What Happens During a Tooth Extraction?

What is a tooth extraction?

A tooth extraction is when a dentist removes your tooth from its socket. If you’ve had this oral surgery procedure, you might say you “had a tooth pulled.”

Healthcare providers prefer to save natural teeth whenever possible. But sometimes, restorative methods — like fillings or crowns — aren’t enough. If your tooth has damage past the point of repair, then removal may be necessary. Your dentist may recommend tooth extraction if you have:

• A fractured tooth
• Advanced gum disease
• An impacted tooth
• Crowded teeth
• Severe tooth decay

Dentists and some dental specialists — like oral and maxillofacial surgeons and periodontists — do tooth extractions. While general dentists do plenty of extractions, more complex cases are usually referred out to specialists.

If you have dental trauma from an accident or injury, you might need an emergency tooth extraction.

How should I prepare for a tooth extraction?

Be sure to tell your dentist about any medications, vitamins or supplements you’re taking. They’ll let you know if you need to skip any medications before your surgery.

During a consultation, your dentist will talk with you about the sedation options they offer. Sedation is an excellent choice if you have dental anxiety or if you simply want to be more relaxed and comfortable during your procedure.

What happens during a tooth extraction?

Here are the general steps to expect during a tooth extraction:

1. Your dentist will give you local anesthesia to numb the affected tooth and surrounding gum tissue. If you choose sedation, they’ll also give you those medications.
2. Using specialized dental instruments, your dentist will gently loosen your tooth and carefully remove it from its socket. They might need to make incisions in your gums to access your tooth — especially if it’s badly decayed or has broken off at the gum line. Or they may need to divide the tooth into sections before removing it.
3. Next, your dentist will clean and disinfect your tooth socket.
4. Your dentist might place a bone graft in the empty socket. This helps prevent bone loss in your jaw.
5. Finally, your dentist may place stitches. (You might not need them.)

Removing one tooth usually takes between 30 and 60 minutes. It might take longer if you need multiple teeth extracted.

What are the benefits of tooth removal?

Tooth extraction reduces harmful bacteria that can damage your teeth and gums. Left untreated, a decayed or damaged tooth can wreak havoc on your smile, causing infection and a host of other problems. Removing your affected tooth gives you the best chance for long-term oral health.

A tooth extraction can also ease dental pain almost immediately, especially if your tooth is severely broken or infected.

What are the risks or complications of tooth extractions?

Like any surgical procedure, dental extraction carries a small risk of complications, like:

• Delayed healing
• Dry socket
• Infection
• Maxillary sinus damage
• Nerve injury

Tooth extraction side effects

Normal side effects after tooth removal include:

• Bleeding. The first night after your tooth extraction, you may still ooze small amounts of blood. This is normal. To manage bleeding, place a folded piece of gauze over the extraction site and gently close down for 15 minutes. Repeat as needed.
• Bruising. You might develop some bruising on your gums or your outer jaw. This should go away after a few days.
• Discomfort. Day three is usually the worst day of pain after a tooth extraction. The best thing to do is to take it easy for the first three days. Rest up, and give yourself some TLC.
• Swelling. It’s normal to notice swollen gums around the extraction area. You might have swelling on your outer jaw, too. To reduce inflammation, apply an ice pack to your face for 20 minutes, then leave it off for 20 minutes. Repeat as needed.

These side effects should go away within a week. Following your dentist’s guidelines can keep you comfortable in the meantime.

How long does recovery take?

Recovery after a tooth extraction depends on several factors, like the size and condition of the affected tooth. But most people feel back to normal in a few days.

You’ll be able to return to routine activities within 48 to 72 hours of a tooth extraction. But it usually takes the jawbone several weeks to heal completely. Most people can return to work or school within a day or two. If you have a job that requires a lot of lifting or physical labor, you may need to take a few more days off work.

If you’re planning on replacing the tooth with a dental implant, you’ll probably need to wait a few months while the socket heals.

How does a tooth extraction heal?

An empty tooth socket heals from the bottom, up. Here’s how the process works:

1. Bleeding begins after extraction.
2. A blood clot forms, which prevents dry socket and protects your jawbone and nerves.
3. The blood clot starts to integrate with the tissue around it. The area might have a whitish appearance. (This is normal and isn’t a sign of infection.)
4. Your tooth socket fills in with new tissue. You might see a small indentation during this healing stage.
5. Your gums fully heal, and the new tissue looks healthy.

If you’re worried about your progress, here’s a good rule of thumb: A normal socket after tooth extraction will look strange at first. For a large tooth, like a molar, it could take up to four months for your jaw to fully heal. Still, you should call your dentist if you develop signs of infection like fever or drainage from the surgical site.

Tooth extraction aftercare

Below are some things to do — and some things to avoid — after your tooth extraction:

Do:

• Eat soft foods. Stock your fridge and pantry with soft foods like rice, pasta, eggs, yogurt and applesauce.
• Keep the extraction site clean. Gently rinse the area with an antimicrobial mouthwash two to three times a day. Avoid brushing directly over your extraction site until your dentist tells you it’s safe to do so. Brush and floss all other areas normally.
• Take all medications as directed. Your dentist may prescribe antibiotics and pain relievers. It’s important to take all these medications exactly as directed. You can also take over-the-counter pain relievers, like acetaminophen and ibuprofen.

Don’t:

• Do any strenuous activity or lift anything over 10 pounds. Elevating your heart rate can cause more pain and bleeding. Skip the gym for the first 48 to 72 hours. Ask your dentist when it’s safe to resume normal routines.
• Poke at the extraction site. It might be tempting to check the area with your tongue. But constantly doing this can disrupt healing.
• Smoke or vape. Vaping or smoking after tooth extraction constricts (shrinks) your blood vessels, reducing blood flow to the extraction site. Reduced blood flow means less oxygen for your healing tissues.
• Spit or rinse vigorously. Use gentle motions when rinsing or spitting. Being too aggressive can dislodge stitches or protective blood clots.
• Use straws. Drinking through a straw can disrupt the blood clot and cause a dry socket.

Your dentist will give you a detailed list of post-surgical instructions. Be sure to ask them if you have specific questions regarding your recovery.

When should I call my healthcare provider?

Any time you develop a toothache or dental pain, it’s important to schedule a visit with a dentist. They can help determine the cause and design a personalized treatment plan.

If you’ve already had a tooth extraction, call your dentist if you develop:

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher
• Drainage (pus) around the extraction site
• Severe pain that doesn’t improve with medication