Tooth Extraction

A tooth extraction is a dental procedure that involves removing a tooth from its socket in the bone. It’s typically performed by a dentist or an oral surgeon. In this extensive guide you’ll find out about the dental extraction procedure, costs and recovery.

What are dental extractions?

Dental extractions are surgical procedures to remove teeth from the dental alveolus (socket) in the alveolar bone. Extractions are performed for various reasons, including severe tooth decay, infection, impacted wisdom teeth, to make space for orthodontic treatment, or because a tooth is damaged beyond repair.

The procedure can be simple or surgical, depending on whether the tooth is visible or impacted within the gums. A simple extraction involves loosening the tooth with a tool called an elevator, then removing it with dental forceps.

A surgical extraction involves making an incision in the gum to remove the tooth, often necessary for broken teeth below the gum line or impacted wisdom teeth.

Post-procedure, patients may experience swelling and discomfort, managed with pain relief and following aftercare instructions to ensure proper healing.

Tooth extraction price

The cost of tooth extraction can vary widely depending on several factors, including the complexity of the extraction (simple vs. surgical), the dentist’s experience, the location of the practice, and whether you have dental insurance that covers part of the cost.

• Simple Extractions: The cost for a simple tooth extraction ranges from approximately $75 to $300 per tooth. Simple extractions are typically performed on teeth that are visible and easily accessible.
• Surgical Extractions: The cost for a surgical extraction, which may be required for impacted teeth or those not fully erupted (such as wisdom teeth), can range from about $150 to $650 or more per tooth.
• Wisdom Tooth Removal: Specifically for wisdom teeth, the cost can vary significantly based on whether the teeth are impacted. Removing all four wisdom teeth in one session can cost anywhere from $600 to $4,000.

These prices can be higher if additional procedures are needed, such as bone grafting, or if the extraction is performed by a specialist like an oral surgeon. Also, geographic location plays a significant role in the overall cost, with prices typically higher in urban areas compared to rural areas.

Tooth extraction procedure

The tooth extraction procedure varies depending on whether it’s a simple or surgical extraction. Here’s a general overview of what to expect:

Before the Procedure

• Consultation: Your dentist will take a detailed medical history and may perform X-rays to understand the tooth’s position and condition.
• Anesthesia: Local anesthesia is administered to numb the area around the tooth to be extracted. For more complex cases or anxious patients, sedation or general anesthesia may be used.

Simple Extraction

• Loosening the Tooth: Once the area is numb, the dentist uses an instrument called an elevator to loosen the tooth by widening the space in the bone around the tooth.
• Removal: The tooth is then grasped with dental forceps and gently rocked back and forth until it is free enough to be removed completely.

Surgical Extraction

• Incision: For a tooth that hasn’t fully emerged from the gum or is broken off at the gum line, the dentist makes a small incision into the gum to expose the tooth and bone.
• Removing Bone or Cutting the Tooth: Sometimes, it’s necessary to remove some of the bone around the tooth or to cut the tooth into pieces to remove it with minimal impact on surrounding tissues.
• Extraction: The tooth is then removed carefully. The dentist may need to remove the tooth in sections to minimize damage to the surrounding bone.
• Stitches: The area may be stitched up to help the healing process. These can be dissolvable stitches that disappear on their own or non-dissolvable stitches that require removal after a few days.

Tooth extraction pain

Tooth extraction pain varies from person to person and depends on the complexity of the extraction (simple vs. surgical) and the individual’s pain tolerance.

Here’s what you can generally expect in terms of pain and how to manage it:

During the Procedure

Anesthesia: Before the extraction, local anesthesia is administered to numb the area around the tooth, effectively blocking pain during the procedure. You might feel pressure or movement, but there should be no pain.

For more complex cases or for patients with dental anxiety, sedation or general anesthesia may be used, in which case you won’t be aware of the procedure and will not feel any pain during it.

After the Procedure

• Immediate Aftercare: Once the anesthesia wears off, it’s common to experience some pain and discomfort. The severity of pain typically depends on the complexity of the extraction and how well you follow aftercare instructions.
• Managing Pain: Your dentist may recommend over-the-counter pain relievers such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) to manage the pain. In some cases, especially after surgical extractions, prescription pain medication may be provided.
• Swelling and Bruising: Applying an ice pack to the cheek near the extraction site can help reduce swelling and pain for the first 24 hours.

Minimizing Pain and Promoting Healing

• Follow Aftercare Instructions: Adhering to your dentist’s aftercare instructions is crucial for minimizing pain and promoting healing. This includes avoiding smoking, not using straws, and not spitting forcefully, as these actions can dislodge the blood clot forming in the socket, leading to increased pain and the risk of dry socket.
• Soft Foods: Stick to a diet of soft foods and liquids for the first few days to avoid aggravating the extraction site.
• Oral Hygiene: Keeping your mouth clean is important for healing but be gentle around the extraction site to not disturb the clot. Rinse with salt water or a prescribed oral rinse according to your dentist’s instructions.

When to Contact Your Dentist

• Persistent or Severe Pain: While some pain is normal, if you experience severe or worsening pain several days after the extraction, it could be a sign of complications such as dry socket or infection.
• Signs of Infection: Fever, severe swelling, pus, or an unpleasant taste in your mouth could indicate an infection, requiring prompt attention from your dentist.

Pain management and recovery vary, but by following your dentist’s advice and taking care of yourself after the procedure, you can minimize discomfort and promote a smooth healing process.

Tooth extraction recovery

Recovering from a tooth extraction usually involves a few key steps and precautions to ensure proper healing and to minimize discomfort.

Here’s a general guide on what to expect and how to care for yourself after the procedure:

Immediate Post-Extraction (First 24 Hours)

• Bleeding Management: It’s normal for the extraction site to bleed slightly for the first few hours. Bite down gently but firmly on the gauze pad placed by your dentist to help stop the bleeding. Change gauze pads as they become soaked. If bleeding continues, a tea bag can be used as the tannic acid helps form a clot.
• Pain Management: Pain after an extraction is normal. Your dentist will likely recommend over-the-counter pain relievers or prescribe medication. Follow their instructions closely.
• Swelling and Bruising: Swelling is a common response to surgery. Apply an ice pack to your cheek near the extraction site to reduce swelling. Use the ice pack for 10 minutes at a time during the first 24 hours.
• Rest: Try to relax and avoid any strenuous activity for the first 24 hours to prevent any additional bleeding or swelling.

Following Days (24 Hours and Beyond)

• Oral Hygiene: Do not rinse your mouth for the first 24 hours. After that, gently rinse with warm salt water (1/2 teaspoon of salt in a cup of water) after meals and before bed. This helps keep the area clean and aids in healing.
• Eating: Stick to soft foods and liquids for the first few days. Avoid using a straw, as the sucking motion can dislodge the blood clot formed in the extraction site, leading to a painful condition known as dry socket.
• Continue to Avoid Strenuous Activity: Keeping physical activities to a minimum for a few days can help reduce bleeding and swelling.
• No Smoking: Smoking can delay healing and increase the risk of complications like dry socket.

Healing Timeline

• Initial Healing Phase: The first few days after extraction are crucial for the formation of a blood clot to stop bleeding and begin the healing process.
• Secondary Healing Phase: Over the following weeks, you’ll gradually be able to reintroduce more solid foods into your diet as the wound begins to heal.
• Full Healing: Complete healing of the gum and bone can take several weeks to months, depending on the complexity of the extraction and your body’s healing capacity.

When to Call Your Dentist

Seek immediate care if you experience symptoms such as:

• Uncontrollable bleeding
• Severe pain not relieved by prescribed medication
• Signs of infection, including fever, severe swelling, or pus from the extraction site
• Nausea or vomiting
• Cough, shortness of breath, chest pain

If you have any concerns or unusual symptoms following an extraction, don’t hesitate to contact your dental care provider.

Tooth extraction aftercare

Tooth extraction aftercare is crucial for a smooth recovery and to minimize the risk of complications.

Immediate Aftercare (First 24 Hours)

• Bleeding Control: Apply pressure to the extraction site with gauze for about 30-60 minutes after the procedure. If bleeding persists, you can replace the gauze and bite down firmly. A dampened tea bag can also be used, as the tannins in tea help promote blood clotting.
• Pain Management: Use the pain relief medication as prescribed by your dentist. If over-the-counter medication is suggested, follow the recommended dosage.
• Swelling Reduction: Apply an ice pack to the cheek near the extraction site to reduce swelling. Do this for 10 minutes at a time during the first 24 hours.
• Rest: Elevate your head with pillows and avoid any strenuous activities to prevent further bleeding and aid in healing.

Diet and Oral Hygiene

• Food and Drink: Stick to soft foods and liquids initially. Avoid hot beverages and do not use a straw, as the suction can dislodge the blood clot in the socket.
• Oral Hygiene: Avoid rinsing, spitting, or touching the extraction site on the day of surgery. The day after, you can gently rinse your mouth with warm salt water (1/2 teaspoon of salt in 8 ounces of water) after meals and before bed.

Ongoing Care

• Avoid Smoking and Alcohol: Smoking can delay healing, and alcohol can interfere with the healing process. It’s best to avoid these for at least 48 hours after the extraction.
• Continue Soft Diet: Gradually reintroduce solid foods as the extraction site begins to heal. Avoid chewy, hard, or spicy foods that could irritate the area.
• Oral Hygiene: Continue gentle brushing and flossing of your teeth, avoiding the extraction site until it has healed sufficiently. Good oral hygiene helps prevent infection.

Healing Process

• Blood Clot Formation: The initial healing phase involves the formation of a blood clot in the socket. It’s crucial to protect this clot as it aids in healing and prevents complications like dry socket.
• Tissue Healing: Over the next few weeks, the gum and surrounding tissue will start to heal. It’s normal for the extraction site to feel a bit uncomfortable or sensitive as this process occurs.
• Bone Healing: The jawbone will remodel and heal over the next several months. This process takes longer and varies depending on individual health and the complexity of the extraction.

First night after tooth extraction

The first night after a tooth extraction is critical for the healing process, and taking the right steps can help ensure a smoother recovery.

Here are some guidelines to help you through that first night:

Managing Pain and Swelling

• Pain Relief: Before the local anesthesia wears off, take the pain medication prescribed by your dentist or an over-the-counter pain reliever recommended by them. This proactive approach can help manage discomfort as the numbness fades.
• Reduce Swelling: Use an ice pack on the side of your face where the extraction occurred. Apply it for 10 minutes at a time, with 20-minute breaks in between, to help minimize swelling.

Bleeding Control

• Gauze Pad: Keep the gauze pad placed by your dentist over the extraction site and bite down gently to apply pressure. This helps to control bleeding and allows a blood clot to form in the socket. Change the gauze as needed when it becomes soaked with blood, but always handle it gently to avoid disturbing the clot.
• Minimal Activity: Avoid any strenuous activity and try to rest as much as possible. Elevated physical activity can increase bleeding.

Protecting the Blood Clot

• Avoid Rinsing or Spitting: Do not rinse your mouth or spit forcefully on the first night, as this can dislodge the blood clot in the socket.
• No Straws: Avoid using straws when drinking, as the suction can also disturb the blood clot.

Sleep Position

• Elevate Your Head: Use extra pillows to keep your head elevated while sleeping. This can help reduce swelling and minimize bleeding.

Nutrition

• Stay Hydrated: Drink plenty of water, but remember not to use a straw. Avoid alcoholic, caffeinated, carbonated, or hot beverages in the first 24 hours.
• Soft Foods: If you feel like eating, choose soft foods that don’t require much chewing and are not too hot or spicy.

Oral Hygiene

• Avoid the Extraction Site: While it’s important to keep your mouth clean, you should avoid brushing directly at the extraction site for the first few days. You can gently brush your other teeth.
• Saltwater Rinse: Starting the day after the extraction, gently rinse your mouth with warm saltwater (1/2 teaspoon of salt in a cup of warm water) after meals and before bed to help keep the area clean.

Things to avoid after tooth extraction

After a tooth extraction, certain activities and substances should be avoided to ensure proper healing and to prevent complications. Here’s a list of things to steer clear of:

Avoid Strenuous Physical Activity

• Reason: Increases blood pressure and can cause the extraction site to bleed.
• Duration: Typically, for the first 24-48 hours or as advised by your dentist.

Don’t Smoke or Use Tobacco Products

• Reason: Smoking can delay healing, reduce the ability to fight infection, and increase the risk of complications like dry socket.
• Duration: Ideally, avoid smoking for at least 48-72 hours after the extraction, but longer is better.

Avoid Sucking Actions

• Reason: Actions like using a straw, spitting, or sucking can dislodge the blood clot that forms in the socket, leading to dry socket.
• Duration: Avoid for the first 24-48 hours or until the site starts to heal.

Stay Away from Hot Foods and Beverages

• Reason: Hot foods and drinks can dissolve or displace the blood clot.
• Duration: Avoid until the numbness from anesthesia wears off, usually a few hours after the extraction.

Don’t Eat Hard, Crunchy, or Sticky Foods

• Reason: These can irritate the extraction site, lodge in the socket, and disrupt healing.
• Duration: Avoid for the first few days up to a week, depending on your healing progress.

Limit or Avoid Alcoholic Beverages

• Reason: Alcohol can interfere with the healing process and the effectiveness of any prescribed medication.
• Duration: Avoid for at least 24-48 hours, especially if taking pain medications or antibiotics.

Don’t Rinse Your Mouth Vigorously

• Reason: Forceful rinsing can disturb the clotting process.
• Duration: Avoid vigorous rinsing for the first 24 hours. After that, gentle rinsing with warm saltwater is encouraged.

Avoid Brushing the Extraction Site Directly

• Reason: Direct brushing can disturb the healing wound.
• Duration: Avoid for the first 24 hours at least, and then gently brush around the area, avoiding direct contact until fully healed.

Don’t Ignore Post-Operative Instructions

• Reason: Your dentist provides specific instructions tailored to your situation for optimal healing.
• Duration: Follow the provided instructions throughout the entire healing process.

Avoid Neglecting Signs of Infection or Complications

• Reason: Ignoring symptoms like excessive bleeding, severe pain, swelling, fever, or foul taste can lead to serious complications.
• Duration: Be vigilant about your healing process and contact your dentist if you notice any concerning symptoms.

FAQ on Tooth Extraction