ask about sedation options.
- Loosening the tooth. Your dentist gently rocks the tooth to widen the socket. You’ll feel firm pressure and pushing. If you feel anything sharp, say so, and more numbing can be given.
- Removing the tooth. The tooth is lifted out. You may hear cracking or creaking sounds, which are normal. A surgical extraction takes longer and may need a few stitches.
- Starting to heal. If you plan to get an implant later, a bone graft may be placed in the socket. Then you bite on gauze to help a blood clot form.
Recovery and aftercare
These are general guidelines. Follow the instructions your dentist gives you.
- Bleeding. Bite firmly on gauze for 30 to 45 minutes. Some oozing on the first day is normal. If bleeding picks up, bite on fresh gauze or a damp black tea bag for 30 more minutes.
- Protecting the clot. For 24 hours, don’t rinse, spit, or use a straw. Don’t smoke or vape for at least a few days. These can pull the clot loose.
- Swelling and pain. Ice your cheek, 20 minutes on and 20 off, for the first day. Swelling often peaks on the second or third day. Take pain relievers as directed.
- Eating and cleaning. Eat soft, cool foods for a day or two, and chew on the other side. After 24 hours, rinse gently with warm salt water a few times a day.
- Dry socket. If pain gets worse two to four days later, the clot may have come out. Call the office, because it can be treated.
Call the office if bleeding stays heavy after an hour of pressure, or if swelling keeps growing after the third day. Also call if you have a fever or see pus. For trouble breathing or swallowing, call 911.
Cost and insurance
The cost depends on whether the extraction is simple or surgical and how many teeth are removed. A bone graft adds to it, and so does sedation where it’s used. Replacing the tooth later is a separate cost to plan for.
Most dental plans cover part of a needed extraction, though how much varies. Financing can spread the cost; see insurance and financing.
Alternatives
- Saving the tooth. Depending on the problem, a root canal, a crown, or gum treatment may let you keep it.
- Watching and waiting. Some teeth, such as wisdom teeth that aren’t causing problems, can be watched with X-rays instead.
- Replacing the tooth afterward. If the tooth comes out, an implant, a bridge, or a partial denture can replace it.
Questions people ask
Does having a tooth pulled hurt?
The area is numbed first, so most people feel pressure and pushing rather than pain. Some soreness afterward is normal for a few days, and pain relievers usually help.
How long does it take to heal?
Most people feel better within a few days, and the gum closes over the socket in a few weeks. The bone underneath keeps healing for a few months.
How do I know if I have a dry socket?
The main sign is pain that gets worse instead of better, usually two to four days after the extraction. It may spread toward your ear, and you might notice a bad taste or smell. Call the office if this happens, because it can be treated.
Should I replace a tooth that’s been pulled?
It depends on the tooth. A missing front tooth affects how you look, and a missing back tooth can change how you chew and let nearby teeth drift. Your dentist can talk with you about an implant, a bridge, a partial denture, or leaving the space.
An exam is how we find out what’s right for you.