What is a tooth extraction?
A tooth extraction is an outpatient procedure to remove a tooth. A tooth extraction is also called pulling a tooth. A tooth extraction is done to treat overcrowded teeth or remove a tooth that is too severely decayed or damaged to save with a filling, root canal, or another procedure.
Extracting a tooth is generally considered safe, but there are risks and potential complications. It is only one method used to treat damaged or overcrowded teeth. Discuss all of your treatment options with your provider to understand which options are right for you.
Types of tooth extractions
There are two general types of tooth extractions. They include:
Simple extractions remove teeth that you can see above your gums. General dentists generally perform simple extractions using local anesthesia and sometimes sedation. Simple extractions do not require the dentist to cut the gums and stitch them back up.
Surgical extractions remove teeth below the gum line, such as teeth that have broken off or teeth that have not completely emerged. Oral and maxillofacial surgeons and general dentists perform surgical extractions using local anesthesia and sedation or general anesthesia.
Surgical tooth extractions involve cutting the gums, breaking up the tooth, and possibly removing bone near the tooth root.
Other procedures that may be performed
Your provider may perform other procedures after a tooth extraction to place an artificial tooth. Leaving a space can lead to the loss of jawbone tissue and the shifting of other teeth. This can result in changes in facial structure and problems with biting, chewing and speaking.
Treatments and restorations that provide artificial teeth include:
Dental bridges replace an extracted tooth by permanently attaching a false tooth to nearby natural teeth. A dental bridge is permanent or fixed. You cannot take it out of your mouth without help from your dentist.
Dental implants consist of a metal post inserted into your jawbone. The implant attaches to an abutment connector, and a permanent false tooth (crown) is fixed on the abutment. Dental implants are permanent or fixed. Sometimes removable dentures are attached to dental implants.
Dentures are removable devices made to replace missing teeth. Dentures may be partial or full and are sometimes attached to a dental implant.
Why is a tooth extracted?
Your provider may recommend extracting a tooth for the following conditions:
Baby teeth that have not fallen out naturally
Impacted adult teeth that have not emerged above the gums. Impacted teeth, such as impacted wisdom teeth, can become infected and grow into and damage other teeth.
Overcrowded or crooked teeth that require tooth extraction as part of orthodontic treatment, such as braces
Severely decayed or infected teeth that cannot be repaired and saved with other procedures, such as dental fillings or root canals
Who performs a tooth extraction?
The following providers extract teeth:
Endodontists specialize in treating diseases of the deep parts of your teeth including the pulp and roots.
General dentists prevent, diagnose and treat diseases and conditions of the teeth, gums, mouth, and associated structures of the jaw and face.
Oral and maxillofacial surgeons perform surgery on the teeth, jaw, gums and face.
Pediatric dentists specialize in caring for the dental needs of children and teens.
Periodontists specialize in treating gum disease (periodontitis) including procedures that regenerate bone and gum tissue lost due to gum disease.
How is a tooth extracted?
Your tooth extraction will be performed in a medical or dental office or clinic. A surgeon or dentist will loosen your tooth then pull it out. Your provider will clean the empty space left by the extracted tooth. Patients often bite on gauze to keep pressure on the extraction site and stop the bleeding. You may also have stitches, as determined by your provider.
Types of anesthesia that may be used
The type of anesthesia you have depends on the position of the tooth and other factors. Your dentist or surgeon may use one or more of the following:
General anesthesia is generally a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.
Intravenous (IV) sedation is a type of conscious sedation or twilight sedation. You will receive sedation medication intravenously (through an IV). You will be very relaxed, unaware of the procedure, and possibly unable to remember it. Some people remember parts of the procedure.
Local anesthesia is the injection of anesthetic medications into the gums near your tooth. This temporarily numbs the pain. Your provider may apply a painless topical anesthetic to numb the gums partially before the injection. Local anesthesia may be combined with sedation.
What to expect during your tooth extraction
Tooth extraction generally includes these steps:
You will sit in a reclining position in a chair and wear a clear shield over your eyes. The shield protects your eyes from spraying liquids and dental instruments.
Your provider will give you one or more types of anesthesia or sedation to keep you comfortable during the procedure.
Your provider will make a small cut in your gums if your tooth is not visible above the gum. This gives your doctor access to the tooth.
Your provider will loosen and pull out the tooth with forceps. If necessary, your provider will break up the tooth and pull out the pieces of the tooth with forceps.
Your provider will clean the empty space left by the extracted tooth (socket) and stitch the gums as needed.
You may bite on gauze to help stop the bleeding.
Will I feel pain?
Your comfort and relaxation are important to you and your care team. You may feel brief sharp pinches when your provider injects your gums with local anesthetic. Ask if your gums can be partially numbed with a painless topical anesthetic before the injections.
You may also feel pressure if you are awake during your procedure. Take a few long, deep breaths to help yourself relax. Tell your provider if any discomfort does not pass quickly.
What are the risks and potential complications of a tooth extraction?
Any dental procedure involves risks and potential complications. Complications may become serious in some cases. Complications can develop during the procedure or your recovery.
Risks and potential complications of a tooth extraction include:
Allergic reaction to the anesthetic
Damage to the nerves in your lower jaw
Damage to the teeth near the extraction site
Infection at the extraction site
Injury to the mouth
Jaw fracture, due to pressure used to extract tooth
Sinus injury during extraction of upper back teeth, which lie below the sinus cavity
Trismus, which is difficulty opening your mouth
Reducing your risk of complications
You can reduce the risk of certain complications by:
Following activity, dietary and lifestyle restrictions and recommendations before your tooth extraction and during recovery
Informing your provider if you are nursing or if there is any possibility of pregnancy
Notifying your provider right away of any concerns after the tooth extraction such as pain, fever, and difficulty chewing
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my tooth extraction?
You are an important member of your own dental care team. The steps you take before your tooth extraction can improve your comfort and outcome.
You can prepare for a tooth extraction by:
Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications and allergies at all times.
Taking or stopping medications exactly as directed. This may include taking antibiotics if you have an infection or certain other conditions.
Telling your doctor if there is any possibility of pregnancy
Questions to ask your dentist or surgeon
Having a tooth extraction can be stressful. It is common for patients to forget some of their questions during an office visit. You may also think of other questions after your appointment. Contact your provider with concerns and questions before your procedure and between appointments.
It is also a good idea to bring a list of questions to your appointments. Questions can include:
How long will the procedure take? When will I go home?
What type of anesthesia will I need?
How long will the procedure take? When will I go home?
What restrictions will I have after the extraction? When can I expect to return to eating, work, and other activities?
What medications will I need before and after the procedures?
How will you treat my pain?
Will I need an artificial tooth to replace the spot left by the tooth you are removing?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my tooth extraction?
Knowing what to expect can help you get back to your everyday life as soon as possible.
How will I feel after the tooth extraction?
Your mouth, gums and tongue may feel numb for a few hours after a tooth extraction procedure if it involved local anesthetic. This is because the local anesthetic will take time to wear off. You may also feel drowsy if you had general anesthesia or IV sedation.
You may also feel some pain, tenderness, bruising, swelling and bleeding where your tooth was extracted. Tell your dentist or surgeon if these symptoms worsen or continue past a few days because they can be a sign of a complication.
Your provider may ask you to take special precautions for the first day or two after your tooth extraction including:
Avoiding hot, carbonated, or alcoholic drinks that may irritate your tooth socket
Avoiding using tobacco products, straws, and mouthwash as directed by your provider
Eating only very soft foods or liquids to prevent food from getting caught in your tooth socket
Rinsing your mouth frequently with water or salt water to keep your tooth socket clean. Avoid forceful spitting.
Using caution when brushing the teeth around the extraction site
When can I go home?
You will probably go home the same day of a tooth extraction. You will stay in the office or clinic for a short period of time after tooth extraction if you had sedation or general anesthesia. You will be discharged home when you are alert, breathing effectively, and your vital signs are stable. This generally takes less than an hour.
You may still be a bit drowsy and will need a ride home from your procedure. You will not be able to drive for about 24 hours, and someone should stay with you during that time. You should plan to rest and relax for the rest of the day.
When should I call my dentist or surgeon?
It’s important to keep your follow-up appointments after your tooth extraction. Call your dentist or surgeon if you have any concerns between appointments. Call right away if you have:
More bleeding than expected or bleeding that does not stop
More pain than expected
Swelling that does not go down or increases within a few days
Seek immediate medical care if you have itching, hives, sudden mouth or tongue swelling, or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing. This may due to a rare allergic reaction to the anesthetic or pain medications.
How might a tooth extraction affect my everyday life?
A tooth extraction can relieve or prevent mouth pain due to a tooth infection. Extracting a tooth may help you move forward with straightening your teeth with braces or other orthodontic treatments.
You may need to have other dental procedures to replace the removed tooth with a false tooth, depending on your case. Follow your dentist’s advice about replacement options, such as a bridge or tooth implant. Removing a tooth without replacing can lead to lead to the loss of jawbone tissue and the shifting of other teeth. This can result in changes in facial structure and problems with biting, chewing and speaking.
You should continue to brush your teeth twice a day and floss daily after your tooth extraction as directed by your dentist or surgeon. Visit your dentist for regular cleanings and checkups as recommended to keep your remaining teeth healthy and free of decay and infection.