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Tooth Extraction

Definition

This is a procedure to remove a tooth.

Reasons for Procedure

While dental techniques can save many teeth, a tooth may need to be removed if it:

  • Is too badly damaged or decayed to be saved by a root canal
  • Has an infected nerve
  • Is affecting normal tooth growth
  • Is loose from advanced gum disease
  • Has a loss of supporting bone, gums, or tissue

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your dentist will review potential problems, like:

  • Bleeding
  • Infection
  • Nerve damage

Factors that may increase the risk of complications include:

  • Smoking
  • Poor nutrition
  • Poor overall health
  • Use of some prescription and non-prescription drugs—talk to your dentist about any medication you are taking.

Be sure to discuss these risks with your dentist before the procedure.

What to Expect

Prior to Procedure

Your dentist will likely:

  • Do a thorough dental exam
  • Do dental x-rays of the mouth

Anesthesia

Depending on the procedure, your dentist will choose:

  • Local anesthesia—An injection is given in the mouth to numb the area that is being worked on. The injection may be preceded by a topical numbing agent.
  • General anesthesia —Blocks pain and keeps you asleep through the procedure.

Description of the Procedure

If the tooth is impacted (buried in the gum), the overlying gum tissue will be opened to expose the tooth. Using forceps, the dentist will grasp the tooth and gently rock it back and forth. This action will loosen the tooth and break the ligaments that hold the tooth in place. The tooth will be pulled, and a blood clot will form in the empty socket. A gauze pad will be packed into the socket. In some cases, a few stitches will be placed to close the gum edges.

Immediately After Procedure

You will need to bite firmly but gently on the gauze pad. This will reduce bleeding and permit a clot to form in the tooth socket. If rapid bleeding continues, replace with a fresh pad every 20-30 minutes. Otherwise, leave the pad in place for 3-4 hours.

How Long Will It Take?

It often takes about 20 minutes, but may take longer for impacted teeth.

How Much Will It Hurt?

You will feel pain in your jaw. You may be given pain medication. A complication called dry socket may occur. A dry socket forms when a blood clot does not form in the tooth socket, leaving the bone in the jaw exposed to air and food. A dry socket takes 2-3 weeks to heal and is painful during the healing process.

Post-procedure Care

It will take 1-2 weeks for the site to heal. New bone and gum tissue will grow into the gap where the tooth was. Do not smoke. Not smoking will speed the healing process. Brush and floss your other teeth as normal to prevent infection where the tooth was taken out. Follow your dentist's instructions.

Having a missing tooth can lead to shifting teeth, improper bite, or difficulty chewing. Your dentist may attempt to restore the area with an implant, fixed bridge, or denture.

Call Your Dentist

Call your dentist if any of the following occur:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, or any discharge from the open socket
  • Excessive bleeding that continues for more than 4 hours after surgery
  • Pain that you cannot control with the medications you have been given
  • New or unexpected symptoms

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

Mouth Healthy—American Dental Association
https://www.mouthhealthy.org

National Institute of Dental and Craniofacial Research
https://www.nidcr.nih.gov

CANADIAN RESOURCES:

Canadian Dental Association
http://www.cda-adc.ca

Dental Hygiene Canada
http://www.dentalhygienecanada.ca

REFERENCES:

Extractions. Mouth Healthy—American Dental Association website. Available at: https://www.mouthhealthy.org/en/az-topics/e/extractions. Accessed March 13, 2018.

Tooth decay. National Institute of Dental and Craniofacial Research website. Available at: https://www.nidcr.nih.gov/health-info/tooth-decay. Accessed March 13, 2018.

Last reviewed March 2018 by EBSCO Medical Review Board Marcie L. Sidman, MD