Tooth extractions
When a tooth needs to come out
When saving a tooth isn't the right call, the extraction itself should be the easiest part. Gentle removal, clear aftercare, and a plan for what comes next.
Why a tooth might need to come out
- Severe decay. When a cavity is too large to restore with a filling, crown, or root canal.
- Advanced gum disease. When the bone supporting a tooth has been lost beyond what we can rebuild.
- Fracture below the gum line. Some cracks extend too far down to allow a successful restoration.
- Impacted wisdom teeth. Wisdom teeth that won't come in properly, get infected, or push other teeth out of alignment.
- Orthodontic preparation. Occasionally, teeth are extracted to create space for orthodontic correction.
- Trauma. Teeth that have been so badly damaged in an accident that repair isn't possible.
What to expect at the appointment
- 1. Numbing. Topical gel and then local anesthetic. You'll feel pressure but not pain.
- 2. The extraction. We loosen the tooth from its socket and remove it. Simple extractions take 20–40 minutes; surgical extractions a bit longer.
- 3. Gauze pressure. You'll bite on a gauze pad for 30–45 minutes to form the blood clot.
- 4. Aftercare instructions. Written and verbal — what to do, what to avoid, when to call us back.
After the extraction
- For 72 hours: no straws, no smoking, no vigorous rinsing — protect the blood clot.
- Ice pack on the cheek for the first day to control swelling.
- Soft foods for the first few days. Drink plenty of fluids.
- Ibuprofen, Tylenol, or what we prescribed — as directed.
- Resume gentle brushing/flossing 24 hours after; avoid the extraction site only.
Replacing the missing tooth
For most adult extractions, replacing the tooth is a good idea — especially in back teeth, where missing teeth can lead to shifting, bite changes, and bone loss over time. We'll talk through your options before the extraction: dental implants (the most tooth-like option), bridges (anchored to neighboring teeth), or partial dentures (removable, lower cost). The right choice depends on the location, your budget, and your long-term goals.
Common questions
Frequently asked
- When does a tooth need to be extracted?
- Common reasons: severe decay too large to restore, advanced gum disease, a fracture that goes below the gum line, or an impacted wisdom tooth causing problems. Sometimes a tooth is removed before orthodontics to create space. We always discuss alternatives (root canal, crown) first when they're an option.
- Is the extraction painful?
- Not the extraction itself — you'll be fully numbed with local anesthetic and feel pressure but not pain. The area may be sore for a few days afterward; we'll talk through pain management before you leave.
- How long does the procedure take?
- A simple extraction usually takes 20 to 40 minutes from when you sit down to when you leave. Surgical extractions (impacted teeth, root tips) take longer.
- What's the difference between simple and surgical extraction?
- Simple extractions are for fully erupted teeth visible above the gum line — most adult extractions are simple. Surgical extractions involve teeth that are impacted, broken at the gum line, or need bone removal — usually wisdom teeth fall into this category.
- Will I need someone to drive me home?
- For a simple extraction with local anesthetic, no — you can drive yourself. For surgical extractions or any procedure with sedation, you'll need a driver.
- How long does recovery take?
- Most simple extractions heal in 7 to 10 days. You'll feel close to normal within 2 to 3 days. Surgical extractions take a bit longer — usually 1 to 2 weeks for the gum to close, several months for the bone to fully fill in.
- Can I replace the missing tooth?
- Yes, in most cases — and it's usually a good idea, especially for back teeth where missing teeth can cause neighboring teeth to shift. We offer dental implants, bridges, and partial dentures depending on the situation. We'll talk through options before the extraction so you know the plan.
- What is 'dry socket'?
- Dry socket happens when the blood clot in the extraction site dislodges before healing is underway, exposing bone. It causes a deep, throbbing pain 2 to 4 days after extraction. Smokers, patients who drink from straws, and women on oral contraceptives are at higher risk. If you suspect dry socket, call us — it's treatable in a quick visit.
We'd love to see you on Thomson Drive
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