Why a tooth may need to come out
- Damage beyond repair from trauma or decay.
- Infection that reaches the pulp, the nerves and blood vessels at the center of the tooth. A root canal often solves this, but a severe infection may require extraction to keep it from spreading.
- Risk of infection, particularly for people with a weakened immune system.
- Overcrowding, often when preparing the mouth for braces, or when a tooth lacks room to come through the gum.
Read more in when is tooth extraction necessary?
Before your extraction
At the consultation, we review your medical history, your planned treatments, and every medication, vitamin, supplement and over-the-counter drug you take. We take X-rays first, and may prescribe antibiotics beforehand if you have an infection, a weakened immune system or certain medical conditions.
- Wear loose, short-sleeved clothing.
- Follow the fasting instructions we give you, and avoid smoking before your appointment.
- Tell us right away if you have a cold, nausea or vomiting. We may need to reschedule or change the anesthesia plan.
- If you will have general anesthesia, arrange for a trusted adult to drive you.
During the procedure
The dentist numbs the area with an injection, so you should feel no pain. If the tooth is impacted, gum and bone covering it are removed first. Afterward you bite on gauze to control bleeding and help a blood clot form. We may place a few stitches to close the gum.
Aftercare
- Keep the first gauze in place for a few hours so the blood clot can form. That clot protects the site and prevents dry socket.
- As the numbness wears off, take the pain relievers, anti-inflammatories or antibiotics you were prescribed as directed.
- Until the site heals, avoid rinsing hard, spitting, sneezing, smoking, using straws and blowing your nose.
- Keep the area clean by changing the gauze and using a gentle salt water solution. Let the water bathe the site rather than swishing it.
Swelling, inflammation and soreness are normal and usually fade in a few days. We normally schedule a follow-up to check the site, clean it and talk about replacing the tooth with an implant or another option. See options for replacing missing teeth.
Possible complications
The most common is dry socket, when the clot does not form or is dislodged and exposes the bone. It can slow healing and lead to infection. Less often, extraction can cause nerve injury, an opening into the sinus, or a shift in your bite when several teeth are removed. Most complications can be treated.
Call us if pain lasts longer than two weeks, or if you think the clot has come loose.
Common questions
How long does the pain last?
Healing generally takes one to two weeks, and pain at the site is typically present for the first 48 to 72 hours. Take medication as prescribed.
Do I need a follow-up appointment?
In most cases yes. A clot can come loose without you noticing, and some complications show no signs. We check and clean the site and discuss ways to replace the tooth.
Do wisdom teeth always have to come out?
No. Only when they are impacted, causing pain or pressure, or pushing on neighboring teeth. See wisdom teeth extraction.
How much does an extraction cost?
Each case is different. Talk to your insurance provider about your coverage, and we can work with you to find a payment option that fits.
What if I have a complication?
Most can be treated. For dry socket, we clean out the area and apply a medicated dressing. Other complications may need further treatment.