Tooth Extraction: All You Need to Know about Having a Tooth Removed

Tooth Extraction: All You Need to Know about Having a Tooth Removed

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Modified:  16 October 2018

Nobody looks forward to hearing that they need a tooth extraction, but 74% of British adults undergo the procedure at some point in their lives.

There are a number of reasons why a dentist may recommend having a tooth removed:

  • Tooth infection or severe decay
  • Periodontal (gum) disease
  • Irreparable damage from trauma
  • Impaction (in the case of wisdom teeth)
  • To make space for tooth realignment with an orthodontic appliance
  • To allow dentures or implants to be fitted

In this guide we’ll explain what to expect when you have a tooth out. Many people worry about tooth extraction pain, but the good news is that modern anaesthetic techniques make it as comfortable as possible. You’ll feel a bit sore afterwards, but we have some advice for aiding healing and recovery after an extraction.

Reasons for removing a tooth

Having a tooth out

Extraction is a common dental procedure

Let’s look first at the main reasons why a dentist may extract a tooth. You can discuss your situation with your dentist to get his or her professional opinion on the condition of your teeth. This procedure is not reversible, so be sure to raise any doubts you have before going ahead.

Infection or damage

Thanks to recent advances in dentistry, infected tooth removal is seen as a last resort. Many cases of tooth decay can be treated simply with a filling. Even if you have developed a dental abscess as a result of tooth infection, root canal treatment can often preserve the tooth.

If the infection persists after this, it will be necessary to extract it to stop the infection spreading through the blood stream to other parts of the body.

Where a large part of the tooth is missing due to tooth decay or injury, your dentist may be able to fit a crown. However, if not enough healthy tooth is left to support a reconstruction, it will have to be removed.

If you have an accident which loosens your teeth or you find yourself in sudden and severe pain, make an out-of-hours dental appointment. The dentist may perform an emergency extraction or other treatment, but they might just administer sufficient pain relief and advise you to make an emergency appointment with your regular dentist.

Wisdom tooth extraction

third molar impaction

An impacted wisdom tooth probably needs to be removed

Wisdom teeth, also known as ‘third molars’, cause problems for many people because our mouths simply don’t have space to accommodate them.

When a tooth doesn’t push through the gum properly because of overcrowding, it’s known as ‘impaction’. A tooth can be fully impacted (completely covered by gum) or partially impacted (only part of it has emerged).

If a wisdom tooth is pushing up against the tooth next to it, this can cause pain and may ultimately damage the healthy tooth. In this case, it’s probably best to have the third molar removed.

Another common reason for wisdom tooth removal is decay. Because these teeth are so far back in our mouths, they’re often very difficult to clean. This means they are more susceptible to tooth decay. Even if the decay isn’t causing any pain, it can eventually spread to the adjacent tooth if the wisdom tooth remains in place.

Not everyone has a full set of four wisdom teeth – and some fortunate people have none at all. But if you do have one or more of your third molars, the chances of complications at some point in your life are fairly high.

Upper wisdom teeth can be easier to extract than lower ones because their roots are often fused together, creating a smaller surface area and smoother shape. However, upper wisdom teeth usually have three roots compared to just two in lower wisdom teeth.

Periodontal disease

Periodontitis, a severe form of gum disease, may cause teeth to become loose. This is because the disease erodes the tissue and bone surrounding the tooth root, which are responsible for holding the tooth securely in place.

If the condition has not progressed too far, it may be possible to treat it and save the tooth. In more advanced cases, extraction may be the only option.

Teeth straightening

braces teeth out

Dentists sometimes have to pull teeth before fitting braces

If you’re getting braces to correct tooth misalignment, you might first need to have one or more teeth removed. This frees up some space in your mouth for your other teeth to move into.

You might not need to have any teeth out before having braces, but this will depend on the current state of your teeth as well as the type of braces you choose. With Invisalign invisible braces, for example, it’s more common to have the sides of your teeth filed slightly to create a small gap between each one.

You’ll need to speak to your orthodontist to find out whether your treatment will require any tooth removal.

In the video below one patient explains what it was like to have teeth removed for braces. She offers some handy tips for anyone who might be about to have this done:

How are teeth removed?

Routine extraction

A straightforward extraction can be done in your usual dental clinic under local anaesthetic. This means you shouldn’t experience any pain but you will be aware of what is happening.

removing a tooth

Dentists have a range of specialist tools for extracting teeth

Your tooth root sits in a deep hole in your gum, called a socket. Ligaments hold the tooth root tightly in place – giving your teeth the biting force you’re used to.

Most often, dentists use a lever tool called an ‘elevator’, which is wedged under the tooth to loosen it. Alternatively, they may have to rock the tooth from side to side to widen the socket. It’s not that different to wiggling a tent peg around in its hole to make it easier to remove.

Once the tooth becomes loose, the dentist can pull it straight out with dental forceps. With the anaesthetic blocking any pain, you will just feel some pressure in your mouth during this process. A simple extraction should only take a few minutes.

If you feel very nervous about having a tooth out, ask your dentist if you can have IV sedation for the procedure. This will make you feel calm and relaxed and you won’t remember much about it afterwards.

Surgical extraction

Third molar removal, especially in the case of impaction, may require a more complicated surgical extraction. The dentist or oral surgeon has to cut into the gum to access the tooth. Larger teeth might be cut into smaller pieces to make them easier to remove.

The video animation below shows methods for extracting wisdom teeth at various levels of impaction. The same type of elevator tool is used as in a simple extraction.

Surgical extraction of a tooth can still be done with a local anaesthetic, but more complex cases may require a general anaesthetic. In this case, the extraction is performed by a dental surgeon in a hospital after you have been put to sleep.

General anaesthetic may also be used when young children have teeth extracted, or if you need to have several teeth removed. This means going to hospital for the treatment but recovery will be much the same.

Another reason you may need a surgical procedure rather than a simple extraction is if there is no tooth remaining above the gum line. This might be because of severe decay or perhaps an injury. In this case, the dentist must cut into the gum to access the remaining tooth root.

Cracked or fractured teeth can also be more complicated to extract since there is a risk of them breaking.

Immediate aftercare

As soon as the tooth is out, the dentist will clean the empty socket and make sure no tissue or bone fragments remain. He or she may press down on the sides of the socket to suppress bleeding and to keep the jawbone in the correct shape.

extracted tooth recovery

A recently stitched extraction site

It’s at this point that your dentist will places stitches in your gum, if needed. It’s normal to get stitches after a surgical incision, and sometimes after a regular extraction. Dentists often use a self-dissolving material which breaks down by itself after a week or so.

Finally, you will be given a piece of folded gauze to bite down on. This absorbs any blood and creates pressure on the extraction site. You may also get an ice pack to minimise swelling. Carefully follow any instructions your dentist gives you with regards to these, as this will aid your recovery.

Does tooth removal hurt?

As we have already mentioned, the local area will be fully anaesthetised. You will feel some pressure – but no pain. The injection to administer the anaesthetic can be a little painful, but your dentist may use a special numbing gel to help with this.

In the unlikely event that you start to feel pinching or pain, alert your dentist immediately. If you’re anxious about feeling pain during the procedure, agree in advance a signal you can use to show your dentist that you need to speak.

It’s more likely that you’ll feel some discomfort or pain after tooth extraction, once the anaesthetic has worn off. You can read more about how to deal with this in the section below on recovery.

How much does tooth removal cost in the UK?

dental forceps extraction

Dental forceps are used for extraction of a tooth

In the UK, Dental extraction is covered by the NHS band 2 treatment charge. This is £59.10 for 2018/19. If you are eligible for NHS treatment you will pay this amount for a single course of treatment, which may involve multiple extractions if necessary.

Under-18s, pregnant women and those who have had a baby in the past 12 months receive free NHS treatment. Extractions may also be free if you need to visit a hospital for the procedure. However, some people struggle to register with an NHS dentist while others prefer to visit a private dentist.

If you pay for private dental treatment, the cost of removing a tooth will depend on the size and location of the tooth, and how complicated the extraction is.

For example, wisdom tooth extraction costs (and any types of surgical tooth removal) will typically be higher than incisors.

The table below gives an idea of tooth extraction costs in the UK, if carried out at a dental clinic. Do keep in mind that private dental charges vary greatly from one practice to another, so it may be worth shopping around if you need to have several teeth extracted.

Type of extraction Cost
Any extraction with an NHS dentist £59.10
Simple tooth extraction £50 - £140
Surgical tooth extraction £100 - £300
Wisdom tooth extraction £80 - £350

These costs include local anaesthesia but IV sedation, if offered, will incur an additional charge. If you need general anaesthesia for a surgical extraction this will increase the cost significantly.

If you need to have teeth removed for braces, this should be included in your overall treatment cost – but it’s worth double-checking this to avoid unexpected bills.

Alternatives to extraction

Regardless of whether you are a private or NHS patient, you’ll probably find that extraction costs less than alternative treatments such as root canals or crowns. If you’re unable to afford the recommended restorative treatment then you may choose the cheaper option of extraction.

Removing a tooth should really only be a last resort, though. An empty space in the mouth affects the appearance of the smile and may eventually cause the face to sag. It can also present problems with eating. In the long term, the surrounding teeth are more susceptible to damage and may start to shift position, causing problems with oral hygiene.

As a general rule, it’s best to keep your original tooth for as long as possible. If it has to be extracted, it’s better to get some kind of replacement tooth rather than leave the gap empty.

root canal treatment

Root canal treatment is a possible alternative to extraction

Artificial teeth such as dentures, bridges and implants (which you can read more about below) all come at their own cost. In the long run, therefore, it might be more cost effective to preserve the original tooth rather than have it extracted.

So if your dentist feels confident they can perform a root canal treatment or fit a crown to save your tooth, you should seriously consider this rather making a decision based purely on the immediate cost.

Healing from an extraction

One thing that many people worry about when it comes to teeth extraction is healing and recovery.

Your dentist will give you advice on what to do after tooth extraction. As this may vary depending on the procedure you had and the position of the tooth, you should follow their instructions first and foremost. Here we have some general information and advice so you know what to expect.

How long will it take?

After an extraction, a blood clot forms in the empty socket. It’s important to do what you can to keep this in place. If the blood clot becomes dislodged the socket is exposed, which is very painful. This condition, known as ‘dry socket’, will require additional dental care.

In simple cases the average tooth extraction healing time is around 7-10 days. After this time the gum tissue is significantly healed and your stitches can be removed (or will dissolve by themselves). Within two weeks, smaller sockets may appear completely healed.

Wisdom tooth extraction recovery can take a little longer, especially if the tooth was impacted and had to be removed surgically. This is simply because the wound from molar extractions is larger and takes longer to heal.

Under the surface, it takes 6-8 months for your jaw bone to grow back and ‘fill in’ the hole left by the tooth.

What if I feel pain after an extraction?

It’s normal for patients to feel some discomfort, soreness or pain after getting a tooth pulled. Your dentist should give you painkillers to help manage this – or they may recommend suitable over-the-counter products.

The area around the socket will probably feel tender and you may experience some swelling in your face.

This discomfort should subside 2-3 days after the extraction. If you continue to experience pain or you suddenly notice the pain worsening several days later, contact your dentist immediately as this could be a result of infection at the extraction site.

Tips for speedy recovery

Giving yourself the right aftercare will help speed up your recovery so you can get back to normal.

In the first 24 hours following removal of a tooth you should:

  • Apply gauze as instructed
    avoid hot drinks after tooth pulling

    Get used to having your coffee lukewarm for a few days

  • Inform your dentist if bleeding doesn’t seem to be reducing
  • Avoid rigorous rinsing with water or mouthwash
  • Avoid brushing the teeth next to the extraction site
  • Resist the temptation to poke at the site with your tongue or finger
  • Avoid hot foods and drinks, since heat may dissolve the blood clot
  • Refrain from smoking or drinking through a straw – the sucking action can pull on the clot
  • Keep your head elevated when you lie down
  • Take it easy and avoid strenuous activities

Consider taking a day or two off work to give your body time to rest. 24 hours after the procedure you can use a salt water rinse for cleaning. Dissolve half a teaspoon of salt in a cup of water and gently swish it around your mouth.

For a few days afterwards it’s best to stick to soft foods and eat on the opposite side of your mouth. If you have had multiple extractions in different locations, your dentist might recommend a liquid diet. You may have to maintain these precautions for up to a week after a surgical extraction.

Keep drinking plenty of water so your body stays hydrated for healing. Just remember not to use a straw.

Once you have fully recovered, try to maintain good oral hygiene to reduce the chances of you needing another extraction or other dental treatment in the future.

Replacing an extracted tooth

Should you need to have a tooth removed, particularly one at the front, you’ll soon be thinking about your options for replacing it. The three main choices are:

  • Dentures (false teeth)
  • A bridge
  • A dental implant
abutment for implant

Consider replacing your missing tooth with an implant

Dental implants are the most permanent option, and also the closest to a natural tooth. The titanium implant is inserted into the jaw bone and an artificial tooth crown is attached on top. The bone fuses with the implant and this minimises bone loss.

But implants are the most expensive option, costing around £2,000 for a single tooth implant and crown. Fortunately, there are ways to save money on the treatment to make implants more affordable.

Bridges and dentures are both types of prosthetic tooth which sit on top of the gum. A bridge is fixed permanently in place while a denture is removable. Both can serve as long-term solutions for missing teeth. They are cheaper than implants, but come with a risk of underlying bone loss over time.

You may be able to have a temporary prosthesis fitted straight away if one of your front teeth is removed. Speak to your dentist to find out which options are available to you, and how much they will cost.

Whatever your current situation, thanks to modern dentistry there are ways to restore your smile and your confidence.

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