What to Expect at Your Next Dental Extraction

Dental extraction is the removal of adult teeth to take on issues like tooth decay, infection, or crowding. The dentist or oral surgeon’s goal is to take out the entirety of the tooth—including its root—from its socket in the gums. This procedure is usually performed while you’re under localized or generalized anesthesia at a dentist’s office or clinic, and it’s generally painless and well-tolerated.

This article will give you a sense of how tooth extraction works, its risks, and what recovery is like afterward. 

Preparing for the Procedure

Prior to the procedure, you’ll need to undergo dental evaluation and imaging to ensure that tooth pulling is the best way to go. Several dental issues call for dental extraction:

• Infection of the tooth (which are “abscesses,” or collections of discharge)
• Overcrowded or crooked teeth
• Significant gum disease impacting tooth stability
• Damage to a tooth due to an impact, accident, or fall

Once your dentist determines you need an extraction, they’ll need to go over your overall health status. Let them know about the medications you’re taking, your medical history, as well as current health status. Because they increase infection risk, tell them if you have or have had any of the following:

• Liver disease, cirrhosis, hepatitis C, or other liver problems
• Heart disease, high blood pressure, coronary artery disease, and other heart issues
• Weakened immune system or autoimmune disorders
• Recent surgery, especially on the heart or involving metal joint implants    

Types of Extractions

Simple Extraction

Simple extractions are sufficient for many cases of tooth decay, abscesses, and other issues. They can be performed by a dentist. Here’s a quick breakdown of this procedure:

• Numbing: The area around the affected tooth, especially the gums and surrounding bone, is made numb using a local anesthetic. This will prevent pain and discomfort during the procedure and generally wears off within a couple of hours.
• Loosening: The dentist rocks and starts to loosen the targeted tooth using a tool called an "elevator." You may feel pressure as this occurs, but you shouldn't feel pain
• Pulling: Once the tooth is loose enough, the dentist uses forceps to physically pull the tooth structure out. The newly empty tooth socket will bleed at first, but soon clots.
• Final steps: The empty socket is cleaned and the jaw bone reshaped as needed. The gums may require stitches in some cases, and you’ll need gauze to take on any bleeding.    

Surgical Extraction

More complex cases require oral surgery. Surgery may be needed for tooth impaction (when they grow in pointed at the wrong angle or without erupting from the gums) or when wisdom teeth need to come out. This work involves:

• Antibiotic medications: Patients typically take an antibiotic prior to the procedure to prevent infection.
• General anesthesia: In contrast to simple extraction, surgical extractions are usually performed while you’re under general anesthesia and sedation (put to “sleep"). Your vital signs will be carefully monitored while you’re under.
• Multiple extractions: If multiple teeth need to be removed, it’s done under general anesthesia using similar methods to the above. The specific treatments necessary depend very much on the scale and scope of the dental issue.
• Complex removal: In some cases, portions of the surrounding bone may need to be removed or reshaped. Dental surgeons access these areas using incisions in the gums. Additionally, they may need to employ “sectioning,” or breaking up the tooth into multiple parts and extracting them in stages.

Risks of Dental Extraction

Complications of tooth extraction are rare. However, there are a number of risks associated with the procedure. These include:

• Infection of the site
• Damage to nerves
• Damage to other teeth, dental crowns, or fillings
• Bruising, swelling, and/or pain at the site
• Continued pain following the operation
• Reactivity to the anesthesia or other medications taken after the procedure
• Prolonged healing of the area
• Dry socket

Healing Stages

Recovery following a tooth extraction is gradual, and very much depends on the individual case. All told, it takes one to two weeks for the socket to heal, though sometimes it takes longer—up to a month or longer—for regrowth of the surrounding bone and complete recovery. This process can be broken down into three stages:

• Inflammation: The blood in the socket clots after the tooth is pulled. Over the following week, calcification, or scarring of the affected area, occurs as tissues gradually regrow and replace the clot. This causes an inflammatory response in the area.     
• Proliferation: Beginning one to two weeks following the procedure, immature bone cells and other types collect in the area. Over time, tissues, blood vessels, nerves, and bone material regrow.
• Maturation: In the final stage of healing, the bone cells mature, and the tissues and other structures complete their development. Some bone loss is expected, something which is monitored by the dentist.

Aftercare for Dental Extraction

What’s most important after a tooth extraction is that you do what you can to ensure everything is healing properly. The most critical, and often uncomfortable, period in recovery is the first couple of days. You and your dentist will need to be vigilant throughout your recovery. Early on, here’s what you should keep in mind:

• Use the prescribed pain medications as indicated or over-the-counter varieties.
• To manage pain, apply ice to the face near the affected area for 10 minutes at a time as needed.
• After 24 hours, gargle your mouth with salt water (1 teaspoon [tsp] salt in 8 ounces [oz] of warm water) multiple times a day.
• Don’t brush or floss for the first 24 hours following the procedure.
• Change gauze pads before they are drenched with blood.

What can you do to ensure a full and complete recovery? Here’s a breakdown:

• Avoid touching the affected area with your tongue.
• Get rest and try to relax afterwards.
• Do not smoke, vape, or consume alcohol during recovery.
• In early recovery, choose soft, easy-to-eat foods, such as gelatin or thin soup.
• Gradually re-introduce tougher to chew food items.
• Keep your head propped up when lying down.
• Don’t use straws or suck with your mouth.
• Be careful and follow your dentist’s orders when it comes to brushing and flossing.
• Be careful with any stitches; some dissolve on their own, while dentists need to remove others.

When to Call the Dentist

Throughout your recovery, it’ll be important for you to monitor your dental health, and several follow-up appointments will be necessary. Several signs prompt a call to your dentist or surgeon:

• Fever, chills, or other signs of infection
• White or yellow discharge from the site and severe swelling
• Severe pain or excessive bleeding for more than several hours after the procedure
• Trouble swallowing
• Coughing, chest pain, or difficulty breathing
• Hives and/or rash 

Summary

Dental extraction is the clinical removal of a tooth or teeth. It’s used to treat a range of issues, such as tooth crowding, impaction, infection of the tooth, loose teeth due to gum disease, or damage due to trauma.

There are two types: simple extraction is performed under localized anesthesia, while surgical extraction—often involving reshaping of the surrounding bone—is more invasive and done under general anesthesia.

Care afterward requires managing symptoms, avoiding smoking and drinking, eating soft foods, and ensuring there are no complications.    

A Word From Verywell 

There’s no doubt that dental extraction can do a great deal for your smile. As with all such procedures, this work has both dental health and cosmetic benefits. If you’re experiencing tooth pain, gum loss, or other issues, you must act fast and get the help you need. The sooner a dentist is on the case, the better off you’ll be.